Department of Population Health & Disease Prevention, University of California, Irvine, CA, USA.
Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA.
Am J Mens Health. 2021 Sep-Oct;15(5):15579883211044557. doi: 10.1177/15579883211044557.
Despite the substantial adverse psychological impact of testicular cancer, few interventions have sought to improve psychosocial functioning and stress-related biomarkers in young adult survivors. oal-focused motion-regulation herapy (GET) is designed to improve distress symptoms, emotion regulation, and goal navigation skills, which would be expected to improve regulation of stress-sensitive biomarkers. The aim was to examine the effects of GET versus an active control intervention on salivary stress and circulating inflammatory markers in young adult survivors of testicular cancer. Young adult men with testicular cancer ( = 44) who had undergone chemotherapy within the last 2 years were randomized to GET or individual supportive therapy (ISP) delivered over 8 weeks. Saliva samples were collected for 2 consecutive days at baseline and post-intervention (awakening, 8 hr later, bedtime) to measure diurnal rhythm. Circulating plasma levels of CRP, IL-6, IL-1ra, TNFαRII, and VEGF were measured at baseline and post-intervention. Regression modeling demonstrated a significant group effect on daily output of salivary cortisol (area under the curve) (β = -57, < .05), with cortisol output decreasing from baseline to post-intervention for those receiving GET (Cohen's = 0.45). There were no significant intervention effects in salivary alpha-amylase. Plasma levels of IL-1ra were significantly lower post-intervention in GET compared to ISP; no other significant plasma effects were observed. GET, an intervention designed to promote goal-related and emotion-focused self-regulation, has potential to mitigate stress-related processes and inflammation in this young adult survivor group. More research is needed to determine efficacy.
尽管睾丸癌会对患者造成严重的心理负面影响，但很少有干预措施旨在改善青年成年睾丸癌幸存者的社会心理功能和与应激相关的生物标志物。以目标为导向的运动调节治疗（GET）旨在改善困扰症状、情绪调节和目标导航技能，这有望改善应激敏感生物标志物的调节。本研究旨在探讨 GET 与积极对照干预对睾丸癌青年成年幸存者唾液应激和循环炎症标志物的影响。在过去 2 年内接受过化疗的睾丸癌青年成年男性（n=44）被随机分配至 GET 组或个体支持性治疗（ISP）组，干预时长为 8 周。在基线和干预后（觉醒后、8 小时后、睡前）连续 2 天采集唾液样本，以测量昼夜节律。在基线和干预后测量循环血浆中 CRP、IL-6、IL-1ra、TNFαRII 和 VEGF 的水平。回归模型显示，在唾液皮质醇（曲线下面积）的日常输出方面，存在显著的组间效应（β=-57，<0.05），接受 GET 治疗的患者从基线到干预后皮质醇输出减少（Cohen's =0.45）。唾液α-淀粉酶没有显著的干预效应。与 ISP 相比，GET 组干预后 IL-1ra 的血浆水平显著降低；未观察到其他显著的血浆效应。GET 是一种旨在促进与目标相关和以情绪为焦点的自我调节的干预措施，有可能减轻该青年成年幸存者群体的应激相关过程和炎症。需要进一步的研究来确定其疗效。
