乳がん生存者における化学療法関連認知障害に対するManaging Cancer and Living Meaningfully（CALM）介入

Managing Cancer and Living Meaningfully (CALM) Intervention on Chemotherapy-Related Cognitive Impairment in Breast Cancer Survivors.

• Ke Ding
• Xiuqing Zhang
• Jingjing Zhao
• He Zuo
• Ziran Bi
• Huaidong Cheng

抄録

中国人乳がん生存者（BC）における化学療法関連認知障害（CRCI）の軽減、心理的苦痛の緩和、QOL（生活の質）の改善に使用されるManaging Cancer and Living Meaningfully（CALM）の有効性と実行可能性を評価すること。 本研究には74人のBC患者が登録された。すべての患者がCALM群または通常通りのケア（CAU）群に無作為に割り付けられた。CRCIを有するBC群にCALMまたはCAUを適用する前後に、全患者をFACT-Cog（Functional Assessment of Cancer Therapy-Cognitive Function）、DT（Distress Thermometer）、FACT-B（Functional Assessment of Cancer Therapy-Breast）で評価した。これらすべてのスコアの差をCALM群と対照群で比較し、認知機能とQOLの相関関係を分析した。 CAU群と比較して、CALM群のFACT-Cog、DT、FACT-Bのパフォーマンスには、CALMの前後で有意な差が認められた（＝-18.909、-5.180、-32.421、＝.000、.000、.000、.000、.000）。最後に、乳がん患者の認知機能とQOLの間には、治療前（＝0.579、＝0.000）と治療後（＝0.797、＝0.000）で正の相関が認められた。 今回の結果から、CALMは乳がん患者の認知機能やQOLの改善、心理的苦痛の緩和などに敬虔な効果があることが示唆され、心理的苦痛と認知機能やQOLとの間に正の相関があることが考えられる。

To evaluate the effectiveness and feasibility of Managing Cancer and Living Meaningfully (CALM), which is used to reduce chemotherapy-related cognitive impairment (CRCI), relieve psychological distress, and improve quality of life (QOL) in Chinese breast cancer survivors (BCs). Seventy-four BCs were enrolled in this study. All patients were randomly assigned to either the CALM group or the care as usual (CAU) group. All patients were evaluated by the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), Distress Thermometer (DT), and the Functional Assessment of Cancer Therapy-Breast (FACT-B) before and after CALM or CAU application to BCs with CRCI. We compared the differences in all these scores between the CALM group and the control group and analyzed the correlation between cognitive function and QOL. Compared with the CAU group, the performance of the CALM group on the FACT-Cog, DT, and FACT-B showed significant differences before and after CALM ( = -18.909, -5.180, -32.421, = .000, .000, .000, respectively). Finally, there was a positive correlation between cognitive function and QOL in breast cancer patients before ( = 0.579, = .000) and after ( = 0.797, = .000) treatment. The present results indicated that CALM has salutary effects on the improvement of cognitive impairment and QOL and relieves psychological distress in breast cancer patients, which may be due to a positive correlation between psychological distress and cognitive function or QOL.