Can complementary medicine increase adherence to chemotherapy dosing protocol? A controlled study in an integrative oncology setting.

Autor: Shalom-Sharabi I; Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, 35 Rothschild St., Haifa, Haifa and Western Galilee District, Israel.; Graduate Studies Authority, Haifa University, Haifa, Israel., Lavie O; Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel., Samuels N; Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel., Keinan-Boker L; School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.; Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel., Lev E; Department of Israel Studies, University of Haifa, Haifa, Israel., Ben-Arye E; Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, 35 Rothschild St., Haifa, Haifa and Western Galilee District, Israel. eranben@netvision.net.il.; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il.
Jazyk: angličtina
Zdroj: Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2017 Dec; Vol. 143 (12), pp. 2535-2543. Date of Electronic Publication: 2017 Aug 20.
DOI: 10.1007/s00432-017-2509-0
Abstrakt: Context and Objectives: The impact of complementary and integrative medicine (CIM) on adherence to chemotherapy regimens is unclear. We explored the effect of patient-tailored CIM treatments on the relative dose intensity (RDI) of chemotherapy among patients with breast and gynecological cancer.
Methods: Chemotherapy-treated patients with breast or gynecological cancer were referred by their oncology healthcare professional to a CIM treatment program. Adherence to integrative care (AIC) was defined as ≥4 CIM treatments, with ≤30 days between each treatment. Relative dose intensity (RDI) of chemotherapy was compared between CIM-treated patients and controls, and among adherence sub-groups.
Results: RDI was calculated for 106-treated patients (62 AIC) and 75 controls. Baseline-to-6-week RDI values were similar in both study arms, with a lower % RDI <1.0 among controls at 12 weeks (47 vs. 57.5%; P = 0.036). Adherence sub-groups had similar RDI values, though at 6 weeks, the AIC group had lower % RDI <1.0 (33.9 vs. 54.5%, P = 0.046). Total administered medication dose/planned dose was higher in the AIC group at 6 weeks for paclitaxel (82%/50%, P = 0.025) and carboplatin (87%/67%, P = 0.028), with no difference in cytoxan/adriamycin dosages.
Conclusion: A patient-tailored CIM program for patients with breast or gynecological cancer may be associated with a lower percentage of reduced RDI at 6 weeks, this in a sub-group of patients with higher adherence to CIM, and for specific chemotherapy agents, though this benefit did not persist after 12 weeks. Further research is needed to better understand the impact of CIM in cancer care.
Databáze: MEDLINE
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