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Eur J Cancer Care (Engl). 2015 Sep;24(5):707-17. doi: 10.1111/ecc.12278. Epub 2015 Jan 19.

Do we have predictors of therapy responsiveness for a multimodal therapy concept and aerobic training in breast cancer survivors with chronic cancer-related fatigue?

Author information

Research Institute Havelhöhe (FIH), Berlin, Germany.
Department of Internal Medicine, Community Hospital Havelhöhe, Berlin, Germany.
Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, Germany.
Institute of Integrative Medicine, Witten, Germany.
Institute for Clinical Research (IKF), Berlin, Germany.
Clinic for Rehabilitative Medicine, Hannover Medical School, Hannover, Germany.
Center for Research in Medical and Natural Sciences, University of Tübingen, Tübingen, Germany.


Cancer-related fatigue (CRF) is a burdensome symptom for breast cancer (BC) patients. In this pilot study, we tested several questionnaires as predictors for treatment responsiveness, along with the implementation of a multimodal therapy concept consisting of sleep, psycho-education, eurythmy, painting therapy and standard aerobic training. At the Community Hospital Havelhöhe and the Hannover Medical School, 31 BC patients suffering from CRF could be evaluated in a 10-week intervention study. CRF was assessed by the Cancer Fatigue Scale (CFS-D). Further questionnaires were the Pittsburgh Sleep Quality Index, the autonomic regulation scale, Self-Regulation Scale (SRS), the Internal Coherence Scale (ICS) and the European Organization of Research and Treatment Health-Related Quality of Life Core Questionnaire scale. We estimated the regression coefficients of all scales on CFS-D by simple and multiple linear regression analyses and compared regression slopes and variances between the different questionnaires on CFS-D at the end of treatment. We found a significant impact of SRS and ICS at baseline on CFS-D at the end of the intervention [absolute standardised multiple regression coefficient values ranging from 0.319 (SRS) to 0.269 (ICS)] but not for the other questionnaires. In conclusion, this study supports the hypothesis that the SRS or ICS measuring adaptive capacities could be more appropriate as outcome predictors than classical questionnaire measures in complex interventions studies.


Anthroposophic medicine; Self-Regulation Scale; breast cancer; cancer-related fatigue; health-related quality of life; internal coherence (ICS)

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