Mindfulness-based stress reduction in patients with differentiated thyroid cancer receiving radioactive iodine therapy: a randomized controlled trial

Tianji Liu,1,* Wenqi Zhang,1,* Shuai Xiao,2 Lei Xu,3 Qiang Wen,1 Lin Bai,1 Qingjie Ma,1 Bin Ji1 1Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China; 2Department of Nursing, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China; 3Department of Psychology and Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China *These authors contributed equally to this work Objective: The aim of this study was to evaluate the efficacy of mindfulness-based stress reduction (MBSR) on health-related quality of life (QoL), depression, and anxiety in patients with differentiated thyroid cancer (DTC) receiving radioactive iodine therapy (RIT).Patients and methods: A randomized controlled trial of MBSR with 120 DTC patients was performed. They were randomly assigned into the MBSR intervention group and usual care (UC) group. An 8-week MBSR program was administered to the MBSR group starting 8 weeks before RIT. Health-related QoL, depression, and anxiety were measured immediately before the start of MBSR (T1), immediately after RIT hospitalization was concluded (1 week after concluding the last MBSR session, T2), and 3 months after RIT hospitalization (T3), using the QoL Questionnaire Core 30 Items (QLQ-C30), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS).Results: Fifty-three patients in the UC group and 49 patients in the MBSR group completed the study and were analyzed. Both the UC and MBSR groups reported low QoL and high SDS and SAS scores immediately after RIT hospitalization. Patients randomly assigned to the MBSR group showed significantly greater improvements in emotional function (P=0.012, d=–0.03 for T2 and d=1.17 for T3), fatigue (P=0.037, d=1.00 for T2 and d=–0.69 for T3), global QoL (P=0.015, d=1.61 for T2 and d=1.56 for T3), depression (P=0.027, d=–1.19 for T2 and d=–0.83 for T3), and anxiety (P=0.043, d=–1.00 for T2 and d=–0.86 for T3).Conclusion: An 8-week MBSR program significantly improved a wide range of scales in health-related QoL and mitigated depression and anxiety among DTC patients receiving RIT. Keywords: mindfulness-based stress reduction, differentiated thyroid cancer, radioactive iodine therapy, quality of life, anxiety, depressio