a Chronobiology and Animal Behaviour Laboratory, School of Studies in Life Science , Pt. Ravishankar Shukla University , Raipur , Chhattisgarh , India.
b Center for Translational Chronobiology , Pt. Ravishankar Shukla University , Raipur , Chhattisgarh , India.
Chronobiol Int. 2018 Oct;35(11):1513-1532. doi: 10.1080/07420528.2018.1493596. Epub 2018 Jul 9.
Chemotherapy administration may result in the disruption of circadian rhythms and impairment of quality of life (QoL) of cancer patients. Nevertheless, we have little knowledge on the long-term consequences of chemotherapy and the effects of hospitalization. In the present study, we employed the two-factor repeated-measure cross-sectional design to determine the effects of chemotherapy and hospitalization on rest-activity (RA) rhythm and QoL of breast cancer patients. Initially, we randomly selected 39 inpatients and 42 outpatients, scheduled to receive six cycles of chemotherapy, from the Regional Cancer Center (RCC), Raipur, India. Finally, 30 patients in each group were included in the current study. We monitored circadian RA rhythm and QoL using wrist actigraphy and QLQ-C30 and QLQ-BR23, respectively, during the 1st (C1), 3rd (C3) and 6th (C6) chemotherapy cycles. Results revealed that with the progression of chemotherapy cycles (from C1 to C6), all rhythm parameters, namely mesor, amplitude, acrophase, rhythm quotient (RQ), circadian quotient (CQ), peak activity (PA), dichotomy index and autocorrelation coefficient, significantly decreased in both cancer in- and outpatients. In both groups of patients and during C1-C6, all functional and global QoL measures of QLQ-C30 and QLQ-BR23 significantly decreased and the symptoms significantly increased, except constipation, body image, sexual functioning and future perspectives in outpatients. The hospitalization exacerbated the problems associated with the RA rhythm and the QoL of the patients. In conclusion, the current study highlighted the negative consequences of hospitalization among inpatients, irrespective of the stage of cancer. We, therefore, recommend that cancer patients should be administered with chemotherapy as outpatients. The proposed protocol might have a covert bearing on the expression of better physiological state leading to satisfactory treatment outcomes.
化疗可能会打乱癌症患者的昼夜节律，影响其生活质量（QoL）。然而，我们对化疗的长期后果以及住院的影响知之甚少。在本研究中，我们采用两因素重复测量的横断面设计，来确定化疗和住院对乳腺癌患者的静息-活动（RA）节律和生活质量的影响。首先，我们从印度 Raipur 的地区癌症中心（RCC）随机选择了 39 名住院患者和 42 名门诊患者，他们计划接受 6 个周期的化疗。最后，每组各有 30 名患者纳入本研究。我们使用腕动描记术监测昼夜 RA 节律，使用 QLQ-C30 和 QLQ-BR23 分别监测 QoL，在第 1 个（C1）、第 3 个（C3）和第 6 个（C6）化疗周期中进行监测。结果表明，随着化疗周期的进展（从 C1 到 C6），所有节律参数，即中值、幅度、高峰时间、节律商（RQ）、昼夜商（CQ）、峰值活动（PA）、二分法指数和自相关系数，在住院和门诊患者中均显著降低。在两组患者中，在 C1-C6 期间，QLQ-C30 和 QLQ-BR23 的所有功能和整体 QoL 测量值均显著降低，除了门诊患者的便秘、身体形象、性功能和未来展望外，症状也显著增加。住院加重了患者的 RA 节律和生活质量问题。总之，本研究强调了住院对住院患者的负面影响，而与癌症的阶段无关。因此，我们建议癌症患者应作为门诊患者接受化疗。所提出的方案可能会对更好的生理状态的表达产生隐蔽的影响，从而带来满意的治疗结果。
