Balneothérapie pour les patientes atteintes d'un cancer du sein subissant une thérapie endocrinienne
Effets de la balnéothérapie chez les patientes atteintes d'un cancer du sein subissant une thérapie endocrinienne
Endocrine therapy is the mainstay of adjuvant therapy in premenopausal women with hormone receptive-positive (HR+) breast cancer as it has been demonstrated that it reduces long-term recurrences and increases survivial. However, this therapy, which suppresses estrogen production and estrogen-induced effects, is associated with the development of joint pain which can significantly reduce quality of life and lead to treatment discontinuation.
The main question the study aims o answer is:
Can balneotherapy (BT) alleviate muscle-skeletal pain (primary objective) derived from endocrine therapy and improve quality of life (secondary objective) in young women with HR+ breast cancer?
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Description détaillée
PATIENTS AND METHODS
Inclusion Criteria:
- Premenopausal women diagnosed with early-stage hormonal receptor (HR+) breast cancer (stages I-III) undergoing ovarian suppression and aromatase inhibitor therapy (i.e., endocrine therapy) for at least three months.
- Reported musculoskeletal pain (VAS score ≥2) associated with the initiation of the endocrine therapy.
Exclusion Criteria:
- Chronic musculo-skeletal conditions predating the initiation of endocrine therapy.
- Anxiety-depression syndrome predating the initiation of endocrine therapy that is pharmacologically treated.
- Fear of water
- Fecal and urinary incontinence
- Severe venous insufficiency
- Epilepsy
- Physical disabilities that may hinder the performance of BT/aquatic exercises
Participants will be recruited in Hospital del Mar's Oncology department and in the hospital's Mineral Metabolism Clinic (Internal Medicine Department).
In addition, Caldes de Montbui's City Council will also advertise the project for patient recruitment on its public website.
Patient selection and recruitment will be performed by the study's investigators at the Hospital del Mar Research Institute.
STUDY DESIGN Prospective randomized controlled study.
STUDY FLOW Eligible particpants will undergo an initial visit (baseline) in which clinical data will be reviewed and registered. Forty-eight participants will be randomly assigned to the BT group and 48 to the control group through a lottery method. At this time point, participants will be asked to answer/complete the following scales/questionnaires: visual analog scale for pain (VAS), the SF-36 quality of life test, the Hospital Anxiety and Depression Scale (HADS), and the Pittsburgh Sleep Quality Index (PSQI). These tools measure pain severity (primary objective), quality of life, levels of anxiety and depression, and sleep quality, respectively. All results will be recorded in an anonymized database managed by the Hospital del Mar Research Institute.
Treatment Program: Participants allocated to BT group will undergo 12 sessions over four weeks (3 weekly sessions) involving thermal water exercises at 32°C (10 min inhalation, 10 min warm-up, 20 min specific exercises, 10 min relaxation), thermal showers (7 min jet or circular showers), and 30 minutes rest. Participants in the control group will be asked to not initiate new physical therapies and to continue with their usual care.
At the end of the BT program (or 4 weeks after baseline for the participants allocated to the control group), participants will be asked to answer/complete the same questionnaires/scales they did at baseline (second timepoint).
All participants will be asked to answer again the same questionnaries 6 months after BT completion or 7 months after baseline in the case of the participants of the control group (third timepoint).
Study outcomes will be obtained by calculating the differences in scores for the study variables (VAS (primary objective), SF-36, PSQI, and HADS (secondary objectives) between the end of BT and baseline, and the third timepoint vs baseline. Outcome analysis will be conducted by a qualified professional who is blinded to the two groups (BT group and control group).
In addition, the following data will be collected at baseline for each patient and included in the database for the study: age (years), Body Mass Index (BMI) (kg/m2), current medications, and time since the initiation of adjuvant endocrine therapy (months).
These data will be used as study variables and for adjustment in the multivariable analysis. The database and analyses will be managed by the principal investigator.
Data will be analyzed using descriptive statistics for qualitative variables and parametric or non-parametric tests for continuous variables. Changes in pain, quality of life, and emotional scores will be evaluated using linear models, with adjustments for confounders. Statistical significance will be set at α = 0.05.
Adverse events will be registered throughout the duration of the study. If participants allocated to the BT group report significant adverse effects directly associated with BT, they will discontinue the therapy.
Type d'étude
Type d'étude
Inscription (Réel)
Inscription
Phase
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
-
Barcelona, Espagne, 08003
- Parc de Recerca Biomèdica de Barcelona
-
Barcelona, Espagne, 08003
- Hospital del Mar
-
-
Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
Premenopausal women diagnosed with early-stage hormonal receptor (HR+) breast cancer (stages I-III) undergoing ovarian suppression and aromatase inhibitor therapy (i.e., endocrine therapy) for at least three months.
- Reported musculoskeletal pain (VAS score ≥2) associated with the initiation of the endocrine therapy.
Exclusion Criteria
- Chronic musculoskeletal conditions predating the initiation of endocrine therapy and/or unrelated to effects derived from the endocrine therapy (i.e. fibromyalgia)
- Anxiety-depression syndrome predating the initiation of endocrine therapy that is treated with drugs.
- Fear of water
- Fecal and/or urinary incontinence
- Severe venous insufficiency
- Epilepsy and physical disabilities that may hinder the performance of Balneotherapy (BT)/aquatic exercises.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Nombre de bras
Armes et Interventions
Groupe de participants / BrasGroupe de participants / Bras |
Intervention / TraitementIntervention / Traitement |
|---|---|
|
Expérimental: Balneotherapy group
These participants will be premenopausal women with estrogen receptor positive early breast cancer treated with adjuvant endocrine therapy allocated to receive 4 weeks of 3 weekly sessions of balneotherapy. |
The intervention consists in 3 weekly sessions of balneotherapy during 4 weeks. |
|
Aucune intervention: Control group
These participants will be premenopausal women with estrogen receptor positive early breast cancer treated with adjuvant endocrine therapy that will not receive balneotherapy but that will be asked to respond to the same scales and questionnaires as the balneotherapy group at the same timepoints. |
Que mesure l'étude ?
Principaux critères de jugement
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Changes in musculo-skeletal pain
Délai: 7 months
|
The primary objective is to determine changes in pain levels through the visual analogic scale (VAS) in the third and second timepoints vs baseline in all participants and to compare these outcomes between participants in the BT and control groups. |
7 months
|
Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Changes in quality of life
Délai: 7 months
|
To asses changes in quality-of-life scores through the SF-36 questionnaire in the third and second timepoints vs baseline in all participants and to compare these outcomes between participants in the BT and control groups. |
7 months
|
|
Changes in sleep quality
Délai: 7 months
|
To asses the changes in sleep quality and sleep disturbances through the Pittsburgh Sleep Quality Index (PSQI) in the third and second timepoints vs baseline in all participants and to compare these outcomes between participants in the BT and control groups. |
7 months
|
|
Changes in anxiety and depression symptoms
Délai: 7 months
|
To assess the changes in anxiety and depression symptoms through the Hospital Anxiety and Depression Scale (HADS) in the third and second timepoints vs baseline in all participants and to compare these outcomes between participants in the BT and control groups. |
7 months
|
Collaborateurs et enquêteurs
Parrainer
Parrainer
Collaborateurs
Collaborateurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Début de l'étude
Achèvement primaire (Réel)
Achèvement primaire
Achèvement de l'étude (Réel)
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour publiée
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- 2024/11531/I
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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