Impact of exercise on ovarian cancer prognosis

卵巢癌导致的死亡人数超过女性生殖系统的任何其他癌症。然而，在这方面， 手术技术和化疗的改进提高了5年生存率 从1976年的37%到2006年的45%由于治疗方式的进步，卵巢癌的数量 主要目标是最大限度地提高无病生存率和维持生活质量的癌症幸存者 (QOL)在增长因此，生存问题变得越来越重要。各种研究报告 卵巢癌患者生活质量差。需要研究开发和测试干预措施，以改善生活质量， 卵巢癌幸存者目前，美国癌症协会建议， 癌症幸存者，以提高癌症和其他慢性病的无病生存率，并改善 生活质量研究表明，身体活动对改善其他类型癌症后的生活质量有很大益处 治疗，例如，乳腺癌，在文献中有很好的记录，但很少有研究的体力活动， 和卵巢癌诊断后的生活质量已经发表。也没有公布数据 研究体力活动是否可以提高卵巢癌生存率或生存率的替代标志物。 虽然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， 因为肥胖在一些研究中已经显示，但不是全部，与生存率呈负相关。结果 观察性研究还表明，体力活动与卵巢癌风险之间存在负相关关系。 癌肥胖和低水平的身体活动之间的联系的可能的生物学解释 不活动和卵巢癌的风险和死亡率涉及雌激素，胰岛素，胰岛素样 生长因子（IGFs）C反应蛋白（CRP）、瘦素、CA-125、催乳素、骨桥蛋白和巨噬细胞 抑制因子考虑到我们对健康人群进行运动干预的随机试验的结果， 女性和乳腺癌幸存者，以及我们对卵巢癌幸存者的QOL干预，一项研究 运动对改善卵巢癌幸存者生活质量和预后替代指标的影响， 有正当理由我们建议在230名诊断为I-III期卵巢癌的久坐妇女中， 6个月中等强度有氧运动干预与注意力控制对生活质量的影响， 预后的替代标志物。女性将被随机分配到锻炼计划组或注意力控制组。 随机分配到运动组的女性每周将参加150分钟的有氧运动（例如，五个30分钟 会话/周）。我们将进行基线和6个月的门诊访视，以评估运动对QOL的影响， 替代标记。我们的研究是在癌症幸存者中进行的最大规模的运动试验，可能是一个“主要证据”， 将提供关键信息，以了解潜在的机制，通过这些机制，身体活动可能 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.