Abstract
BackgroundLiver compresses are frequently used in integrative medicine as supportive therapy during cancer treatment in order to reduce fatigue. We performed a pilot study to test whether the external application of yarrow liver compresses impacts fatigue in patients with metastatic cancer undergoing radiation therapy.MethodsA randomized prospective pilot trial was performed including patients with brain metastasis or bone metastasis of solid tumors. Patients underwent either palliative radiation therapy (RT) of the metastatic lesions (control group) over two weeks or the same RT with additional external application of yarrow liver compresses once daily during RT. The primary objective was improvement on the general fatigue subscale of the multidimensional fatigue inventory (MFI-20) at the end of treatment, where a mean difference of two points is considered clinically relevant. Secondary objectives included psychological distress, quality of life and qualitative analysis with self-established visual analogue scales (VAS). Mean differences in general fatigue at the end of treatment compared to baseline were analyzed using the ANCOVA test.ResultsFrom 09/2017 to 08/2019 a total of 39 patients were randomized. Due to drop outs 24 patients (12 per group) were available for analysis. Patients in the intervention group received a mean number of 10.5 (range, 7–14) applications of yarrow liver compresses. The mean improvement at the end of therapy on the general fatigue subscale of the MFI-20 was 2 points in favor of the intervention group (p = 0.13), and all other MFI-20 subscales showed at least a trend towards improvement in favor of the intervention group. Likewise, psychological distress and VAS data was improved, the latter reaching statistical significance for the symptoms fatigue, tension and lack of drive. Major toxicities were not observed.ConclusionsExternal application of liver compresses appears to reduce fatigue within a clinical relevant range in patients with metastatic cancer undergoing radiation therapy.Trial registration: ISRCTN, ICTRP DRKS00012999
Highlights
Liver compresses are frequently used in integrative medicine as supportive therapy during cancer treatment in order to reduce fatigue
The criteria for patient eligibility were age ≥ 18 years, with at least minor fatigue according to the general fatigue subscale of the multidimensional fatigue inventory (MFI-20) [13], estimated life expectancy > 3 months, Karnofsky performance score ≥ 60%, indication for inpatient palliative whole brain radiation therapy (WBRT) or palliative analgesic RT of bone metastasis
Patients in the intervention group received a mean number of 10.5 applications of yarrow liver compresses
Summary
Liver compresses are frequently used in integrative medicine as supportive therapy during cancer treatment in order to reduce fatigue. We performed a pilot study to test whether the external application of yarrow liver compresses impacts fatigue in patients with metastatic cancer undergoing radiation therapy. Fatigue has been described to be present in ≥ 30% of cancer patients and adversely impacts upon quality of life (QoL) [1]. Patients who undergo palliative radiation therapy (RT) for brain or bone metastases are commonly frail patients suffering symptoms caused by the disease and the treatment and fatigue has been shown to increase during and three months after RT [5, 6]. Yarrow liver compresses are commonly used in integrative medicine as supportive therapy during cancer treatment due to its hepatoprotective qualities, amongst others to reduce fatigue. While aspects of palliative care already strongly impact on daily practice in radiation oncology [11] skepticism exists towards integrative approaches and its effects [12]
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