Breast Cancer Survivors: Physical Activity, Inflammation, Fatigue, and Distress

乳腺癌幸存者：体力活动、炎症、疲劳和痛苦

基本信息

批准号：
8255356
负责人：
JANICE KIECOLT-GLASER
金额：
$ 32.26万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-06-01 至 2014-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8255356
关键词：
12p Acute Address Adjuvant Therapy Affect Aftercare Age Ally Anti-Inflammatory Agents Anti-inflammatory Anxiety Aromatase Inhibitors Behavior Behavioral Cancer Survivor Data Depressed mood Distress Exercise Fatigue Feedback Fright Health behavior Impairment Individual Inflammation Inflammatory Inflammatory Response Interleukin-6 Intervention Laboratories Literature Malignant Neoplasms Measures Mental Depression Moods NF-kappa B Neuraxis Operative Surgical Procedures Pain Participant Pathway interactions Perceived quality of life Performance Physical Function Physical activity Physiological Posture Production Psychological Stress Quality of life Radiation Randomized Randomized Clinical Trials Recruitment Activity Recurrence Relative (related person)Research Personnel Sampling Serum Sleep Staging Stress Symptoms Tamoxifen Time Treatment Efficacy Waiting Lists Woman Yoga arm behavioral health biological adaptation to stress cancer therapy chemotherapy cytokine depressive symptoms design flexibility functional status ilium inflammatory marker malignant breast neoplasm men programs psychologic response sedentary stressor transcription factor

项目摘要

DESCRIPTION (provided by applicant): Breast cancer survivors confront a number of post-treatment problems including fatigue, decreased physical function, fears of recurrence, and treatment-related sequelae. Persistent fatigue, the most common and distressing problem, appears to be related in part to overactivation of the inflammatory network. Higher levels of depressive symptoms can effectively prime the inflammatory response, promoting larger NF-kappa B and proinflammatory responses to stressors. Physical activity interventions that simultaneously enhance physical performance and reduce depressive symptoms can reduce fatigue-related symptoms, as well as inflammation. This project provides the opportunity to examine mechanistic connections among fatigue, stressors, depressive symptoms, and proinflammatory cytokines both cross-section ally and longitudinally in a randomized clinical trial, building on preliminary studies that have demonstrated anti-inflammatory changes associated with yoga. A total of 200 stage I, II, and Ilia breast cancer survivors will be recruited, ages 40 and older; the women will have completed cancer treatment within the past year (except for tarnoxifen/aromatase inhibitors), and will be at least two months post surgery or adjuvant therapy or radiation, whichever occurred last. All of the women will have received chemotherapy as part of their treatment. Using a block-randomized design, participants will be assigned to either a 1 2-week (twice-weekly) hatha yoga intervention or a delayed intervention arm that receives the yoga intervention after a 6-month observation period. Differences between the two arms will be assessed at 3 months (at the conclusion of the 12-week intervention), and at 6 months (3 months after the formal intervention), controlling for any baseline (pre-randomization) measures. NF-kappa B and proinflammatory cytokine responses to a laboratory stressor will be assessed at baseline and 3 months. AIMS: (1) The primary aim is to determine if the yoga intervention will decrease inflammation, fatigue, and depressive symptoms relative to the wait-list controls. Additional aims are (2) to ascertain the extent to which the intervention modulates psychological, behavioral, and physical functioning; (3) to evaluate the relationship between depressive symptoms and the magnitude of the physiological responses elicited by a laboratory stressor, as well as the relationship of both to fatigue; and (4) to assess the extent to which the yoga intervention wiII decrease physiological stress responses.

描述（由申请人提供）：乳腺癌幸存者面临许多治疗后问题，包括疲劳、身体机能下降、担心复发以及治疗相关的后遗症。持续疲劳是最常见和令人痛苦的问题，似乎部分与炎症网络的过度激活有关。较高水平的抑郁症状可以有效地引发炎症反应，促进更大的 NF-κB 和对压力源的促炎症反应。同时增强身体表现和减少抑郁症状的体育活动干预措施可以减少与疲劳相关的症状以及炎症。该项目提供了在随机临床试验中横向和纵向检查疲劳、压力源、抑郁症状和促炎细胞因子之间机制联系的机会，该项目建立在已证明与瑜伽相关的抗炎变化的初步研究的基础上。总共将招募 200 名 I、II 和 Ilia 期乳腺癌幸存者，年龄在 40 岁及以上；这些妇女将在过去一年内完成癌症治疗（塔诺昔芬/芳香酶抑制剂除外），并且在手术或辅助治疗或放射（以最后发生者为准）后至少两个月。作为治疗的一部分，所有女性都将接受化疗。采用分块随机设计，参与者将被分配到 1 两周（每周两次）哈他瑜伽干预组或延迟干预组，在 6 个月的观察期后接受瑜伽干预。将在 3 个月（12 周干预结束时）和 6 个月（正式干预后 3 个月）评估两组之间的差异，并控制任何基线（随机化前）测量。将在基线和 3 个月时评估 NF-κ B 和促炎细胞因子对实验室应激源的反应。目的：(1) 主要目的是确定与等待名单对照相比，瑜伽干预是否会减少炎症、疲劳和抑郁症状。其他目标是（2）确定干预措施调节心理、行为和身体功能的程度； (3) 评估抑郁症状与实验室应激源引起的生理反应强度之间的关系，以及两者与疲劳的关系； (4)评估瑜伽干预减少生理应激反应的程度。