Biobehavioral Effects of Qigong During Treatment for Rectal Cancer

描述（由申请人提供）：癌症及其治疗与相当大的痛苦、生活质量受损、精神健康状况不佳和身体功能下降有关。对于长期接受多模式治疗的直肠癌患者尤其如此。大多数患者将接受放射治疗，然后是手术，通常还有化疗。重要的是要制定方案，以帮助改善治疗相关的发病率，随着时间的推移积累的直肠癌患者。此外，考虑到接受放射治疗的紧张时间需求（患者通常每周接受5天治疗，持续6周），将治疗方案轻松纳入治疗计划至关重要。研究表明，针对癌症环境量身定制的减压计划可以帮助患者应对治疗的急性影响，并改善治疗后的生活质量。气功是一种古老的练习，通过操纵自己的气（能量流）来有益于身体、情感、精神或精神健康，它结合了减压技术，包括调节呼吸、视觉想象、冥想和各种轻柔的动作。气功可能对直肠癌患者在接受放射治疗时、手术和化疗前特别有用，因为气功的压力管理和放松技术以及温和的动作应该有助于恢复。在这个可行性/试点项目中，我们将试点和研究在直肠癌患者中开展气功项目作为辅助放疗的可行性和有效性。正在接受化疗的直肠癌患者将被随机分配到气功组（QI）、轻度运动对照组（LE）或候补对照组（WL）。QI组和LE组的参与者将在他们为期6周的放疗计划中每周参加3天的会议。会议将与治疗时间表协调，并在治疗设施附近进行。在随机化前、放射治疗中期、放射治疗最后一周、放射治疗结束后1个月和3个月进行简短评估。除了确定该计划的可接受性和可行性外，本研究还将检查气功计划对疲劳和睡眠障碍的影响。二级调节指标包括生活质量和心理健康。我们假设气功项目是可行的，病人会发现这个项目是可以接受的，是一种积极的体验。将气功项目整合到放疗患者的治疗方案中，会使患者相对容易参与到治疗方案中，我们假设气功项目有助于患者的康复，减轻正在接受放疗的患者所经历的心理和生理副作用。

DESCRIPTION (provided by applicant): Cancer and its treatment are associated with considerable distress, impaired quality of life, poor mental health, and reduced physical function. This is particularly true for patients with rectal cancer who receive multimodal treatment over an extended period of time. Most patients will undergo radiotherapy, followed by surgery and often chemotherapy. It is important to develop programs that can help ameliorate the treatment-related morbidity that accumulates over time for patients with rectal cancer. Furthermore, given the stressful time demands of undergoing radiotherapy (patients typically receive treatment 5 days per week for 6 weeks) it is crucial that programs be easily incorporated into the treatment schedule. Research suggests that stress- reduction programs tailored to the cancer setting help patients cope with the acute effects of treatment and improve QOL after treatment. Qigong, an ancient practice for manipulating one's own Qi (energy flow) to benefit one's physical, emotional, mental, or spiritual health incorporates stress-reduction techniques including regulated breathing, visual imagery, meditation, and various gentle movements. Qigong may be particularly useful for patients with rectal cancer while undergoing radiation treatment and prior to surgery and chemotherapy because of the stress management and relaxation techniques and the gentle movements that should facilitate recovery. In this feasibility/pilot project, we will pilot-test and examine the feasibility and usefulness of conducting a Qigong program with rectal cancer patients as an adjuvant to their radiotherapy treatment. Rectal cancer patients undergoing radiotherapy treatment will be randomly assigned Patients with rectal cancer who are undergoing chemo-radiotherapy will be randomly assigned to either a Qigong group (QI), or a light exercise control group (LE), or a waitlist control group (WL). Participants in the QI and LE groups will attend sessions 3 days/week throughout their 6-week radiotherapy schedule. The sessions will be coordinated with the treatment schedule and conducted adjacent to the treatment facility. Measures will be obtained prior to randomization, a brief assessment in the middle of radiotherapy, during last week of radiotherapy, and 1 and 3 months after the end of radiotherapy. In addition to determining the acceptability and feasibility of the program, this study will also examine the effects of the Qigong program on fatigue and sleep disturbances. Secondary indices of adjustment include QOL and mental health. We hypothesize that the Qigong program will be feasible and that patients will find the program acceptable and a positive experience. Integrating a Qigong program into the treatment regimen for patients undergoing radiotherapy will make it relatively easy to participate in the program and we hypothesize that such a program will help facilitate recovery and alleviate the psychological and physiological side effects experienced by patients who are currently undergoing radiotherapy. Public Health Relevance Paragraph: The proposed study will examine the feasibility and initial usefulness of incorporating a Qigong program alongside radiotherapy for patients with rectal cancer. If we find that the Qigong program facilitates recovery and alleviates the psychological and physiological side effects experienced by patients undergoing radiotherapy then this type of program can be incorporated into the treatment plan. As the proposed trial is a feasibility/pilot project a larger trial would need to be conducted and possibly include other cancer populations undergoing radiotherapy.