Yale School of Medicine, New Haven, CT, USA.
Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA.
Br J Cancer. 2023 Aug;129(2):283-290. doi: 10.1038/s41416-023-02290-2. Epub 2023 May 13.
We sought to assess the influences of sleep duration, sleep adequacy, and daytime sleepiness on survival outcomes among Stage III colon cancer patients.
We conducted a prospective observational study of 1175 Stage III colon cancer patients enrolled in the CALGB/SWOG 80702 randomised adjuvant chemotherapy trial who completed a self-reported questionnaire on dietary and lifestyle habits 14-16 months post-randomisation. The primary endpoint was disease-free survival (DFS), and secondary was overall survival (OS). Multivariate analyses were adjusted for baseline sociodemographic, clinical, dietary and lifestyle factors.
Patients sleeping ≥9 h-relative to 7 h-experienced a worse hazard ratio (HR) of 1.62 (95% confidence interval (CI), 1.01-2.58) for DFS. In addition, those sleeping the least (≤5 h) or the most (≥ 9 h) experienced worse HRs for OS of 2.14 (95% CI, 1.14-4.03) and 2.34 (95% CI, 1.26-4.33), respectively. Self-reported sleep adequacy and daytime sleepiness showed no significant correlations with outcomes.
Among resected Stage III colon cancer patients who received uniform treatment and follow-up within a nationwide randomised clinical trial, very long and very short sleep durations were significantly associated with increased mortality. Interventions targeting optimising sleep health among indicated colon cancer patients may be an important method by which more comprehensive care can be delivered.
ClinicalTrials.gov Identifier: NCT01150045.
我们旨在评估睡眠时长、睡眠充足度和日间困倦对 III 期结肠癌患者生存结局的影响。
我们对 1175 例入组 CALGB/SWOG 80702 随机辅助化疗试验的 III 期结肠癌患者进行了前瞻性观察性研究，这些患者在随机分组后 14-16 个月完成了一份关于饮食和生活方式习惯的自我报告问卷。主要终点是无病生存期（DFS），次要终点是总生存期（OS）。多变量分析调整了基线社会人口统计学、临床、饮食和生活方式因素。
与睡眠 7 小时相比，睡眠≥9 小时的患者 DFS 的危险比（HR）为 1.62（95%置信区间（CI），1.01-2.58）。此外，睡眠最少（≤5 小时）或最多（≥9 小时）的患者 OS 的 HR 分别为 2.14（95% CI，1.14-4.03）和 2.34（95% CI，1.26-4.33）。自我报告的睡眠充足度和日间困倦与结局无显著相关性。
在全国范围内随机临床试验中，接受统一治疗和随访的 III 期结肠癌患者中，过长和过短的睡眠时间与死亡率升高显著相关。针对有针对性的结肠癌患者优化睡眠健康的干预措施可能是提供更全面护理的重要方法。
ClinicalTrials.gov 标识符：NCT01150045。
