Radiotherapy (RT) for head and neck cancer (HNC) can cause debilitating side effects and functional problems. To mitigate these issues, concurrently applied targeted yoga therapy may buffer against treatment-related sequelae. Considering high rates of distress in spouses and interdependence of distress in couples, additional benefits may be gained with the involvement of a spousal caregiver in the intervention.
In this study, researchers randomized patient-caregiver dyads to either a dyadic yoga (DY), patient yoga (PY) or usual care (UC) control arm. Regarding functional outcomes and healthcare utilization, they hypothesized that both yoga arms are better than the UC arm. The comparison between the DY vs PY group was considered exploratory.
HNC patients received ≥25 fractions of RT. Caregivers completed baseline assessments. They were then randomized to receive either DY, PY or UC. Both yoga programs had 15 sessions and were delivered in person or via videoconferencing, parallel to the RT schedule. Patients completed the PG-SGA self-report part weekly during RT (5-6 weeks). Healthcare utilization metrics, including FT, ED and HA, were extracted from patients' electronic medical records as binary variables (yes/no).
Key findings from this intervention are:
· There were 100 patients with a mean age of 60.3 years. 85 % were male, 79 % NHW, 67 % early stage, 54 % chemo-RT.
· The mean age of caregivers was 54 years. 83 % were female and 78 % NHW. Thirty-four were randomized to DY, 33 to PY and 33 to UC.
· For both yoga arms, session attendance was high, with 88% attending≥ 10 sessions. The mean was 13.13 sessions in the DY and 13.30 sessions in the PY group.
· Intent to treat analyses using multi-level modelling controlling for age, sex, stage of disease and treatment (RT vs CRT) revealed a significant effect between the DY and UC group for the physical function and the nutrition intake PG-SGA subscales favouring the DY
· The other comparisons were insignificant. None of the comparisons related to symptom and weight subscales were significant.
· Based on the logistic regression analyses, there was a significant effect for FT placement, so both the DY and PY groups had significantly fewer FTs than the UC group.
· The effect for ED visits was marginally significant, and the effect for HA was insignificant.
Concluding further, they said, in our study, we found that Yoga therapy, when delivered to patient-caregiver dyads, is a beneficial behavioural, supportive care strategy for HNC patients undergoing RT.
In our study findings, we revealed significantly improved physical function and nutrition intake and fewer FTs relative to a UC comparison group. However, further investigations are warranted.
Reference:
https://meetings.asco.org/abstracts-presentations/227889
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