Effects of bright light on co-occurring cancer-related symptoms in breast cancer survivors: A personalized intervention

项目摘要/摘要 患有癌症的人数正在快速增长，到2024年将达到1900万人。超过50%的 癌症幸存者在治疗完成后会同时出现多种症状。有迫切的需要 寻求可以同时管理多种症状的有效策略。昼夜节律之间的联系 目前的文献和我们的初步数据支持畸形和癌症相关症状。 治疗强光在治疗昼夜节律睡眠障碍和缓解疾病方面显示出有效性。 与昼夜节律异常有关的各种症状。尽管之前的试验表明那天早上 据观察，在化疗期间和化疗后，明亮的光线可以防止疲劳和生活质量恶化 由于没有考虑昼夜节律模式的个体差异，这种影响可能已经受到了影响。 这项初步研究的目的是评估实施个性化强光的可行性。 干预和评估强光对4种常见的癌症长期或晚期影响(睡眠)的影响 障碍、疲劳、抑郁和认知功能障碍)和对治疗后幸存者生活质量的影响 乳腺癌。为了测试我们假设的机制，强光对昼夜节律的影响也将是 检查过了。长期目标是确定强光的治疗效果，并开发有效的 减轻癌症相关多种症状的干预措施对患者自身是可行的 管理层。具体目标是：1)评估实施基于家庭的、个性化的 强光干预和建议的数据收集计划；2)评估强光对睡眠的影响 干扰、疲劳、抑郁、认知和生活质量，以及3)对昼夜节律的影响 乳腺癌。这项随机对照的初步研究将招募34名患有I-III期乳房的女性幸存者 癌症。参与者将随机接受12,000勒克斯或暗淡的30分钟蓝绿光治疗 红灯控制在5勒克斯。灯光将在家中使用遮光帽进行连续14天的自我管理。 根据个体的昼夜规律量身定做，光线将在醒来后30分钟内到达 早上或晚上1900-2000小时之间。夜间睡眠模式将由所有人监测- 夜间实验室多导睡眠监测；睡眠质量、疲劳、抑郁和生活质量将自我报告； 干预前后将对认知情况进行客观评估。昼夜节律将由 干预前后夜间核心体温。可行性将由 联系、招募和保留受试者的比例，以及收集的数据的完整性。主观性 反馈和负担将在研究结束时进行评估。

PROJECT SUMMARY/ABSTRACT Numbers of individuals living with cancer are fast growing, reaching 19 million by 2024. More than 50% of cancer survivors live with multiple concurrent symptoms after treatment completion. There is immediate need for effective strategies that can manage multiple symptoms simultaneously. Linkages between circadian aberrations and cancer-associated symptoms are supported by the current literature and our preliminary data. Therapeutic bright light has shown effectiveness in treating circadian rhythm sleep disorders and alleviating various symptoms associated with circadian aberrations. Although previous trials have shown that morning bright light prevented fatigue and quality of life from worsening during and after chemotherapy, those observed effects may have been compromised because individual differences in circadian patterns were not considered. The objective of this pilot study is to evaluate the feasibility of implementing a personalized bright light intervention and to estimate the effects of bright light on 4 common long-term or late effects of cancer (sleep disturbance, fatigue, depression, and cognitive dysfunction) and on quality of life in post-treatment survivors of breast cancer. To test our hypothesized mechanism, effects of bright light on circadian rhythms will also be examined. The long term goal is to identify the therapeutic effect of bright light and to develop effective interventions to attenuate multiple symptoms associated with cancer that are feasible for patient self- management. The specific aims are: 1) To assess the feasibility of implementing a home-based, personalized bright light intervention and the proposed data collection plan; 2) To estimate the effect of bright light on sleep disturbance, fatigue, depression, cognition, and quality of life, and 3) on circadian rhythms, in survivors of breast cancer. This randomized, controlled pilot study will recruit 34 female survivors with Stage I-III breast cancer. The participants will be randomized to either 30-minute blue-green light therapy at 12,000 lux or dim red light control at 5 lux. Light will be self-administered using a light visor cap at home for 14 consecutive days. Tailored to the individual's circadian pattern, light will be delivered either within 30 minutes of waking in the morning or between 1900-2000 hours in the evening. The nocturnal sleep patterns will be monitored by all- night in-lab polysomnography; sleep quality, fatigue, depression, and quality of life will be self-reported; cognition will be objectively assessed before and after the intervention. Circadian rhythm will be indexed by nocturnal core body temperature before and after the intervention. Feasibility will be determined by the proportion of contacted, recruited, and retained subjects, and completeness of the data collected. Subjective feedback and burden will be assessed at study exit.