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: 8687616
• 负责人: HEATHER S.L. JIM
• 金额: $ 48.83万
• 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/8687616
• 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; 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.

描述（由申请人提供）：研究突出了化学疗法期间睡眠和体育锻炼（即疾病行为）的疲劳，抑郁和中断的患病率和破坏性。然而，疾病行为的生物学机制尚不清楚。疾病行为的一种潜在的生物学机制是增加促炎细胞因子。横断面观察性研究表明，在治疗后乳腺癌幸存者中经历慢性癌症相关疲劳的循环促炎细胞因子较高。尽管有这些数据，但在化学疗法期间和之后，没有研究纵向研究了疾病行为与促炎性细胞因子之间的关系。因此，促炎性细胞因子相对于疾病行为的轨迹和时机尚不清楚。此外，行为干预措施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。一种可能性是增加心情放松。拟议的项目将通过自我报告，行动术和静脉穿刺术评估疲劳，抑郁，睡眠，活动和循环促炎细胞因子，其中150名接受基于铂和紫杉烷化学疗法的妇科癌症患者，这是癌症最艰巨的治疗方案之一。患者将在第一周，第三和第六个化学疗法输注以及化学疗法结束后的六和十二个月后进行评估。这项研究设计将捕获疾病行为和细胞因子进行治疗以及早期生存期的变化。报告临床意义疲劳或抑郁症的患者参与者十二个月评估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。由于没有癌症的女性还会出现疲劳，抑郁症，睡眠不足和体育锻炼减少，并且由于循环促炎性细胞因子的正常波动的数据稀少，因此该研究还将评估150名与基于年龄和ZIP代码的患者相匹配的150名女性的疾病行为，而促炎性细胞因子在相当的情况下进行促炎性细胞因子。这项研究将提供有关疾病行为的自然过程和与没有癌症的女性相比，接受化学疗法治疗的癌症患者的自然过程和循环促炎细胞因子的循环促炎细胞因子。此外，它将确定放松的诱导是否是减少疾病行为的行为干预措施的有效组成部分。这些数据将构成研究疾病行为的生物行为机制的未来研究和改善它们的干预措施的基础。