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Research: KISSANE and Colleagues,
Listed in Issue 155
Abstract
KISSANE and Colleagues, Department of Psychiatry and Behavioural Sciences, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. kissaned@mskcc.org write that mixed reports exist about the impact of supportive-expressive group therapy (SEGT) on survival.
Background
Methodology
From 485 women with advanced breast cancer recruited between 1996-2002, 227 (47%) consented and were randomized within an average 10 months of cancer recurrence in a 2:1 ratio to intervention with 1 year or more of weekly SEGT plus three classes of relaxation therapy (147 women) or to control receiving three classes of relaxation therapy (80 women). The primary outcome was survival; psychosocial well-being was appraised secondarily. Analysis was by intention-to-treat.
Results
SEGT did not prolong survival (median survival 24.0 months in SEGT and 18.3 in controls; univariate hazard ratio for death 0.92 [95% CI, 0.69-1.26]; multivariate hazard ratio, 1.06 [95% CI, 0.74-1.51]). Significant predictors of survival were treatment with chemotherapy and hormone therapy (p<0.001), visceral metastases (p<0.001) and advanced disease at first diagnosis (p<0.05). SEGT ameliorated and prevented new DSM-IV depressive disorders (p = 0.002), reduced hopeless-helplessness (p = 0.004), trauma symptoms (p = 0.04) and improved social functioning (p = 0.03).
Conclusion
SEGT did not prolong survival. It improved quality of life, including treatment of and protection against depression.
References
Kissane DW, Grabsch B, Clarke DM, Smith GC, Love AW, Bloch S, Snyder RD and Li Y. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial. Psycho-Oncology. 16(4):277-86 Apr 2007.
