Impact of exercise on ovarian cancer prognosis

运动对卵巢癌预后的影响

• 批准号: 8066465
• 负责人: Melinda L Irwin
• 金额: $ 63.17万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-05 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8066465
• 关键词: Activities of Daily Living; Address; Adherence; Adipose tissue; Adverse effects; Aerobic Exercise; Affect; Aftercare; American Cancer Society; Androgens; Anxiety; Attention; Biological; Body Composition; Body fat; C-reactive protein; CA-125 Antigen; Cancer Patient; Cancer Prognosis; Cancer Survivor; Cancer Survivorship; Cells; Cessation of life; Chronic Disease; Clinic Visits; Clinical Trials; Continuance of life; Control Groups; Cross-Sectional Studies; Data; Development; Diagnosis; Dimensions; Disease-Free Survival; Distress; Ensure; Epithelial; Estradiol; Estrogens; Estrone; Exercise; Fasting; Goals; Guidelines; Health; Hip region structure; Hormones; Insulin; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Insulin-Like Growth Factor II; Intervention; Leptin; Life Style; Link; Literature; Longevity; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of ovary; Measures; Menopause; Mission; Modality; Nature; Obesity; Observational Study; Operative Surgical Procedures; Ovarian; Overweight; Performance; Physical activity; Play; Postmenopause; Prolactin; Publishing; Quality of life; Randomized; Recruitment Activity; Reporting; Research; Risk; Role; Sex Hormone-Binding Globulin; Shapes; Somatomedins; Source; Staging; Surrogate Markers; Survival Rate; Survivors; Symptoms; Techniques; Testing; Therapeutic; Weight; Weight maintenance regimen; Woman; cancer care; cancer risk; cancer therapy; carcinogenesis; caregiving; chemotherapy; clinical practice; design; experience; factor C; female reproductive system; fitness; improved; macrophage; malignant breast neoplasm; mortality; multi-site trial; osteopontin; outcome forecast; programs; psychologic; randomized trial; sedentary; social; survivorship; treatment as usual

DESCRIPTION (provided by applicant): Ovarian cancer results in more deaths than any other cancer of the female reproductive system. However, improvements in surgical techniques and chemotherapy have led to an increase in the 5-year survival rate from 37 percent in 1976 to 45 percent in 2006. Because of advances in therapeutic modalities, the number of ovarian cancer survivors for whom primary goals are to maximize disease-free survival and maintain quality of life (QOL) is growing. As such, survivorship issues are becoming increasingly important. Various studies report poor QOL in ovarian cancer patients. Research is needed to develop and test interventions to improve QOL in ovarian cancer survivors. Currently, the American Cancer Society recommends a physically active lifestyle for cancer survivors to increase disease-free survival from cancer and other chronic diseases, and to improve quality of life. Studies of a strong benefit of physical activity on improving QOL following other types of cancer treatment, e.g., breast cancer, are well documented in the literature; yet very few studies of physical activity and QOL after a diagnosis of ovarian cancer have been published. There are also no published data examining whether physical activity may improve ovarian cancer survival or surrogate markers of survival. Although the impact of exercise on ovarian cancer survival is unknown, it may play a role via weight control, since obesity has been shown in some studies, but not all, to be negatively associated with survival. Results from observational studies also suggest an inverse association between physical activity and risk of ovarian cancer. Possible biological explanations for the associations between obesity and low levels of physical inactivity and ovarian cancer risk and mortality involve the potential role of estrogens, insulin, insulin-like growth factors (IGFs) C-reactive protein (CRP), leptin, CA-125, prolactin, osteopontin, and macrophage inhibitory factor. Given the promising results from our randomized trials of exercise interventions in healthy women and breast cancer survivors, and our QOL interventions in ovarian cancer survivors, a trial examining the impact of exercise in improving QOL and surrogate markers of prognosis in ovarian cancer survivors is warranted. We propose to evaluate, in 230 sedentary women diagnosed with Stage I-III ovarian cancer, the impact of a 6-month, moderate-intensity, aerobic exercise intervention vs. attention control upon QOL and surrogate markers of prognosis. Women will be randomized to an exercise program or attention control group. Women randomized to exercise will participate in 150 minutes of aerobic exercise per week (e.g., five 30-min sessions/wk). We will conduct baseline and 6-month clinic visits to evaluate the effect of exercise on QOL and surrogate markers. Our study, the largest exercise trial in cancer survivors, could be a "proof of principal" and will provide critical information in understanding the potential mechanisms through which physical activity may impact ovarian cancer risk and prognosis. PUBLIC HEALTH RELEVANCE: Despite an increase in longevity, surviving ovarian cancer often brings an array of unpleasant side effects and compromises in QOL. Our proposed trial will be the first study to test whether exercise compared with attention control has a beneficial impact on quality of life, fitness and surrogate markers of prognosis. Our study will examine the effect of exercise on QOL and surrogate markers of ovarian cancer prognosis in 230 ovarian cancer survivors. Our study, the largest exercise trial in ovarian cancer survivors, could be a "proof of principal" and will also help shape post-treatment physical activity guidelines for millions of cancer survivors.

描述（由申请人提供）：卵巢癌导致死亡人数多于女性生殖系统的任何其他癌症。然而，手术技术和化学疗法的改善导致5年生存率从1976年的37％提高到2006年的45％。由于治疗方式的进步，卵巢癌幸存者的数量是，卵巢癌幸存者的数量是最大程度地提高疾病生存和维持生命质量（QOL）。因此，生存问题变得越来越重要。各种研究报告卵巢癌患者的质量较差。需要进行研究以开发和测试干预措施以改善卵巢癌幸存者的质量。目前，美国癌症协会建议为癌症幸存者一种身体上积极的生活方式，以增加癌症和其他慢性疾病的无病生存，并改善生活质量。在文献中充分记录了体育活动对改善其他类型的癌症治疗（例如乳腺癌）改善QOL的强大益处。然而，诊断为卵巢癌后的体育活动和QOL的研究很少。还没有发布的数据来研究身体活动是否可以改善卵巢癌的生存或生存的替代标志。尽管运动对卵巢癌存活的影响尚不清楚，但它可能通过体重控制发挥作用，因为在某些研究中已经显示了肥胖症，但并非全部与生存呈负相关。观察性研究的结果还表明，体育活动与卵巢癌风险之间存在反比相关。对肥胖症与卵巢癌的低水平与卵巢癌的风险和死亡率之间关联之间关联的可能生物学解释涉及雌激素，胰岛素，胰岛素样生长因子（IGFS）C-反应蛋白（CRP），Leptin，Ca-125，CA-125，CA-125，催乳素，prolactin，prolactin，osteoponpontin和Macroppopage的潜在作用。鉴于我们对健康妇女和乳腺癌幸存者的运动干预措施的随机试验以及我们对卵巢癌幸存者的QOL干预的结果，该试验涉及锻炼在改善QOL和预后中替代预后标志物在卵巢癌幸存者中的影响。我们建议评估230名被诊断为I-III期卵巢癌的久坐的妇女，这是6个月，中等强度的有氧运动干预措施与对QOL的注意力控制和预后替代标志物的影响。妇女将被随机分为运动计划或注意力控制小组。随机运动的妇女每周将参加150分钟的有氧运动（例如，五个30分钟/周）。我们将进行基线和6个月的诊所就诊，以评估运动对QOL和替代标记的影响。我们的研究是癌症幸存者中最大的运动试验，可能是“主要的证明”，并将提供关键信息，以了解体育锻炼可能影响卵巢癌风险和预后的潜在机制。公共卫生相关性：尽管寿命的增加，但幸存的卵巢癌通常会带来一系列令人不快的副作用和QoL的妥协。我们提出的试验将是第一个测试与注意力控制相比的运动是否对预后的生活质量，健身和替代标志物具有有益的影响。我们的研究将检查运动对230个卵巢癌幸存者卵巢癌预后的QOL和替代标记的影响。我们的研究是卵巢癌幸存者中最大的运动试验，可能是“主要的证明”，还将有助于塑造数百万癌症幸存者的治疗后体育活动指南。