Impact of art therapy (AT) on fatigue and quality of life (QoL) during adjuvant external beam irradiation (EBI) in breast cancer patients (pts): a randomized trial

Background

AT as a supportive care may help pts to cope with cancer treatments. This randomized trial assessed the impact of AT on severe fatigue and QoL in localized breast cancer pts treated with EBI.

Methods

320 pts were randomized (assessable): 157 (125) in AT group (ATG) and 163 (127) in standard group (SG). For ATG, 8 weekly 1-hour AT sessions (+4 optional) were proposed during EBI by a trained therapist. Complementary supportive care was available for both groups. The primary endpoint was severe global fatigue (FACIT-F score 

Results

Groups were similar at baseline: age (55 ± 9 y); chemotherapy, CT (41% in ATG, 44% in SG); regular artistic activity (41% and 39%); anxiety (55% and 57%); depression (26% and 21%). Over study time, use of other supportive care was similar in 2 groups (20% and 16%). Severe initial global fatigue was observed in 43% of pts in each group, 64% in case of CT. 103 (82%) ATG pts attended ≥ 8 AT sessions. No difference was found for severe global fatigue at 1 mo post EBI (45% and 50%), or over time, whatever the initial fatigue level or prior CT. Using MFI-20, pts with initial low mental fatigue (MFF) score had improved MFF at 1 mo post EBI (79% and 44%, p = 0.007). Globally, social well-being (SWB) tended to be improved in ATG (31% vs 20%, p = 0.07), with a significant difference in case of CT (41% vs 18%, p = 0.017) or initial severe global fatigue (34% vs 16%, p = 0.02). At 6 mo post EBI, pts with initial severe global fatigue had improved global QoL (p = 0.034), SWB (p = 0.025) and emotional well-being (EWB, p = 0.017) and pts with low initial RMF (reduction of motivation) score had improved RMF (95% and 63%, p = 0.03). Longitudinal analysis highlighted the positive link between the number of AT sessions and fatigue and QoL.

Conclusions

Despite no effect of AT on global fatigue was found for the whole population, pts with initial severe global fatigue benefited from AT with an improvement of several dimensions of fatigue and QoL.

Clinical trial identification

NCT01331629

Legal entity responsible for the study

N/A

Funding

French League against Cancer (Ligue Nationale Contre le Cancer)

Disclosure

All authors have declared no conflicts of interest.