A PILOT STUDY OF PREHABILITATION DURING THE NEOADJUVANT WINDOW OF OPPORTUNITY IN OLDER WOMEN WITH OVARIAN CANCER (FIT4SURGERY)

老年卵巢癌女性新辅助治疗机会窗期间康复的试点研究 (FIT4SURGERY)

• 批准号: 10474514
• 负责人: Emma Barber
• 金额: $ 16万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10474514
• 关键词: Accelerometer; Activities of Daily Living; Address; Adjuvant; Adoption; Adverse event; Age; Aging; Award; Behavior Therapy; Behavioral; COVID-19; Cancer Patient; Cancer Survivor; Caregiver support; Chronic Disease; Clinical Research; Complex; Data; Elderly; Enrollment; Epidemiology; Evaluable Disease; Feasibility Studies; Feedback; Foundations; Geriatric Assessment; Geriatrics; Goals; Gynecologic Oncologist; Health; Health Benefit; Health Professional; Home; Individual; Inferior; Intervention; Knowledge; Length of Stay; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of ovary; Medical; Mentorship; Metastatic breast cancer; Morbidity - disease rate; Motivation; Neoadjuvant Therapy; Nutritional Support; Oncology; Operative Surgical Procedures; Outcome; Participant; Patient-Focused Outcomes; Patients; Persons; Physical Exercise; Physical Function; Physical activity; Physiological; Pilot Projects; Population; Postoperative Complications; Postoperative Pain; Postoperative Period; Process; Prognostic Factor; Quality of life; Randomized; Reporting; Research; Resources; Risk; Scientist; Solid; Stress; Structure; Surgeon; Surgical complication; Survival Rate; Symptoms; Testing; Time; Training; Treatment Protocols; Tumor Debulking; Waxes; Woman; Women' s Health; adverse event risk; anxiety reduction; base; behavioral clinical trial; cancer survival; cancer therapy; career; chemotherapy; comorbidity; efficacy evaluation; energy balance; exercise intervention; frailty; functional status; group intervention; health related quality of life; high risk; high risk population; hospital readmission; improved; indexing; insight; mHealth; mobile application; mortality; multimodality; novel; older patient; older women; patient population; pilot test; programs; sarcopenia; skills; social cognitive theory; standard of care; stressor; surgery outcome; treatment as usual

PROJECT SUMMARY/ABSTRACT Treatment for ovarian cancer begins with complex radical surgery in women who often are older with high rates of frailty and comorbid conditions. This results in postoperative complications and the highest mortality amongst all gynecologic cancers. Postoperative adverse events, such as surgical complications and hospital readmissions, can delay the initiation of post-operative chemotherapy, leading to decreased survival. Given the increased risk of postoperative morbidity and inferior cancer-specific survival for older women with ovarian cancer, targeted interventions are needed to improve their outcomes. Prehabilitation refers to enhancing functional capacity prior to an upcoming stressor, such as surgery, with the goal of improving postoperative outcomes. Physical activity, specifically, has been found to have myriad health benefits and is a component of many prehabilitation interventions. However, prehabilitation interventions often use prescriptive static goals of high intensity activity delivered by health care professionals which may not be scalable and may not be appropriate for an older frail patient population receiving chemotherapy. To address these issues, this proposal pilot tests a home-based, symptom-tailored, physical activity intervention (Fit4Surgery) among older women with ovarian cancer undergoing neoadjuvant chemotherapy. Interventions such as this are effective in patients with chronic diseases and in this proposal will be tested in a novel setting and a high-risk population. By increasing the amount of physical activity older women with ovarian cancer perform in the months prior to debulking surgery, we aim to improve functional status and quality of life while decreasing frailty, postoperative complications, and time to adjuvant cancer therapy, ultimately improving long-term cancer survival. As a gynecologic oncologist with formal epidemiology training, I have a solid foundation in clinical research with a focus on surgical quality and outcomes in women’s health. Through my research, I have identified older women with ovarian cancer as a high-risk population and the mechanisms of physiologic aging are prevalent in women with cancer and those undergoing chemotherapy. In order to fulfill my career goal to improve the quality of life and survival of older women with gynecologic cancers, I am in need of further training and mentorship in aging, geriatric assessment, and frailty assessment. This proposal will help me fill these gaps directly through formal coursework, seminars, and mentorship by Dr McKoy (geriatrics, geriatric oncology), Dr Simon (gynecologic malignancies and aging), Dr Phillips (physical activity in cancer, physical activity in older adults) and Dr Kocherginsky (clinical trials of behavioral interventions). The skills, knowledge and preliminary data, that I acquire as a result of this award will allow me examine the efficacy of the Fit4Surgery intervention in improving surgical outcomes for older women with ovarian cancer and will substantively contribute to my transition to an independent surgeon-scientist studying aging and gynecologic cancers.

项目摘要/摘要 卵巢癌的治疗始于通常年龄较大的女性复杂的根治性手术 脆弱和合并条件。这导致术后并发症和最高死亡率 在所有妇科癌症中。术后不良事件，例如手术并发症和医院 再入院可能会延迟术后化疗的主动性，从而导致存活率降低。鉴于 卵巢老年妇女的术后发病率和较低癌症特异性生存的风险增加 需要采取癌症，有针对性的干预措施来改善其结果。居民是指增强 在即将进行的压力源之前（例如手术）之前的功能能力，目的是改善术后 结果。特别是，已经发现体育锻炼具有无数的健康益处，并且是 许多预居住干预措施。但是，预居住干预措施通常使用规定的静态目标 医疗保健专业人员提供的高强度活动可能无法扩展，可能不是 适合接受化学疗法的老年脆弱患者。为了解决这些问题，该提议 试验测试老年妇女的家庭症状，体育锻炼干预（FIT4SURGIGY） 接受新辅助化疗的卵巢癌。这样的干预措施对患者有效 有了慢性疾病，在此提案中，将在新型环境和高风险人群中进行测试。经过 增加卵巢癌老年女性的体育锻炼量在前几个月 暂停手术，我们旨在提高功能状况和生活质量，同时降低脆弱性，术后 并发症和调整癌症治疗的时间，最终改善了长期的癌症生存。 作为正式流行病学培训的妇科肿瘤学家，我在临床研究方面拥有坚实的基础 专注于手术质量和女性健康状况。通过我的研究，我已经确定了年龄较大的 患有卵巢癌的妇女是高危人群，生理衰老的机制很普遍 患有癌症的妇女和接受化疗的妇女。为了实现我的职业目标，以提高 妇科癌症老年妇女的生活质量和生存，我需要进一步的培训和 衰老，老年评估和脆弱评估的遗传。该建议将帮助我填补这些空白 直接通过McKoy博士（老年肿瘤学）的正式课程，半学院和精神训练，博士 西蒙（妇科恶性肿瘤和衰老），菲利普斯博士（癌症的体育活动，年龄较大的体育活动 成人）和科赫金斯基博士（行为干预的临床试验）。技能，知识和初步 我获得该奖项的数据将使我检查Fit4Surgery干预的效率 改善老年卵巢癌女性的手术结局，并为我的 过渡到独立的外科医生科学家研究衰老和妇科癌症。