Abstract
Integrative oncology (IO) has been shown to improve quality-of-life (QoL) and increase adherence to planned chemotherapy regimens. This study examined the impact of a patient-tailored IO program on adherence to chemotherapy among patients with advanced gynecological cancer. This prospective non-randomized, pragmatic, preference study examined patients with stage III/IV gynecological cancers undergoing 6weeks of weekly IO treatments. Adherence to the planned chemotherapy regimen was assessed using the relative dose intensity (RDI) calculation. Patients consistently attending IO treatments (consistent-IO group) were compared to those who were not (non-consistent IO group). RDI was calculated for 73 patients in the consistent-IO group (99 chemotherapy cycles) and 61 in the non-consistent-IO group (96 cycles with IO care, 126 cycles without). Both groups had similar baseline demographic characteristics, with endometrial cancer more prevalent in the consistent-IO group. RDI was significantly less reduced in the consistent-IO chemotherapy group (p = 0.005). During taxane-based regimens, RDI was better maintained in the consistent-IO group (0.93 vs. 0.87, p = 0.012), though not with platinum-based cycles. Linear regression model found a correlation between preserved RDI and consistent attendance at weekly IO treatments, and lower rates of chemotherapy-induced peripheral neuropathy and pain. Patient-tailored IO programs for patients with advanced gynecological cancer may help preserve adherence to chemotherapy at 6weeks, especially with taxane-based regimens. Further research needs to explore whether this correlation is chemotherapy agent-specific.
Highlights
The term "Integrative Oncology" (IO) describes a framework in which complementary medicine practices are provided to patients within conventional oncology settings
This study examined the impact of a patient-tailored Integrative oncology (IO) program on adherence to chemotherapy among patients with advanced gynecological cancer
Linear regression model found a correlation between preserved relative dose intensity (RDI) and consistent attendance at weekly IO treatments, and lower rates of chemotherapy-induced peripheral neuropathy and pain
Summary
The term "Integrative Oncology" (IO) describes a framework in which complementary medicine practices are provided to patients within conventional oncology settings. The emphasis on a patient-centered and patienttailored treatment approach is core to these IO services, and focuses primarily on improving patients' quality of life (QoL) and wellbeing. This research has shown significantly beneficial effects of these therapies in the relief of cancer-related fatigue, pain, appetite, nausea/vomiting and sleep-related disturbances, more so among patients who are consistent (i.e., adherent) in their attendance of patient-tailored IO programs,,,. Clinical research has demonstrated a statistically significant correlation between consistent attendance at IO treatment programs and patient adherence to their conventional oncology regimen, as measured using the relative dose intensity (RDI) of chemotherapy. A greater preservation of RDI scores (i.e., greater adherence) was found among patients undergoing chemotherapy for breast and gynecological cancer who were consistent in their attendance at weekly IO sessions. The findings of this research, have been methodologically limited by its pragmatic, non-randomized methodology, with the incorporation of patient preference and heterogeneity of the individually-tailored IO treatments
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