Preservation of immune function in cervical cancer patients during chemoradiation using a novel integrative approach.
Patients receiving chemoradiation for cervical cancer are at risk for distress, chemoradiation-related side-effects, and immunosuppression. This prospective randomized clinical trial examined effects of a complementary therapy, Healing Touch (HT), versus relaxation training (RT) and usual care (UC) for (1) supporting cellular immunity, (2) improving mood and quality of life (QOL), and (3) reducing treatment-associated toxicities and treatment delay in cervical cancer patients receiving chemoradiation. Sixty women with stages IB1 to IVA cervical cancer were randomly assigned to receive UC or 4 ×/weekly individual sessions of either HT or RT immediately following radiation during their 6-week chemoradiation treatment. Patients completed psychosocial assessments and blood sampling before chemoradiation at baseline, weeks 4 and 6. Multilevel regression analyses using orthogonal contrasts tested for differences between treatment conditions over time. HT patients had a minimal decrease in natural killer cell cytotoxicity (NKCC) over the course of treatment whereas NKCC of RT and UC patients declined sharply during chemoradiation (group by time interaction: p = 0.018). HT patients showed greater decreases in two different indicators of depressed mood (CES-D depressed mood subscale and POMS depression scale) compared to RT and UC (group by time interactions: p<0.05). No between group differences were observed in QOL, treatment delay, or clinically-rated toxicities. HT may benefit cervical cancer patients by moderating effects of chemoradiation on depressed mood and cellular immunity. Effects of HT on toxicities, treatment delay, QOL, and fatigue were not observed. Long-term clinical implications of findings are not known.
Lutgendorf
Susan K
SK
Department of Psychology, University of Iowa, Iowa City, IA 52242, USA. susan-lutgendorf@uiowa.edu
Mullen-Houser
Elizabeth
E
Russell
Daniel
D
Degeest
Koen
K
Jacobson
Geraldine
G
Hart
Laura
L
Bender
David
D
Anderson
Barrie
B
Buekers
Thomas E
TE
Goodheart
Michael J
MJ
Antoni
Michael H
MH
Sood
Anil K
AK
Lubaroff
David M
DM
D000328:Adult; D000339:Affect / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003131:Combined Modality Therapy; D000529:Complementary Therapies; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000502:physiology; D007958:Leukocyte Count; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D012063:Relaxation / Q000502:physiology; D012064:Relaxation Therapy; D012944:Social Support; D012959:Socioeconomic Factors; D019124:Therapeutic Touch; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000276:immunology* / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
D000970:Antineoplastic Agents