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: 8515362
• 负责人: HEATHER S.L. JIM
• 金额: $ 47.64万
• 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/8515362
• 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.

描述（由申请人提供）：研究强调了疲劳、抑郁以及睡眠和体力活动中断的普遍性和破坏性（即，疾病行为）。然而，继发于化疗的疾病行为的生物学机制仍然未知。疾病行为的一个潜在的生物学机制是促炎细胞因子的增加。横断面观察性研究表明，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，没有研究纵向检查疾病行为和促炎细胞因子之间的关系在化疗期间和化疗后。因此，促炎细胞因子相对于疾病行为的轨迹和时间是未知的。此外，行为干预对细胞因子和疾病行为产生有益影响的成分尚不清楚;一种可能性是通过增加放松的情绪。拟议的项目将通过自我报告，活动记录和静脉穿刺评估150名接受铂和紫杉烷化疗的妇科癌症患者的疲劳，抑郁，睡眠，活动和循环促炎细胞因子，这是最艰巨的癌症治疗方案之一。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6个月和12个月进行评估。该研究设计将捕获治疗期间以及早期存活期的疾病行为和细胞因子的变化。在12个月评估中报告临床显著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。因为没有癌症的女性也会经历疲劳，抑郁，睡眠不佳和身体活动减少，并且因为关于循环促炎细胞因子的正常波动的数据很少，该研究还将评估疾病行为，以及促炎细胞因子在可比的时间段内，在150名没有癌症的女性样本中，根据年龄和邮政编码分别与患者匹配。该研究将提供有关接受化疗的癌症患者的疾病行为和循环促炎细胞因子的自然过程的有价值的信息，包括变化率，时间相互关系，与非癌症女性相比的变化。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的有效组成部分。这些数据将成为未来研究的基础，研究疾病行为的生物行为机制和干预措施，以改善他们。