Acupuncture for Cognitive Health in Older Survivors of Prostate Cancer (ACHIEVE)

项目摘要 这个职业发展奖，针灸对老年前列腺癌幸存者的认知健康 （ACHIEVE），将培训Liou博士成为一名独立的临床研究者，具有综合性的专业知识。 前列腺癌（PC）幸存者的认知健康和症状管理治疗。背景技术背景： 到2030年，PC幸存者预计将成为美国最大的癌症幸存者群体。 癌症相关认知功能障碍（CRCD）是这一不断增长的人口中的一个重要问题，但证据- 缺乏基础治疗。PC中的大多数CRCD研究集中在雄激素的神经毒性 剥夺疗法（ADT）。然而，关于ADT与CRCD之间相关性的文献仍不一致， 提示其他因素可能在CRCD中起作用。越来越多的其他人群的研究表明， 共病症状（焦虑、抑郁、疲劳、失眠、失眠）可能导致认知功能障碍。 这些症状在PC幸存者中普遍存在，但在CRCD中对它们的作用仍然知之甚少。 PC人口。将CRCD研究扩展到不可改变的因素（既往ADT暴露）之外， 关注可变因素（共病症状）有可能为新的治疗方法提供信息 为CRCD。根据Liou博士的初步研究，针灸直接改善了客观CRCD，但它可能 通过共病症状间接改善主观CRCD。根据之前的工作，Liou博士将测试 一种直接针对CRCD的新型针灸干预，可选择联合治疗症状 与CRCD同时发生。研究：Liou博士将评估共病症状之间的关联 和CRCD在PC幸存者的横断面研究（目的1）。Liou博士将评估可行性， 针灸治疗CRCD和共病症状的初步随机对照试验 PC幸存者（目标2）。职业发展：Liou博士将获得CRCD评估，PC 症状科学，临床试验设计，生物统计学和赠款写作。他的训练将得到 指导，课程，独立学习，研讨会，会议，和手稿的准备， 赠款。导师：Liou博士将由国际公认的研究人员团队指导， CRCD、神经心理学评估、PC症状科学、综合 医学，肿瘤针灸，临床试验设计，生物统计学和PC医学。工作环境： 纪念斯隆凯特琳癌症中心将为这项研究提供机构支持和资源。 影响：拟议的研究有可能促进对CRCD的多因素理解， 非药物治疗选择的流行症状影响老龄PC人群。刘医生会 获得初步数据，以支持竞争性R 01赠款申请，以测试针灸的疗效 PC幸存者中CRCD和共病症状。该奖项将为独立的 在PC生存护理，认知健康和综合肿瘤学方面具有持续影响的研究计划。

PROJECT SUMMARY This career development award, Acupuncture for Cognitive Health in Older Survivors of Prostate Cancer (ACHIEVE), will train Dr. Liou to become an independent clinician-investigator with expertise in integrative therapies for cognitive health and symptom management in prostate cancer (PC) survivors. BACKGROUND: By 2030, PC survivors are expected to become the largest group of cancer survivors in the United States. Cancer-related cognitive dysfunction (CRCD) is a significant concern in this growing population, but evidence- based treatments are lacking. Most CRCD studies in PC have focused on the neuro-toxicities of androgen deprivation therapy (ADT). However, the literature on the association between ADT and CRCD remains mixed, suggesting other factors may play a role in CRCD. Growing research from other populations demonstrates that co-morbid symptoms (anxiety, depression, fatigue, insomnia, nocturia) may contribute to cognitive dysfunction. These symptoms are prevalent among PC survivors, but their role in CRCD remains poorly understood in the PC population. Expanding CRCD research beyond the non-modifiable factors (prior ADT exposure) and focusing on modifiable factors (co-morbid symptoms) has the potential to inform novel treatments approaches for CRCD. Based on Dr. Liou’s preliminary studies, acupuncture improves objective CRCD directly, but it may improve subjective CRCD indirectly through co-morbid symptoms. Informed by this prior work, Dr. Liou will test a novel acupuncture intervention that directly targets CRCD with the optionality to jointly address symptoms co-occurring with CRCD. RESEARCH: Dr. Liou will evaluate the association between co-morbid symptoms and CRCD in a cross-sectional study of PC survivors (Aim 1). Dr. Liou will then evaluate the feasibility and preliminary effects of acupuncture for CRCD and co-morbid symptoms in a pilot randomized controlled trial of PC survivors (Aim 2). CAREER DEVELOPMENT: Dr. Liou will acquire competence in CRCD evaluation, PC symptom science, clinical trial design, biostatistics, and grant-writing. His training will be supported by mentorship, coursework, independent study, workshops, conferences, and preparation of manuscripts and grants. MENTORS: Dr. Liou will be mentored by a team of internationally-recognized researchers with complementary expertise in CRCD, neuropsychological assessment, PC symptom science, integrative medicine, oncology acupuncture, clinical trial design, biostatistics, and PC medicine. ENVIRONMENT: Memorial Sloan Kettering Cancer Center will provide the institutional support and resources for the research. IMPACT: The proposed studies have potential to advance multi-factorial understanding of CRCD and expand non-pharmacological treatment options for prevalent symptoms affecting the aging PC population. Dr. Liou will acquire the preliminary data to support a competitive R01 grant application to test the efficacy of acupuncture for CRCD and comorbid symptoms in PC survivors. This award will establish the foundation for an independent research program with sustained impact in PC survivorship care, cognitive health, and integrative oncology.