Originally published as JCO Early Release 10.1200/JCO.2008.16.8872 on November 24 2008

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Managing Symptoms Among Patients With Breast Cancer During Chemotherapy: Results of a Two-Arm Behavioral Trial

Charles W. Given, Alla Sikorskii, Deimante Tamkus, Barbara Given, Mei You, Ruth McCorkle, Victoria Champion, David Decker

From the Departments of Family Medicine and Medicine, and College of Nursing, Department of Statistics, Michigan State University; Rose Cancer Center at W. Beaumont Hospital, Royal Oak, MI; School of Nursing, Yale University, New Haven, CT; and Simon Cancer Center, Indiana University, Indianapolis, IN

Corresponding author: Charles W. Given, PhD, Department of Family Practice, Michigan State University, B108 Clinical Center; East Lansing, MI 48824; e-mail: givenc{at}msu.edu

Purpose In this study, we compare symptom response and times to response among patients with breast cancer who were assigned to either a cognitive behavioral Nurse-Administered Symptom Management intervention or an Automated Telephone Symptom Management (ATSM) intervention.

Patients and Methods Patients with breast cancer were identified from a larger trial. Baseline equivalence existed between arms, and there was no differential attrition by arm. Anchor-based definition of response using mild, moderate, and severe categories of symptom severity were used. Responses and times to response for 15 symptoms were investigated in relation to trial arm, comorbid conditions, treatment protocols, and metastatic versus localized disease.

Results The ATSM arm was more effective among patents with metastatic disease. Compared with patients receiving combination chemotherapy protocols, those treated with single agents had greater response and shorter time to response.

Conclusion An educational information intervention delivered via an automated voice response system that assesses symptoms and refers patients to a Symptom Management Guide is more effective than a complex cognitive behavioral approach in terms of producing greater symptom responses in shorter time intervals among patients with metastatic disease.

published online ahead of print at www.jco.org on November 24, 2008

Supported by Grant No. CA030724 from the National Cancer Institute and the Walther Cancer Institute.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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