Treating Cancer-Related Fatigue Through Systematic Bright White Light

通过系统亮白光治疗与癌症相关的疲劳

• 批准号: 8306110
• 负责人: William H Redd
• 金额: $ 17.59万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8306110
• 关键词: Activities of Daily Living; Adjustment Disorders; Adrenal Cortex Hormones; Antidepressive Agents; Boxing; Cancer Burden; Cancer Control; Cancer Intervention; Cancer Patient; Cancer Survivor; Cessation of life; Chemotherapy-Oncologic Procedure; Clinical; Cognitive; Cognitive Therapy; Diagnosis; Distress; Emotional; Exercise; Exposure to; Fatigue; Foundations; Goals; Gold; Hematopoietic stem cells; Home environment; Informed Consent; Intervention; Interview; Israel; Life; Light; Malignant Neoplasms; Measures; Mediating; Mental Depression; Moods; National Comprehensive Cancer Network; Outcome; Patients; Physical Capacity; Placebos; Procedures; Quality of life; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recruitment Activity; Reporting; Research; Sleep; Sleep disturbances; Stem cell transplant; Survivors; Symptoms; Telephone; Testing; Time; Treatment-Related Cancer; Work; arm; cancer therapy; chemotherapy; clinical efficacy; clinically significant; efficacy testing; exhaustion; light treatment; malignant breast neoplasm; psychostimulant; standard care; standardize measure

DESCRIPTION (provided by applicant): Cancer related fatigue (CRF), defined by the National Comprehensive Cancer Network as "a distressing, persistent, subjective sense of physical, emotional, and cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity," can severely interfere with activities of daily living, physical capacity, and ability to work. There are even reports of fatigue being a factor in patient requests for hastened death. CRF can represent a serious clinical problem after all treatment has ended. In our research with cancer survivors 1 to 3 years after completion of hematopoietic stem cell transplant (HSCT), 40% of those we interviewed reported that CRF was a major obstacle to the resumption of usual activities. Despite its impact on quality of life, CRF is under-reported, under-diagnosed, and under- treated. There is no widely accepted CRF intervention that has demonstrated clinical efficacy. A variety of pharmacologic agents have been studied to treat CRF; most notably psychostimulants, antidepressants, and corticosteroids. But there is not sufficient evidence to recommend the use of any of the currently available pharmacologic agents. A number of non-pharmacologic strategies have been tested. The most promising are exercise and cognitive-behavior therapy (CBT). Results from two randomized clinical trials suggest that exercise and CBT are equal in overall efficacy, but with only moderate effects. Indeed, at this time there is no "gold standard" treatment for CRF. One promising new intervention for CRF is "bright white light" (BWL --- systematic daily 30-minute exposure to bright white light from a commercially available "lightbox") treatment. In a small randomized controlled clinical trial, BWL was protective against increases in sleep disturbances, mood symptoms and fatigue across cycles of chemotherapy. We want to investigate BWL to control CRF in 1 to 3 year survivors of HSCT for three reasons. First, CRF is a major problem for a large proportion of survivors (40%). Second, BWL may be more acceptable to survivors than CBT or exercise because BWL is less physically demanding and can be carried out at home. Third, BWL is likely to be less expensive since it can be implemented by phone, requiring less professional and patient time and effort than that required for exercise and CBT. The feasibility of the proposed research is assured by the fact that we have identified a group of 150 HSCT survivors who report clinically significant levels of CRF and who have provided informed consent to participate in further research. Specific Aims: 1) Develop and pilot test a BWL exposure intervention with HSCT survivors suffering from CRF to assess the impact on fatigue, sleep quality, and quality of life using objective and subjective measures; 2) To investigate the possible mediating effects of depression on fatigue; and 3) Assess the feasibility and acceptability of BWL as an intervention for CRF in cancer survivors.

描述（由申请人提供）：由国家综合癌症网络定义的癌症相关疲劳（CRF）是“一种令人沮丧，持久，主观的身体，情感和认知疲倦或与癌症或癌症治疗相关的疾病，与最近活动不成比例，可以严重干扰日常生活，能力以及工作能力以及工作能力。甚至有报道称疲劳是患者要求加速死亡的一个因素。所有治疗结束后，CRF可以代表一个严重的临床问题。在造血干细胞移植（HSCT）完成后1至3年的癌症幸存者的研究中，我们采访的40％的人报告说，CRF是恢复常规活动的主要障碍。尽管CRF对生活质量有影响，但报告不足，诊断和治疗不足。没有广泛接受的CRF干预措施表现出临床功效。已经研究了各种药理剂来治疗CRF。最著名的是精神刺激剂，抗抑郁药和皮质类固醇。但是，没有足够的证据建议使用任何当前可用的药理学剂。已经测试过许多非药物策略。最有希望的是运动和认知行为疗法（CBT）。两项随机临床试验的结果表明，运动和CBT的总体功效相同，但仅具有适度的影响。确实，目前尚无CRF的“黄金标准”处理。 CRF的一种有希望的新干预是“明亮的白光”（BWL ---系统的每日30分钟，可从市售的“ Lightbox”接触到明亮的白光）。在一项小型的随机对照临床试验中，BWL可保护睡眠障碍，情绪症状和化学疗法周期疲劳的增加。我们希望研究BWL以三个原因来控制HSCT 1至3年幸存者的CRF。首先，CRF是大部分幸存者（40％）的主要问题。其次，BWL可能比CBT或运动更容易接受，因为BWL的身体要求较低，可以在家中进行。第三，BWL可能会更便宜，因为它可以通过电话实施，而与锻炼和CBT所需的时间和耐心的时间和精力相比，需要的时间和耐心时间要少。我们已经确定了一组150个HSCT幸存者，他们报告了临床意义的CRF水平，并提供了知情同意参加进一步的研究，因此确保了拟议研究的可行性。具体目的：1）与患有CRF的HSCT幸存者进行BWL暴露干预，以评估使用客观和主观措施对疲劳，睡眠质量和生活质量的影响； 2）研究抑郁症对疲劳的可能介导作用； 3）评估BWL作为CRF在癌症幸存者中的可行性和可接受性。