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

项目总结/摘要 患有癌症的人数正在快速增长，到2024年将达到1900万。的50%以上 癌症幸存者在治疗完成后仍有多种并发症状。有迫切的需要 寻找可以同时处理多种症状的有效策略。昼夜节律之间的联系 畸变和癌症相关症状得到了当前文献和我们的初步数据的支持。 治疗性强光在治疗昼夜节律睡眠障碍和缓解 与昼夜节律失常有关的各种症状。尽管之前的审判显示那天早上 观察到，明亮的光线可以防止化疗期间和化疗后的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，因此可能会影响效果。 这项试验性研究的目的是评估实施个性化亮光的可行性 干预，并估计明亮的光对癌症的4种常见的长期或晚期影响（睡眠）的影响。 干扰，疲劳，抑郁和认知功能障碍）和治疗后幸存者的生活质量 乳腺癌为了测试我们假设的机制，我们还将研究强光对昼夜节律的影响。 考察长期目标是确定明亮光线的治疗效果， 减轻与癌症相关的多种症状的干预措施， 管理具体目标是：1）评估实施以家庭为基础的个性化 强光干预和建议的数据收集计划; 2）估计强光对睡眠的影响 干扰，疲劳，抑郁，认知和生活质量，和3）昼夜节律，在幸存者 乳腺癌这项随机、对照的初步研究将招募34名I-III期乳腺癌女性幸存者。 癌参与者将被随机分配到12，000勒克斯或昏暗的30分钟蓝绿光治疗 红灯控制在5勒克斯。将在家中使用遮光帽进行自我光照，连续14天。 根据个人的昼夜节律模式，光线将在醒来后30分钟内提供， 早上或晚上1900-2000之间。夜间睡眠模式将由所有人监控- 夜间实验室多导睡眠描记;自我报告睡眠质量、疲劳、抑郁和生活质量; 在干预前后将对认知进行客观评估。昼夜节律将由以下指标索引： 干预前后的夜间核心体温。可行性将由 联系、招募和保留的受试者比例以及收集的数据的完整性。主观 将在研究退出时评估反馈和负担。

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.