CRF is highly prevalent in early BC. PA and psychosocial interventions were proven to be effective in several meta-analyses and are recommended management strategies for CRF. Some randomized trials support the use of acupuncture, while there are no data showing benefits of homeopathy for CRF. We aimed to assess use of PA and SC among pts with early BC.
Pts with stage I-III BC were prospectively included from the CANTO cohort (NCT01993498). Baseline CRF was evaluated shortly after treatment using EORTC-C30 for global CRF and EORTC-FA12 for its physical, emotional and cognitive domains. A score of 40 or higher defined CRF as severe (Abrahams HJ, Ann Oncol 2016). Data on adherence to PA recommendations (10 MET-hours/week or more) and SC consultations with a psychologist, acupuncturist or homeopath were collected in CANTO and therefore served as outcomes. Multivariable logistic regression examined associations between baseline CRF status (severe v not) and use of PA or SC consultations over the 12 months after baseline CRF assessment. Covariates included socio-demographics and psychological distress.
Among 9691 pts included in CANTO, 6282 had available data on PA and 7598 on SC consultations. At baseline, 36% pts reported severe global CRF, and 36%, 23% and 14% pts reported severe physical, emotional and cognitive CRF, respectively. Overall, 64% pts were adherent to PA recommendations and only 10% pts saw a psychologist, whereas 8% saw an acupuncturist and 7% a homeopath. Pts reporting severe global CRF (v not severe) were less likely to adhere to PA recommendations (60% v 67%; adjusted odds ratio [aOR] 0.82, 95% CI 0.72-0.94), but more likely to see a psychologist (14% v 7%; aOR 1.31, 1.07-1.59), acupuncturist (10% v 6%; aOR 1.51, 1.22-1.86) or homeopath (10% v 6%; aOR 1.55, 1.25-1.92). There were differences in use of PA and SC consultations by CRF domain: pts reporting severe physical CRF showed lower adherence to PA (59% v 67%; aOR 0.73, 0.63-0.85), whereas pts with severe emotional CRF were more prone to psychology consultations (17% v 8%; aOR 1.41, 1.10-1.82).
This large study calls for the need to optimize and personalize the uptake of recommendations to manage CRF among pts with early BC.
Clinical trial identification
Legal entity responsible for the study
Agence nationale de la Recherche (ANR-10-COHO-0004); Susan G. Komen (CCR17483507 to I. Vaz-Luis); Odyssea; Gustave Roussy.
A. Di Meglio: Honoraria (self): ThermoFisher. I. Vaz-Luis: Honoraria (self): Novartis; Honoraria (self): Kephren; Honoraria (self): AstraZeneca; Advisory/Consultancy: Ipsen; Honoraria (self): Amgen. All other authors have declared no conflicts of interest.