Circadian function in patients with advanced non-small-cell lung cancer
Circadian function in patients with advanced non-small-cell lung cancer
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DOI：
10.1038/sj.bjc.6602859
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发表时间：
2005-11-28
影响因子：
8.8
通讯作者：
Hrushesky, WJM
中科院分区：
文献类型：
--
作者：
Levin, RD;Daehler, MA;Hrushesky, WJM
这项研究旨在评估晚期非小细胞肺癌患者是否会经历休息-活动日常节律中断，睡眠质量差，虚弱，并保持与昼夜节律功能相关的属性，如疲劳。本报告描述了33名非小细胞肺癌患者的休息-活动模式，这些患者参加了一项评估褪黑激素益处的随机临床试验。报告了随机化和治疗前的昼夜节律功能、健康相关生活质量（QoL）、主观睡眠质量和焦虑/抑郁水平的数据。体动图数据，昼夜节律功能的客观测量，表明患者的休息-活动昼夜节律功能显着不同于对照组。我们的患者报告睡眠质量差和高度疲劳。Ferrans和Powers QoL指数工具发现对健康相关QoL的不满程度很高。欧洲癌症研究和治疗组织的数据报告说，从事日常生活活动的能力很差。在医院接受化疗期间或化疗前后接受研究的患者比在门诊接受研究的患者有更明显的昼夜节律功能异常。我们的数据表明，昼夜睡眠/活动动力学的测量应在门诊/家庭环境中完成，至少4 - 7个昼夜周期，以确保它们最能代表患者的真实状况。我们的结论是，晚期肺癌患者的日常睡眠/活动模式受到干扰。这些伴随着明显的生活质量和功能破坏。这些数据表明，调查这种功能不良和生活质量差实际上是由这种昼夜节律紊乱引起的，以及纠正昼夜节律/睡眠活动模式的行为、基于光的和/或药理学策略是否可以改善功能和生活质量。
This study aimed to evaluate whether patients with advanced non-small-cell lung cancer experience disrupted rest - activity daily rhythms, poor sleep quality, weakness, and maintain attributes that are linked to circadian function such as fatigue. This report describes the rest - activity patterns of 33 non-small-cell lung cancer patients who participated in a randomised clinical trial evaluating the benefits of melatonin. Data are reported on circadian function, health-related quality of life (QoL), subjective sleep quality, and anxiety/depression levels prior to randomisation and treatment. Actigraphy data, an objective measure of circadian function, demonstrated that patients' rest - activity circadian function differs significantly from control subjects. Our patients reported poor sleep quality and high levels of fatigue. Ferrans and Powers QoL Index instrument found a high level of dissatisfaction with health-related QoL. Data from the European Organization for Research and Treatment for Cancer reported poor capacity to fulfil the activities of daily living. Patients studied in the hospital during or near chemotherapy had significantly more abnormal circadian function than those studied in the ambulatory setting. Our data indicate that measurement of circadian sleep/activity dynamics should be accomplished in the outpatient/home setting for a minimum of 4 - 7 circadian cycles to assure that they are most representative of the patients' true condition. We conclude that the daily sleep/activity patterns of patients with advanced lung cancer are disturbed. These are accompanied by marked disruption of QoL and function. These data argue for investigating how much of this poor functioning and QoL are actually caused by this circadian disruption, and, whether behavioural, light-based, and or pharmacologic strategies to correct the circadian/sleep activity patterns can improve function and QoL.