Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, # 0733, La Jolla, CA 92093-0733, USA.
Support Care Cancer. 2012 Jun;20(6):1211-9. doi: 10.1007/s00520-011-1203-z. Epub 2011 Jun 11.
Fatigue is one of the most disturbing complaints of cancer patients and is often the reason for discontinuing treatment. This randomized controlled study tested the hypothesis that increased morning bright light, compared to dim light, would result in less fatigue in women with breast cancer undergoing chemotherapy.
Thirty-nine women newly diagnosed with stage I-III breast cancer were randomized to either bright white light (BWL) or dim red light (DRL) treatment and were instructed to use the light box for 30 min every morning throughout the first four cycles of chemotherapy. The Multidimensional Fatigue Symptom Inventory was administered prior to the start of chemotherapy (baseline), during the chemotherapy treatment week of cycle 1 (C1TW), the last week (recovery week) of cycle 1 (C1RW), the chemotherapy treatment week of cycle 4 (C4TW), and the last week (recovery week) of cycle 4 (C4RW).
The DRL group reported increased fatigue at C1TW (p = 0.003) and C4TW (p < 0.001) compared to baseline, while there was no significant change from baseline in the BWL group. A secondary analysis showed that the increases in fatigue levels in the DRL group were not mediated through nor associated with changes in sleep or in circadian rhythms as measured with wrist actigraphy.
The results of this study suggest that morning bright light treatment may prevent overall fatigue from worsening during chemotherapy. Although our hypothesis that overall fatigue would improve with bright light treatment was not supported, the lack of deterioration in total fatigue scores suggests that bright morning light may be a useful intervention during chemotherapy for breast cancer.
疲劳是癌症患者最困扰的症状之一,往往也是停止治疗的原因。本随机对照研究旨在检验以下假设,即与暗光相比,增加早晨明亮的光线会减少正在接受化疗的乳腺癌女性的疲劳感。
39 名新诊断为 I-III 期乳腺癌的女性被随机分配至明亮白光(BWL)或暗淡红光(DRL)治疗组,并被指示在化疗的前四个周期的每个早晨使用光盒 30 分钟。在化疗开始前(基线)、第 1 周期化疗治疗周(C1TW)、第 1 周期最后一周(恢复期)(C1RW)、第 4 周期化疗治疗周(C4TW)和第 4 周期最后一周(恢复期)(C4RW)时,使用多维疲劳症状量表进行评估。
与基线相比,DRL 组在 C1TW(p = 0.003)和 C4TW(p < 0.001)时报告的疲劳感增加,而 BWL 组在这两个时间点的疲劳感均无显著变化。二次分析表明,DRL 组疲劳水平的增加并非通过睡眠或腕动仪测量的昼夜节律变化来介导或与之相关。
本研究结果表明,早晨明亮的光线治疗可能会防止化疗期间整体疲劳感恶化。尽管我们关于明亮光线治疗会改善整体疲劳感的假设没有得到支持,但总疲劳评分没有恶化表明,在乳腺癌化疗期间,早晨明亮的光线可能是一种有用的干预措施。