1389P - Use of integrative therapies in breast cancer patients. Health service research in a network of integrative oncology
|Date||30 September 2012|
|Event||ESMO Congress 2012|
|Session||Poster presentation II|
|Topics|| Supportive Care
Bioethics, Legal, and Economic Issues
F. Schad1, J. Axtner2, A. Happe3, A. Voigt4, J. Gutsch5, G. Spahn6, C. Herbstreit7, M. Debus8, M. Kroez3, H. Matthes9
Diagnosis of breast cancer induces high emotional distress. Integrative oncology (IO) responds to patients needs by offering a variety of non-pharmacotherapeutic interventions (NPI) and Viscum album extracts (VA). VA enhances health-related quality of life and reduces adverse effects caused by conventional strategies, whereas NPI activate patients’ resources. In the present study we evaluated the use of IO therapies in breast cancer patients from a clinical registry.Methods
We analyzed 3289 female patients collected by the Network Oncology, a conjoint clinical registry of German hospitals and out-patient practitioners. We used non-parametric Fisher exact test (F) to compare observed frequencies, Wilcoxon rank sum (W), Kruskal-Wallis test (KW) for differences between groups. We fitted a logistic regression model to explain use of VA and NMI.Results
Mean age was 54.5 ± 11.7 and frequencies of UICC stages were 0: 71%, I: 31%, II: 41%, III: 15% and IV: 7%. 93% of the patients got VA and were in median three years younger than non-VA patients (medVA= 52, W, p= 0.002). Median length of VA was 4.11 years (1stQ 0.13, 3rdQ 7.42) and was neither influenced by UICC nor age. Median time until start of VA after diagnosis was 7 month (1stQ 2.31, 3rdQ 17.43). Radiation, chemotherapy and surgery were significantly associated with getting VA (βrad =1.07, prad< 0.001; βche= 0.49, pche= 0.006; βsur= -1.47, psur= 0.042). 68% of the patients got NPI (eurythmy 60%, massages 52%, embrocations 51%, wrappings 51%, drawing 41%, modeling 13%, music 8%, psychological 6%, lymph drainage 6% and hyperthermal therapy 2%) and choose in median 4 different NPI. Frequencies of NPI quantities were affected by UICC stage (F, p< 0.001). Chemo therapy, UICC IV, III and radiation were significantly associated with receiving NPI (βche= -0.83, pche< 0.001; βIV =0.83, pIV= 0.001; βIII =0.62, pIII= 0.003; βrad= -0.28, prad= 0.003).Conclusions
In an IO setting VA and NPI are part of standard care and frequently used by breast cancer patients. Conventional therapies are major predictors if patients receive VA or NMI. Results suggest that health service research data provide a solid data basis for warranted prospective studies on outcome related studies in IO.Disclosure
H. Matthes: PD Dr. med. Harald Matthes is member of the board of directors of the Weleda A.G. Arlesheim/ Switzerland.
All other authors have declared no conflicts of interest.