Dietary and Lifestyle Determinants of Colon Cancer Recurrence and Survival

结肠癌复发和生存的饮食和生活方式决定因素

• 批准号: 7418239
• 负责人: CHARLES S FUCHS
• 金额: $ 46.79万
• 依托单位: DANA-FARBER CANCER INST
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-05-07 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7418239
• 关键词: Address; Adjuvant; Adjuvant Chemotherapy; Adjuvant Therapy; All-Trans-Retinol; Anti-Inflammatory Agents; Anti-inflammatory; Area; Aspirin; Body mass index; CDKN1A gene; Cancer Biology; Cancer and Leukemia Group B; Characteristics; Colon Carcinoma; Data; Databases; Diet; Dietary Factors; Exhibits; Fatty acid glycerol esters; Fluorouracil; Future; Health Personnel; Human; Individual; Intake; Knowledge; Life Style; Malignant Neoplasms; Meat; Molecular; Mutate; Mutation; NIH Program Announcements; National Cancer Institute; Neoplasm Metastasis; Obesity; Outcome; PTGS2 gene; Paraffin Embedding; Pathologic; Patients; Pattern; Performance Status; Pharmaceutical Preparations; Physical activity; Polyunsaturated Fatty Acids; Postoperative Period; Protein Overexpression; Proteins; Randomized Clinical Trials; Recommendation; Research; Research Personnel; Residual state; Risk; Specimen; Staging; TP53 gene; Toxic effect; Vascular Endothelial Growth Factors; Vitamin A; Vitamin D; Vitamin E; base; cancer diagnosis; cancer recurrence; chemotherapy; cohort; cruciferous vegetable; density; disease characteristic; energy balance; follow-up; fruits and vegetables; improved; mortality; oncoprotein p21; outcome forecast; p27 Cell Cycle Protein; p27 Enzyme Inhibitor; programs; prospective; response; tumor

DESCRIPTION (provided by applicant): Epidemiologic and scientific research indicates that diet and other lifestyle factors have a significant influence on the risk of developing colon cancer. However, the influence of diet, physical activity, obesity, and other lifestyle factors on the outcome of patients with established colon cancer is virtually unknown. Randomized clinical trials demonstrate a significant survival advantage for individuals with stage III colon cancer who receive adjuvant fluorouracil-based chemotherapy. Nonetheless, 40-45% of stage III patients receiving current adjuvant chemotherapy will develop metastases. Patients often seek to understand what, if any, diet and lifestyle will reduce their chances of cancer recurrence as well as the potential toxicities associated with adjuvant therapy. Moreover, how diet and lifestyle influence prognosis may depend, in part, on molecular characteristics of the tumor. In response to a NIH Program Announcement, PA-06-404, "Studies of Energy Balance and Cancer in Humans," we propose to address these gaps in knowledge by utilizing a large, completed National Cancer Institute-sponsored adjuvant chemotherapy trial (CALGB 89803) in stage III colon cancer which provides a) two longitudinal prospective, validated assessments of diet, medication, and lifestyle; b) paraffin-embedded tumor specimens to examine how dietary factors interact with specific molecular alterations; and c) comprehensive data on cancer recurrence, mortality, and chemotherapy-related toxicity. Since pathologic stage, performance status, post-operative therapy and follow-up were carefully defined in this trial, residual confounding by disease characteristics and use of adjuvant therapy should be minimized. This database will provide a unique opportunity to examine the influence of diet (Aim 1), energy balance (Aim 2), and aspirin and other medications (Aim 3) on the risk of colon cancer recurrence, mortality, and chemotherapy-related toxicity. Each specific aim in this proposal extends current knowledge in these areas. Beyond the aforementioned hypotheses, this cohort will allow for the rapid examination of future hypotheses as they emerge. Ultimately, this database will permit us to ascertain the influence of numerous factors on colon cancer survival, improve our understanding of colon cancer biology, and potentially offer substantive dietary and lifestyle recommendations for patients and health care providers.

描述（由申请人提供）：流行病学和科学研究表明饮食和其他生活方式因素对患结肠癌的风险有显着影响。然而，饮食、体力活动、肥胖和其他生活方式因素对结肠癌患者预后的影响实际上尚不清楚。随机临床试验表明，接受基于氟尿嘧啶的辅助化疗的 III 期结肠癌患者具有显着的生存优势。尽管如此，接受当前辅助化疗的 III 期患者中有 40-45% 会出现转移。患者经常寻求了解哪些饮食和生活方式（如果有的话）可以减少癌症复发的机会以及与辅助治疗相关的潜在毒性。此外，饮食和生活方式如何影响预后可能部分取决于肿瘤的分子特征。为了响应 NIH 计划公告 PA-06-404“人类能量平衡和癌症研究”，我们建议通过利用一项大型、完整的国家癌症研究所资助的辅助化疗试验 (CALGB 89803) 来解决这些知识差距) 在 III 期结肠癌中，它提供了 a) 对饮食、药物和生活方式的两项纵向前瞻性、经过验证的评估； b) 石蜡包埋的肿瘤标本，以检查饮食因素如何与特定分子改变相互作用； c) 关于癌症复发、死亡率和化疗相关毒性的综合数据。由于本试验中仔细定义了病理分期、体能状态、术后治疗和随访，因此应尽量减少疾病特征和辅助治疗使用造成的残余混杂。该数据库将提供一个独特的机会来检查饮食（目标 1）、能量平衡（目标 2）以及阿司匹林和其他药物（目标 3）对结肠癌复发、死亡率和化疗相关毒性风险的影响。该提案中的每个具体目标都扩展了这些领域的当前知识。除了上述假设之外，该队列还将允许对未来出现的假设进行快速检验。最终，该数据库将使我们能够确定多种因素对结肠癌生存的影响，提高我们对结肠癌生物学的理解，并有可能为患者和医疗保健提供者提供实质性的饮食和生活方式建议。