正念和太极对癌症健康(MATCH)研究:一项基于偏好的多地点随机比较有效性试验的主要结果。

IF 41.9 1区 医学 Q1 ONCOLOGY
Journal of Clinical Oncology Pub Date : 2025-07-20 Epub Date: 2025-06-12 DOI:10.1200/JCO-24-02540
Linda E Carlson, Jennifer M Jones, Devesh Oberoi, Katherine-Ann Piedalue, Peter M Wayne, Daniel Santa Mina, Oluwaseyi A Lawal, Michael Speca
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引用次数: 0

摘要

目的:许多癌症幸存者都有高度的痛苦和心理社会症状。治疗这些问题的两种身心干预是基于正念的癌症康复(MBCR)和太极/气功(TCQ)。然而,尽管与常规护理相比,这两种干预措施都显示出疗效,但它们从未被一起研究过。据我们所知,这项试验是第一次将创新设计特征纳入其中,包括患者选择,同时评估两种干预措施来治疗痛苦的癌症幸存者。方法:采用基于偏好的多地点随机比较疗效试验设计,采用广泛实用的纳入标准。偏好MBCR或TCQ的参与者接受他们喜欢的干预措施,而没有偏好的参与者则随机按1:1分配到两种干预措施中。此外,参与者都被随机分配为2:1立即干预组或候补组。干预后情绪状态谱上的总情绪障碍(TMD)是主要观察指标。结果:587名参与者提供了基线数据,75%为女性,平均年龄为60.7岁。在12种癌症类型中,最常见的是乳腺癌(40.7%)、前列腺癌(11.2%)和胃肠道癌(9.7%)。大多数诊断为0-II期(50.1%),其中17%为更晚期的疾病。大约三分之二的人有偏好,其中57%的人选择TCQ, 43%的人选择MBCR。剩下的36%同样随机分配。选择一个特定的项目或选择随机分配对结果没有显著影响。组合随机分配和偏好的MBCR组和TCQ组在TMD评分上的改善都比各自的候补组要大,有小到中等的影响。MBCR在紧张、愤怒和活力亚量表和TCQ在愤怒、抑郁和活力亚量表上的改善最大。结论:这项大型、实用的试验表明,正念和TCQ干预都能改善痛苦的癌症幸存者的情绪,无论他们是选择一个项目还是选择随机分配。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mindfulness and Tai Chi for Cancer Health (MATCH) Study: Primary Outcomes of a Preference-Based Multisite Randomized Comparative Effectiveness Trial.

Purpose: Many cancer survivors have high levels of distress and psychosocial symptoms. Two mind-body interventions for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared with usual care, they have never been studied together. This trial was the first, to our knowledge, to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors.

Methods: A preference-based multisite randomized comparative effectiveness trial design with broad pragmatic inclusion criteria was used. Participants with a preference for either MBCR or TCQ received their preferred intervention, while those without a preference were randomly assigned 1:1 into either intervention. Furthermore, participants were all randomly assigned 2:1 into immediate intervention or waitlist control. Total mood disturbance (TMD) on the Profile of Mood States after intervention was the primary outcome.

Results: Five hundred eighty-seven participants provided baseline data, 75% were female, with an average age of 60.7 years. Of 12 cancer types, the most prevalent were breast (40.7%), prostate (11.2%), and GI (9.7%) cancers. Most had stage 0-II (50.1%) diagnoses, with 17% having more advanced disease. Approximately two thirds had a preference, with 57% of those choosing TCQ and 43% choosing MBCR. The remaining 36% were equally randomly assigned. Choosing a specific program or choosing to be randomly assigned had no significant effect on outcomes. Both the combined random assignment and preference MBCR and TCQ groups improved more than their respective waitlists on TMD scores with small to medium effects. The largest improvements occurred for MBCR on subscales of tension, anger, and vigor and in TCQ on anger, depression, and vigor.

Conclusion: This large, pragmatic trial demonstrated both mindfulness and TCQ interventions improved mood in distressed cancer survivors, whether they chose a program or chose to be randomly assigned.

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来源期刊
Journal of Clinical Oncology
Journal of Clinical Oncology 医学-肿瘤学
CiteScore
41.20
自引率
2.20%
发文量
8215
审稿时长
2 months
期刊介绍: The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer.
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