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

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.