Managing Cancer and Living Meaningfully (CALM): A Randomized Controlled Trial of a Psychological Intervention for Patients With Advanced Cancer
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- Gary Rodin
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Christopher Lo
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Anne Rydall
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Joanna Shnall
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Carmine Malfitano
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Aubrey Chiu
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Tania Panday
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Sarah Watt
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Ekaterina An
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Rinat Nissim
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Madeline Li
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Camilla Zimmermann
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
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- Sarah Hales
- All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada.
説明
<jats:sec><jats:title>Purpose</jats:title><jats:p> Individuals with advanced cancer experience substantial distress in response to disease burden and impending mortality. Managing Cancer And Living Meaningfully (CALM) is a novel, brief, manualized psychotherapeutic intervention intended to treat and prevent depression and end-of-life distress in patients with advanced cancer. We conducted a randomized controlled trial to compare CALM with usual care (UC) in this population. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Patients with advanced cancer were recruited from outpatient oncology clinics at a comprehensive cancer center into an unblinded randomized controlled trial. Permuted block randomization stratified by Patient Health Questionnaire-9 depression score allocated participants to CALM plus UC or to UC alone. Assessments of depressive symptoms (primary outcome), death-related distress, and other secondary outcomes were conducted at baseline, 3 months (primary end point), and 6 months (trial end point). Analyses were by intention to treat. Analysis of covariance was used to test for outcome differences between groups at follow-up, controlling for baseline. Mixed-model results are reported. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Participants (n = 305) were recruited between February 3, 2012, and March 4, 2016, and randomly assigned to CALM (n = 151) or UC (n = 154). CALM participants reported less-severe depressive symptoms than UC participants at 3 months (Δ = 1.09; P = .04; Cohen’s d = 0.23; 95% CI, 0.04 to 2.13) and at 6 months (Δ = 1.29; P = .02; d = 0.29; 95% CI, 0.24 to 2.35). Significant findings for greater end-of-life preparation at 6 months also favored CALM versus UC. No adverse effects were identified. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Findings suggest that CALM is an effective intervention that provides a systematic approach to alleviating depressive symptoms in patients with advanced cancer and addresses the predictable challenges these patients face. </jats:p></jats:sec>
収録刊行物
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- Journal of Clinical Oncology
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Journal of Clinical Oncology 36 (23), 2422-2432, 2018-08-10
American Society of Clinical Oncology (ASCO)