Impact of exercise on ovarian cancer prognosis

运动对卵巢癌预后的影响

• 批准号: 8253752
• 负责人: Melinda L Irwin
• 金额: $ 60.64万
• 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/8253752
• 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

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% in 1976 to 45% 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.

卵巢癌导致的死亡人数比女性生殖系统的任何其他癌症都要多。然而， 手术技术和化疗的改进提高了5年生存率 从 1976 年的 37% 到 2006 年的 45%。由于治疗方式的进步，卵巢的数量 癌症幸存者的主要目标是最大限度地提高无病生存率并维持生活质量 （生活质量）正在增长。因此，生存问题变得越来越重要。各项研究报告 卵巢癌患者的生活质量较差。需要进行研究来开发和测试干预措施，以改善生活质量 卵巢癌幸存者。目前，美国癌症协会推荐身体活跃的生活方式 癌症幸存者提高癌症和其他慢性病的无病生存率，并改善 生活质量。研究表明体力活动对改善其他类型癌症后的生活质量有很大益处 治疗，例如乳腺癌，在文献中有详细记载；但对身体活动的研究却很少 卵巢癌诊断后的生活质量和生活质量已发表。也没有公布数据 检查体力活动是否可以提高卵巢癌的生存率或生存的替代标志。 尽管运动对卵巢癌生存的影响尚不清楚，但它可能通过控制体重发挥作用， 因为一些研究（但不是全部）表明肥胖与生存呈负相关。结果 观察性研究还表明体力活动与卵巢癌风险之间呈负相关 癌症。肥胖与低水平体质之间关联的可能生物学解释 缺乏活动与卵巢癌风险和死亡率涉及雌激素、胰岛素、胰岛素样药物的潜在作用 生长因子 (IGF)、C 反应蛋白 (CRP)、瘦素、CA-125、催乳素、骨桥蛋白和巨噬细胞 抑制因子。鉴于我们对健康人群进行运动干预的随机试验取得了令人鼓舞的结果 女性和乳腺癌幸存者，以及我们对卵巢癌幸存者的生活质量干预，一项试验 运动对改善卵巢癌幸存者的生活质量和预后替代标志物的影响 保证。我们建议对 230 名被诊断患有 I-III 期卵巢癌的久坐女性进行评估 为期 6 个月的中等强度有氧运动干预与注意力控制对 QOL 和 预后的替代标志物。女性将被随机分配到锻炼计划组或注意力对照组。 随机分配运动的女性将每周参加 150 分钟的有氧运动（例如 5 次 30 分钟的有氧运动） 会话/周）。我们将进行基线和 6 个月的临床访问，以评估运动对生活质量和健康的影响 替代标记。我们的研究是癌症幸存者中最大规模的运动试验，可以成为“原则证明” 将为理解体力活动可能产生的潜在机制提供关键信息 影响卵巢癌的风险和预后。