Impact of exercise on ovarian cancer prognosis

卵巢癌导致的死亡比女性生殖系统的任何其他癌症都要多。然而， 手术技术和化疗的改进提高了5年存活率。 从1976年的37%上升到2006年的45%。由于治疗方式的进步，卵巢细胞的数量 癌症幸存者，他们的主要目标是最大限度地提高无病生存率和维持生活质量 (QOL)正在增长。因此，生存问题正变得越来越重要。多项研究报告 卵巢癌患者的生活质量较差。需要研究来开发和测试改善中国人生活质量的干预措施 卵巢癌幸存者。目前，美国癌症协会推荐身体活动的生活方式 癌症幸存者增加癌症和其他慢性病的无病存活率，并改善 生活质量。体力活动对改善其他类型癌症患者生活质量的研究 治疗方法，如乳腺癌，在文献中有很好的记载；但对体力活动的研究却很少 和卵巢癌诊断后的生活质量相继发表。也没有已发布的数据 检查体育锻炼是否可以提高卵巢癌的存活率或替代存活期的标记物。 尽管运动对卵巢癌生存率的影响尚不清楚，但它可能通过控制体重发挥作用， 因为肥胖已经在一些研究中被证明与生存负相关，但不是全部。结果 观察性研究还表明，体力活动与卵巢疾病风险之间存在负相关。 癌症。肥胖与低体力水平之间联系的可能生物学解释 不活动与卵巢癌风险和死亡率涉及雌激素、胰岛素、胰岛素样物质的潜在作用 生长因子(IGF)、C反应蛋白(CRP)、瘦素、CA-125、催乳素、骨桥蛋白和巨噬细胞 抑制因子。鉴于我们对健康人群进行运动干预的随机试验结果令人振奋 女性和乳腺癌幸存者，以及我们对卵巢癌幸存者的生活质量干预：一项试验 运动对改善卵巢癌幸存者的生活质量和替代预后标记物的影响是 这是正当的。我们建议在230名被诊断为I-III期卵巢癌的久坐女性中评估 为期6个月的中等强度有氧运动干预与注意力控制对生活质量和生活质量的影响 预后的替代标志物。女性将被随机分配到锻炼计划或注意力控制组。 被随机安排参加锻炼的女性将参加每周150分钟的有氧运动(例如，5次30分钟 会话/周)。我们将进行基线和为期6个月的临床访问，以评估锻炼对生活质量和 代孕标记。我们的研究是对癌症幸存者进行的最大规模的运动试验，可能是一种“原则证明”，而且 将为理解体力活动可能通过的潜在机制提供关键信息 影响卵巢癌风险和预后。

Ovarian cancer results in more deaths than any other cancer of the female reproductive system. However, improvements in surgical techniques and chemotherapy have led to an increase in the 5-year survival rate from 37% in 1976 to 45% in 2006. Because of advances in therapeutic modalities, the number of ovarian cancer survivors for whom primary goals are to maximize disease-free survival and maintain quality of life (QOL) is growing. As such, survivorship issues are becoming increasingly important. Various studies report poor QOL in ovarian cancer patients. Research is needed to develop and test interventions to improve QOL in ovarian cancer survivors. Currently, the American Cancer Society recommends a physically active lifestyle for cancer survivors to increase disease-free survival from cancer and other chronic diseases, and to improve quality of life. Studies of a strong benefit of physical activity on improving QOL following other types of cancer treatment, e.g., breast cancer, are well documented in the literature; yet very few studies of physical activity and QOL after a diagnosis of ovarian cancer have been published. There are also no published data examining whether physical activity may improve ovarian cancer survival or surrogate markers of survival. Although the impact of exercise on ovarian cancer survival is unknown, it may play a role via weight control, since obesity has been shown in some studies, but not all, to be negatively associated with survival. Results from observational studies also suggest an inverse association between physical activity and risk of ovarian cancer. Possible biological explanations for the associations between obesity and low levels of physical inactivity and ovarian cancer risk and mortality involve the potential role of estrogens, insulin, insulin-like growth factors (IGFs) C-reactive protein (CRP), leptin, CA-125, prolactin, osteopontin, and macrophage inhibitory factor. Given the promising results from our randomized trials of exercise interventions in healthy women and breast cancer survivors, and our QOL interventions in ovarian cancer survivors, a trial examining the impact of exercise in improving QOL and surrogate markers of prognosis in ovarian cancer survivors is warranted. We propose to evaluate, in 230 sedentary women diagnosed with Stage I-III ovarian cancer, the impact of a 6-month, moderate-intensity, aerobic exercise intervention vs. attention control upon QOL and surrogate markers of prognosis. Women will be randomized to an exercise program or attention control group. Women randomized to exercise will participate in 150 minutes of aerobic exercise per week (e.g., five 30-min sessions/wk). We will conduct baseline and 6-month clinic visits to evaluate the effect of exercise on QOL and surrogate markers. Our study, the largest exercise trial in cancer survivors, could be a "proof of principal" and will provide critical information in understanding the potential mechanisms through which physical activity may impact ovarian cancer risk and prognosis.