Supportive‐expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial

TLDR

Supportive‑expressive group therapy’s effect on survival in metastatic breast cancer has been inconsistently reported. In a 2:1 randomized controlled trial of 227 women with advanced breast cancer, participants received either weekly supportive‑expressive group therapy plus relaxation classes or relaxation classes alone, with survival as the primary outcome assessed by intention‑to‑treat analysis. The trial found no survival benefit from SEGT (median 24.0 vs 18.3 months, HR≈1.0), but it significantly reduced depression, hopelessness, trauma symptoms, and improved social functioning. © 2007 John Wiley & Sons, Ltd.

Abstract

Abstract Background : Mixed reports exist about the impact of supportive‐expressive group therapy (SEGT) on survival. Methods : 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). Conclusions : SEGT did not prolong survival. It improved quality of life, including treatment of and protection against depression. Copyright © 2007 John Wiley & Sons, Ltd.