Resiliency among Older Adults Receiving Lung Cancer Treatment: A Supportive Care Intervention Study

接受肺癌治疗的老年人的复原力：支持性护理干预研究

• 批准号: 10493276
• 负责人: Carolyn Presley
• 金额: $ 24.2万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10493276
• 关键词: Academy; Activities of Daily Living; Adherence; Adult; Age; Aging; Anxiety; Award; Behavior Therapy; Cancer Control; Chest; Chiroptera; Chronic Disease; Clinical; Clinical Trials; Clinical Trials Design; Common Terminology Criteria for Adverse Events; Data; Diagnosis; Disease; Dyspnea; Effectiveness; Elderly; Enrollment; Ensure; European Organization for Research and Treatment of Cancer; Exhibits; Fatigue; Feasibility Studies; Geriatrics; Goals; Health Services; Immunooncology; Immunotherapy; International; Intervention; Intervention Studies; Intervention Trial; Joints; Knowledge; Leadership; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Medicine; Mental Depression; Mentors; Mentorship; Methods; Modeling; Multicenter Studies; Muscle relaxation phase; Oncologist; Oncology; Outcome; Pain; Participant; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Physical Performance; Physical therapy; Physicians; Population; Prospective cohort study; Randomized Clinical Trials; Relaxation; Reporting; Research; Research Design; Research Personnel; Risk Factors; Role; Science; Scientist; Supervision; Supportive care; Symptoms; Testing; Time; Training; Treatment Efficacy; Treatment-related toxicity; United States; Woman; Work; active method; aging population; anticancer research; arm; behavior change; behavioral clinical trial; cancer clinical trial; cancer diagnosis; cancer therapy; career; career development; design; disability; feasibility testing; forging; functional decline; functional independence; functional outcomes; functional status; improved; instrumental activity of daily living; modifiable risk; novel; patient population; preservation; prevent; primary outcome; psychological symptom; randomized trial; recruit; resilience; response; retention rate; role model; secondary outcome; standard measure; standard of care; study population; success; virtual; virtual delivery; virtual health

PROJECT ABSTRACT/SUMMARY. Lung cancer is a disease of older adults, who make up the least studied population of patients in cancer research. Evidence gaps persist in understanding the impact of newer treatments such as immunotherapy on functional status, the ability to recover from disability (resiliency), and clinical outcomes (e.g. symptom burden and treatment toxicity) among older adults. Current evidence indicates that the majority of older adults with cancer prioritize maintaining functional independence (i.e. no disability) over survival. Despite this common desire among older adults, disability in basic activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility is a common consequence of cancer treatment. Functional status in terms of ADLs, IADLs, and mobility is often unmonitored throughout the treatment course. Among older adults with lung cancer, poor physical capability and psychological symptoms such as anxiety and depression are common and represent potentially modifiable risk factors to achieve resiliency rather than disability. Interventions that focus on helping older adults enhance resiliency and prevent functional decline during treatment are urgently needed. Therefore, the objective of this application is to test a novel supportive care intervention specifically designed to enhance resiliency among older adults with advanced lung cancer. This supportive care intervention, called Resiliency among Older Adults Receiving Lung Cancer Treatment (ROAR-LCT), is designed to help patients engage in behavior change to preserve functional status, by optimizing a resilience response to cancer treatment, and is delivered virtually to decrease treatment burden for older adults. The first aim of this proposal is to conduct the ROAR-LCT pilot randomized clinical trial, comprising physical therapy plus relaxation versus standard-of-care, to evaluate a) feasibility and b) the preliminary effect on functional status (primary outcome). The second and third aims are to compare secondary outcome differences (physical capability and psychological symptoms) and exploratory outcome differences (symptom burden and treatment toxicity) between the two study groups. As a geriatric thoracic oncologist, my overall career goal is to become an independent physician-scientist conducting research to understand the problem of disability following a lung cancer diagnosis and developing empirically supported strategies to improve a resilience response and prevent disability among older adults. This award and training proposal will provide the support to advance my knowledge of patient-reported functional outcomes for older adults, implement this knowledge in the design of behavioral clinical trials, and share this knowledge in new leadership roles. To help ensure the success of this application, I have developed relationships with a distinguished mentorship team having expertise in behavioral interventions, cancer control, lung cancer, and geriatrics. This award will provide me with the additional training and career development I need to become an independent physician-scientist focused on cancer and aging and to achieve my long-term goal of becoming an international leader in geriatric oncology and a role model and mentor for women in academic medicine.

项目摘要/摘要。肺癌是一种老年人的疾病，构成研究最少的疾病 癌症研究中的患者人群。证据差距持续理解新治疗的影响 例如功能状况的免疫疗法，从残疾（弹性）中恢复的能力和临床 老年人的结局（例如症状负担和治疗毒性）。当前的证据表明 大多数患有癌症的老年人优先维持功能独立性（即无残疾）而不是生存。 尽管老年人有这种共同的愿望，但日常生活的基本活动（ADL），工具性的残疾 日常生活的活动（IADL）和流动性是癌症治疗的普遍结果。功能状态 就ADL而言，IADL和流动性在整个治疗过程中常常不受监控。在老年人中 由于肺癌，身体能力不佳和焦虑和抑郁等心理症状是 常见并代表了实现弹性而不是残疾的潜在可修改风险因素。干预措施 该专注于帮助老年人提高韧性并防止治疗期间的功能下降 需要。因此，本应用的目的是专门测试新型的支持护理干预措施 旨在提高患有晚期肺癌的老年人的弹性。这种支持性的护理干预措施， 接受肺癌治疗（Roar-LCT）的老年人中称为弹性，旨在帮助 患者通过优化对癌症的弹性反应来进行行为改变以保持功能状态 治疗，实际上是为了减轻老年人的治疗负担。该提议的第一个目的 是进行咆哮-LCT飞行员随机临床试验，包括物理疗法以及放松 标准护理，评估a）可行性和b）对功能状态的初步影响（主要结果）。 第二和第三的目标是比较次要结果差异（身体能力和心理 两项研究之间的症状）和探索性结果差异（症状负担和治疗毒性） 组。作为一名老年胸部肿瘤学家，我的整体职业目标是成为独立的医师科学家 进行研究以了解肺癌诊断和发展后残疾问题 经验支持改善弹性反应并防止老年人残疾的策略。这 奖励和培训建议将提供支持，以提高我对患者报告功能的了解 老年人的成果，在行为临床试验的设计中实施此知识，并分享 新领导角色的知识。为了帮助确保该应用程序的成功，我已经建立了关系 杰出的指导团队在行为干预，癌症控制，肺癌，肺癌， 和老年医学。该奖项将为我提供我需要的额外培训和职业发展 一个独立的医师科学家，专注于癌症和衰老，并实现我的长期目标 老年肿瘤学的国际领导者，是学术医学中女性的榜样和导师。