Sickness Behaviors in Gynecologic Cancer Patients Treated with Chemotherapy

接受化疗的妇科癌症患者的疾病行为

• 批准号: 8305302
• 负责人: HEATHER S.L. JIM
• 金额: $ 54.55万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8305302
• 关键词: Address; Adverse effects; Aftercare; Age; Attention; Behavior; Behavior Therapy; Biological; Cancer Patient; Cancer Survivor; Chronic; Clinical; Code; Data; Distress; Evaluation; Fatigue; Funding; Future; Inflammation; Inflammatory; Infusion procedures; Intervention; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Mediating; Mental Depression; Modeling; Moods; Observational Study; Participant; Patient Self-Report; Patients; Pattern; Physical activity; Platinum; Prevalence; Public Health; Recording of previous events; Recruitment Activity; Relative (related person); Relaxation; Reporting; Research; Research Design; Sampling; Secondary to; Severities; Sleep; Statistical Models; Symptoms; Taxane Compound; Testing; Time; Treatment Protocols; Variant; Venipunctures; Woman; Work; actigraphy; base; biobehavior; chemotherapy; clinically significant; cytokine; effective intervention; evidence based guidelines; experience; improved; malignant breast neoplasm; next generation; prevent; survivorship; taxane; time interval

DESCRIPTION (provided by applicant): Research has highlighted the prevalence and disruptiveness of fatigue, depression, and disruptions in sleep and physical activity (i.e., sickness behaviors) during chemotherapy. Biological mechanisms of sickness behaviors secondary to chemotherapy remain unknown, however. One potential biological mechanism of sickness behaviors is increased pro-inflammatory cytokines. Cross-sectional observational studies suggest that circulating pro-inflammatory cytokines are higher in post-treatment breast cancer survivors who experience chronic cancer-related fatigue. Despite these data, no studies have longitudinally examined the relationship between sickness behaviors and pro-inflammatory cytokines during and after chemotherapy. The trajectory and timing of pro-inflammatory cytokines relative to sickness behaviors is therefore unknown. Moreover, the components through which behavioral interventions exert beneficial effects on cytokines and sickness behaviors is unclear; one possibility is by increasing relaxed mood. The proposed project will assess fatigue, depression, sleep, activity, and circulating pro-inflammatory cytokines via self-report, actigraphy, and venipuncture in 150 gynecologic cancer patients receiving platinum- and taxane-based chemotherapy, one of the most arduous treatment regimens for cancer. Patients will be assessed the week before and the week after their first, third, and sixth chemotherapy infusions, as well as six and twelve months after chemotherapy ends. This study design will capture changes in sickness behaviors and cytokines on-treatment as well as in the early survivorship period. Patient participants who report clinically significant fatigue or depression a the twelve month assessment will participate in an experimental induction of relaxed mood to test the short-term effects of relaxation on cytokines and sickness behaviors. Because women without cancer also experience fatigue, depression, poor sleep, and reduced physical activity, and because data are sparse regarding normal fluctuations in circulating pro-inflammatory cytokines, the study will also assess sickness behaviors, and pro-inflammatory cytokines over a comparable time period in a sample of 150 women without cancer matched individually to patients based on age and zip code. The study will provide valuable information regarding the natural course of sickness behaviors and circulating pro-inflammatory cytokines in cancer patients treated with chemotherapy, including rates of change, temporal interrelationships, variation compared to women without cancer. In addition, it will determine whether induction of relaxation is an effective component of behavioral interventions to reduce sickness behaviors. These data will form the basis for future studies examining biobehavioral mechanisms of sickness behaviors and interventions to ameliorate them. PUBLIC HEALTH RELEVANCE: A better understanding of potential mechanisms underlying common symptoms during chemotherapy may be helpful in developing more effective interventions to prevent or reduce these symptoms, thereby improving public health. The proposed study will model change and relationships over time between fatigue, depression, disruptions in sleep and physical activity, and pro-inflammatory cytokines in gynecologic cancer patients during chemotherapy and early survivorship, and over a comparable period of time in a matched sample of women without cancer. To examine whether behavioral interventions improve symptoms and inflammation through relaxation, patient participants who report clinically significant fatigue or depression will be invited to participate in experimental induction of relaxd mood to determine short-term effects on cytokines and symptoms.

描述（由申请人提供）：研究强调了化疗期间疲劳、抑郁以及睡眠和身体活动中断（即疾病行为）的普遍性和破坏性。然而，化疗继发的疾病行为的生物学机制仍然未知。疾病行为的一种潜在生物学机制是促炎细胞因子的增加。横断面观察研究表明，在经历慢性癌症相关疲劳的治疗后乳腺癌幸存者中，循环促炎细胞因子较高。尽管有这些数据，但还没有研究纵向研究化疗期间和化疗后疾病行为与促炎细胞因子之间的关系。因此，促炎细胞因子与疾病行为相关的轨迹和时间尚不清楚。此外，行为干预对细胞因子和疾病行为产生有益影响的组成部分尚不清楚。一种可能性是增加放松的情绪。拟议的项目将通过自我报告、体动记录和静脉穿刺对 150 名接受铂类和紫杉烷类化疗的妇科癌症患者进行疲劳、抑郁、睡眠、活动和循环促炎细胞因子的评估，化疗是最艰难的治疗方案之一。癌症。患者将在第一次、第三次和第六次化疗输注前一周和后一周以及化疗结束后六个月和十二个月接受评估。该研究设计将捕捉治疗期间以及早期生存期疾病行为和细胞因子的变化。在十二个月的评估中报告临床显着疲劳或抑郁的患者参与者将参与放松情绪的实验诱导，以测试放松对细胞因子和疾病行为的短期影响。由于未患癌症的女性也会经历疲劳、抑郁、睡眠质量差和体力活动减少，并且由于有关循环促炎细胞因子正常波动的数据很少，因此该研究还将评估可比时间内的疾病行为和促炎细胞因子根据年龄和邮政编码，将 150 名未患有癌症的女性样本与患者进行单独匹配。该研究将提供有关接受化疗的癌症患者疾病行为和循环促炎细胞因子的自然过程的宝贵信息，包括变化率、时间相互关系以及与未患癌症的女性相比的变化。此外，它将确定诱导放松是否是减少疾病行为的行为干预的有效组成部分。这些数据将为未来研究疾病行为的生物行为机制和改善疾病行为的干预措施奠定基础。 公共卫生相关性：更好地了解化疗期间常见症状的潜在机制可能有助于制定更有效的干预措施来预防或减少这些症状，从而改善公共卫生。拟议的研究将模拟妇科癌症患者在化疗期间和早期生存期间的疲劳、抑郁、睡眠和体力活动中断以及促炎细胞因子之间的变化和关系，以及在匹配的女性样本中的相当一段时间内的变化和关系。没有癌症。为了检查行为干预是否可以通过放松改善症状和炎症，报告临床显着疲劳或抑郁的患者参与者将被邀请参加放松情绪的实验诱导，以确定对细胞因子和症状的短期影响。