Sleep During Oncological Treatment - A Systematic Review and Meta-Analysis of Associations With Treatment Response, Time to Progression and Survival.
Sleep During Oncological Treatment - A Systematic Review and Meta-Analysis of Associations With Treatment Response, Time to Progression and Survival.
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肿瘤治疗期间的睡眠-与治疗反应、进展时间和生存相关的系统回顾和荟萃分析
DOI：
10.3389/fnins.2022.817837
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发表时间：
2022
影响因子：
4.3
通讯作者：
Zachariae, Robert
中科院分区：
文献类型：
--
作者：
Strom, Louise;Danielsen, Josefine T.;Amidi, Ali;Cardenas Egusquiza, Ana Lucia;Wu, Lisa Maria;Zachariae, Robert
在接受肿瘤治疗的癌症患者中经常观察到睡眠和睡眠-觉醒活动中断。这些干扰通常与症状负担加重和健康相关生活质量下降有关，进而可能影响治疗依从性，从而影响治疗效果。此外，睡眠中断与致癌过程有关，最终可能导致更糟糕的预后结果。我们的目的是系统地回顾并进行荟萃分析，以检查睡眠和睡眠-觉醒活动之间的关联以及接受肿瘤治疗的癌症患者的预后结果。 2020 年 6 月，使用 PubMed、Cochrane 图书馆和 CINAHL 对英语论文进行了全面系统的检索。两名审稿人独立筛选了 4,879 篇摘要。叙述性评论共纳入26篇论文。对反映二分预测变量（睡眠）和预后结果之间关联的风险比的 13 篇论文进行了荟萃分析。对总共 7,092 名癌症患者进行的 26 项合格研究中，有 19 项报告了较差的睡眠与较差的治疗反应、较短的进展时间和/或降低的总生存率之间的关联，但在所调查的睡眠和结果参数方面存在高度异质性。荟萃分析显示，自我报告的睡眠质量不佳与总生存率降低（HR = 1.33 [95% CI 1.09–1.62]，k = 11）和进展时间较短（HR = 1.40 [95% CI 1.23–1.59]，k = 3）之间以及客观评估的睡眠质量不佳与总生存率降低之间（HR = 1.74 [95% CI 95% CI 1.05–2.88]，k = 4）。目前的研究结果表明，治疗期间睡眠不安可能是癌症预后不良的相关行为标志。研究数量有限、单一项目睡眠测量的普遍使用以及潜在的发表偏倚凸显了进一步高质量纵向研究的必要性。
Disrupted sleep and sleep-wake activity are frequently observed in cancer patients undergoing oncological treatment. These disruptions are often associated with aggravated symptom burden and diminished health-related quality of life that in turn may compromise treatment adherence and, thus, effectiveness. In addition, disrupted sleep has been linked to carcinogenic processes, which ultimately could result in worse prognostic outcomes. Our aim was to systematically review and conduct a meta-analysis of studies examining the associations between sleep and sleep-wake activity and prognostic outcomes in cancer patients undergoing oncological treatment. A comprehensive systematic search of English language papers was undertaken in June 2020 using PubMed, The Cochrane Library, and CINAHL. Two reviewers independently screened 4,879 abstracts. A total of 26 papers were included in the narrative review. Thirteen papers reporting hazard ratios reflecting associations between a dichotomized predictor variable (sleep) and prognostic outcomes were subjected to meta-analysis. Nineteen of the 26 eligible studies on a total of 7,092 cancer patients reported associations between poorer sleep and poorer response to treatment, shorter time to progression, and/or reduced overall survival, but were highly heterogeneous with respect to the sleep and outcome parameters investigated. Meta-analysis revealed statistically significant associations between poor self-reported sleep and reduced overall survival (HR = 1.33 [95% CI 1.09–1.62], k = 11), and shorter time to progression (HR = 1.40 [95% CI 1.23–1.59], k = 3) and between poor objectively assessed sleep and reduced overall survival (HR = 1.74 [95% CI 1.05–2.88], k = 4). The current findings indicate that disturbed sleep during treatment may be a relevant behavioral marker of poor cancer prognosis. The limited number of studies, the common use of single item sleep measures, and potential publication bias highlight the need for further high quality and longitudinal studies.
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影响因子：
3.1
作者：
Desai, Krupali;Mao, Jun J.;Su, Irene;DeMichele, Angela;Li, Qing;Xie, Sharon X.;Gehrman, Philip R.
通讯作者：
Gehrman, Philip R.
影响因子：
2.8
作者：
Chang, Wen-Pei;Lin, Chia-Chin
通讯作者：
Lin, Chia-Chin
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
4.8
作者：
Baillet, Marion;Cosin, Charlotte;Mayo, Willy
通讯作者：
Mayo, Willy
影响因子：
1.4
作者：
Chandra, Smita;Gupta, Vibha;Gupta, Ravi
通讯作者：
Gupta, Ravi