Acupuncture for Cognitive Health in Older Survivors of Prostate Cancer (ACHIEVE)

项目总结 这个职业发展奖，针灸促进前列腺癌老年幸存者的认知健康 (实现)，将培训刘博士成为一名具有综合医学专业知识的独立临床医生兼研究员 前列腺癌(PC)存活者认知健康和症状管理的治疗。背景： 到2030年，PC幸存者预计将成为美国最大的癌症幸存者群体。 癌症相关认知功能障碍(CRCD)在这个不断增长的人口中是一个重要的担忧，但有证据表明- 缺乏基于基础的治疗。大多数慢性前列腺癌的研究都集中在雄激素的神经毒性上。 剥夺疗法(ADT)。然而，关于ADT和CRCD之间的关联的文献仍然是混合的， 提示其他因素可能在慢性阻塞性肺疾病中起作用。来自其他人群的越来越多的研究表明 共病症状(焦虑、抑郁、疲劳、失眠、夜尿)可能会导致认知功能障碍。 这些症状在PC幸存者中很常见，但它们在CRCD中的作用在 个人电脑数量。扩大CRCD研究，超越不可修改的因素(先前的ADT暴露)和 关注可改变的因素(共病症状)有可能成为新的治疗方法的依据。 用于CRCD。根据刘博士的初步研究，针灸可以直接改善客观CRCD，但它可能 通过共病症状间接改善主观性慢性阻塞性肺疾病。受这项先前工作的启发，刘博士将测试 一种新的针灸干预方法，直接针对慢性阻塞性肺疾病，可选择联合治疗症状 与慢性阻塞性肺疾病同时发生。研究：刘博士将评估共病症状之间的联系 和CRCD在一项关于PC幸存者的横断面研究中(目标1)。然后，刘博士将评估可行性并 针刺治疗慢性阻塞性肺疾病及其合并症的初步疗效 PC幸存者(目标2)。职业发展：刘博士将获得CRCD评估、PC的能力 症状科学、临床试验设计、生物统计学和拨款撰写。他的训练将由 指导、课程作业、独立学习、讲习班、会议和手稿的准备以及 资助金。导师：刘博士将由国际公认的研究人员组成的团队进行指导 CRCD、神经心理评估、PC症状科学、综合性专业知识互补 医学、肿瘤学针灸、临床试验设计、生物统计学和PC医学。环境： 纪念斯隆·凯特琳癌症中心将为这项研究提供机构支持和资源。 影响：拟议的研究有可能促进对慢性阻塞性肺疾病的多因素理解并扩大 影响老年PC人群的普遍症状的非药物治疗选择。刘医生会 获得初步数据以支持竞争性R01拨款申请，以测试针灸的疗效 用于慢性阻塞性肺疾病和PC幸存者的共病症状。这一奖项将为独立的 在个人电脑生存护理、认知健康和综合肿瘤学方面具有持续影响的研究计划。

PROJECT SUMMARY This career development award, Acupuncture for Cognitive Health in Older Survivors of Prostate Cancer (ACHIEVE), will train Dr. Liou to become an independent clinician-investigator with expertise in integrative therapies for cognitive health and symptom management in prostate cancer (PC) survivors. BACKGROUND: By 2030, PC survivors are expected to become the largest group of cancer survivors in the United States. Cancer-related cognitive dysfunction (CRCD) is a significant concern in this growing population, but evidence- based treatments are lacking. Most CRCD studies in PC have focused on the neuro-toxicities of androgen deprivation therapy (ADT). However, the literature on the association between ADT and CRCD remains mixed, suggesting other factors may play a role in CRCD. Growing research from other populations demonstrates that co-morbid symptoms (anxiety, depression, fatigue, insomnia, nocturia) may contribute to cognitive dysfunction. These symptoms are prevalent among PC survivors, but their role in CRCD remains poorly understood in the PC population. Expanding CRCD research beyond the non-modifiable factors (prior ADT exposure) and focusing on modifiable factors (co-morbid symptoms) has the potential to inform novel treatments approaches for CRCD. Based on Dr. Liou’s preliminary studies, acupuncture improves objective CRCD directly, but it may improve subjective CRCD indirectly through co-morbid symptoms. Informed by this prior work, Dr. Liou will test a novel acupuncture intervention that directly targets CRCD with the optionality to jointly address symptoms co-occurring with CRCD. RESEARCH: Dr. Liou will evaluate the association between co-morbid symptoms and CRCD in a cross-sectional study of PC survivors (Aim 1). Dr. Liou will then evaluate the feasibility and preliminary effects of acupuncture for CRCD and co-morbid symptoms in a pilot randomized controlled trial of PC survivors (Aim 2). CAREER DEVELOPMENT: Dr. Liou will acquire competence in CRCD evaluation, PC symptom science, clinical trial design, biostatistics, and grant-writing. His training will be supported by mentorship, coursework, independent study, workshops, conferences, and preparation of manuscripts and grants. MENTORS: Dr. Liou will be mentored by a team of internationally-recognized researchers with complementary expertise in CRCD, neuropsychological assessment, PC symptom science, integrative medicine, oncology acupuncture, clinical trial design, biostatistics, and PC medicine. ENVIRONMENT: Memorial Sloan Kettering Cancer Center will provide the institutional support and resources for the research. IMPACT: The proposed studies have potential to advance multi-factorial understanding of CRCD and expand non-pharmacological treatment options for prevalent symptoms affecting the aging PC population. Dr. Liou will acquire the preliminary data to support a competitive R01 grant application to test the efficacy of acupuncture for CRCD and comorbid symptoms in PC survivors. This award will establish the foundation for an independent research program with sustained impact in PC survivorship care, cognitive health, and integrative oncology.