Breast Cancer Integrative Oncology: Prospective Matched Controlled Outcomes Study

乳腺癌综合肿瘤学：前瞻性匹配对照结果研究

基本信息

批准号：
7847187
负责人：
MARIN R ANDERSEN
金额：
$ 59.37万
依托单位：
BASTYR UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-01 至 2015-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7847187
关键词：
Acupuncture and Oriental Medicine Adverse effects Aftercare Age Alternative Medicine Area Breast Cancer Treatment Cancer Patient Cancer Relapse Cancer Survivor Caring Categories Characteristics Client satisfaction Clinic Clinical Communities Complementary and alternative medicine Consult Data Decision Making Diagnosis Diagnostic Neoplasm Staging Discipline Disease Disease-Free Survival Effectiveness Estrogen Receptors Ethnic Origin Evaluation Evidence based practice Feeling Fred Hutchinson Cancer Research Center Frequencies Geographic Locations Health Integrative Medicine Life Life Experience Malignant Neoplasms Marital Status Measures Medical Methods Nature Outcome Outcome Study Palliative Care Patients Physicians Progesterone Receptor Status Quality of life Questionnaires Race Relapse Research Risk SF-36 Sampling Science Services Staging Survival Rate Symptoms Time Treatment Protocols United States Universities Washington Wellness Center Woman acronyms base cancer care cancer recurrence cancer rehabilitation cancer therapy care seeking case control cohort community setting comparison group conventional therapy cost end of life experience follow-up health related quality of life improved malignant breast neoplasm oncology oncology service outcome forecast prevent prognostic prospective public health relevance response standard care

项目摘要

DESCRIPTION (provided by applicant): Purpose: To conduct a prospective outcomes study describing use of Complementary and Alternative medicine (CAM), and integrated oncology (IO) and their effects on breast cancer patients in community settings. Background: Between 50% and 80% of women in the United States with breast cancer supplement their conventional medical treatment regimen with some form of CAM therapy. Most CAM use is self-prescribed and unsupervised, however, IO has matured into a set of science-based practices that warrant evaluation. IO clinics are directed by physicians, MDs, naturopathic physicians (NDs), and doctors of acupuncture and Oriental medicine (DAOM), who use best practices and evidence-based CAM to improve the health and well being of cancer patients who also receive standard conventional cancer therapy. This study will describe IO care as provided in community clinics and provide an initial evaluation of the effects of IO care and CAM use on breast cancer patients' Health Related Quality of Life (HRQOL). Hypothesis: IO services improve patients' quality of life and decrease cancer recurrence rates in breast cancer patients, as compared to women with similar disease states and prognoses who do not receive IO care, and may or may not use CAM treatment on their own. Methods: A partnership between Bastyr University and Fred Hutchinson Cancer Research Center will create a case-control matched cohort of IO using breast cancer patients and breast cancer patients with similar prognosis at time of diagnosis who did not use IO care and may or may not have used CAM on a self- prescription basis. This cohort will be followed prospectively allowing for a description of the outcomes of IO breast cancer care provided through a community IO clinic network in Seattle. Aims: 1) To describe the treatments received by breast cancer patients receiving physician level integrative oncology (IO) care from community clinics (cohort; n = 600) and the cost of IO care for breast cancer; 2) To describe the Health Related Quality of Life (HRQOL) experienced by breast cancer patients receiving physician level Integrative Oncology (IO) care (cohort; n = 300) and that of a group of comparison women with breast cancer (cohort; n = 900) receiving conventional treatment with or without self-prescribed CAM (n = 400- 450 and n = 450-500). In addition to describing changes in HRQOL associated with IO and CAM use and estimating the effects attributable to IO or CAM use, 3) To collect pilot data on survival and disease free survival in outcomes at 2 and 3 years follow-up in a cohort of 300 IO breast cancer patients, and a matched comparison group of 900 who did not choose to use IO during their initial treatment for breast cancer. PUBLIC HEALTH RELEVANCE: The purpose of this five year project is to conduct a prospective matched controlled outcomes study that describes physician directed integrated oncology therapies and their effects on breast cancer patients' quality of life, cancer recurrence and survival rates for those who receive integrated oncology care in Seattle, Washington.

描述（由申请人提供）：目的：进行一项前瞻性结果研究，描述补充和替代医学 (CAM) 和综合肿瘤学 (IO) 的使用及其对社区环境中乳腺癌患者的影响。背景：美国 50% 至 80% 的乳腺癌女性患者会通过某种形式的 CAM 疗法来补充其常规治疗方案。大多数 CAM 的使用都是自我规定且无人监督的，但是 IO 已经成熟为一套值得评估的基于科学的实践。 IO 诊所由内科医生、医学博士、自然疗法医生 (ND) 以及针灸和东方医学医生 (DAOM) 指导，他们使用最佳实践和循证 CAM 来改善接受标准传统疗法的癌症患者的健康和福祉。癌症治疗。本研究将描述社区诊所提供的 IO 护理，并对 IO 护理和 CAM 使用对乳腺癌患者健康相关生活质量 (HRQOL) 的影响进行初步评估。假设：与未接受 IO 护理且可能或可能不单独使用 CAM 治疗且疾病状态和预后相似的女性相比，IO 服务可改善乳腺癌患者的生活质量并降低癌症复发率。方法：巴斯蒂尔大学和 Fred Hutchinson 癌症研究中心之间的合作将创建一个病例对照匹配的 IO 队列，使用乳腺癌患者和诊断时预后相似的乳腺癌患者，这些患者没有使用 IO 护理，并且可能有或可能没有在自我处方的基础上使用 CAM。该队列将被前瞻性地跟踪，以描述通过西雅图社区 IO 诊所网络提供的 IO 乳腺癌护理的结果。目的： 1) 描述接受社区诊所医生级综合肿瘤学 (IO) 护理的乳腺癌患者接受的治疗（队列；n = 600）以及乳腺癌 IO 护理的费用； 2) 描述接受医师级综合肿瘤学 (IO) 护理的乳腺癌患者（队列；n = 300）和一组对照乳腺癌女性（队列；n = 300）所经历的健康相关生活质量 (HRQOL) 900) 接受常规治疗，有或没有自行处方 CAM（n = 400-450 和 n = 450-500）。除了描述与 IO 和 CAM 使用相关的 HRQOL 变化并估计 IO 或 CAM 使用的影响外，3) 收集一组患者 2 年和 3 年随访结果中生存率和无病生存率的初步数据。 300 名 IO 乳腺癌患者，以及 900 名在乳腺癌初始治疗期间未选择使用 IO 的匹配对照组。公共健康相关性：这个为期五年的项目的目的是进行一项前瞻性匹配对照结果研究，描述医生指导的综合肿瘤治疗及其对乳腺癌患者生活质量、癌症复发和接受综合肿瘤治疗的生存率的影响华盛顿州西雅图的护理。