Association of Time-Varying Rest-Activity Rhythm With Survival in Older Adults With Lung Cancer

Abstract

Background To the best of our knowledge, this is the first study to examine the relationship of rest-activity rhythm with survival in older adults with lung cancer and to consider variations in rest-activity rhythm over time. Objective The aim of this study was to explore the relationship between rest-activity rhythm variations and survival in 33 older adults with lung cancer by considering rest-activity rhythm as a time-dependent covariate over time. Methods In this prospective study with 5 repeated measurements, patients' rest-activity rhythm over 3 days was measured using actigraphy. The rest-activity rhythm was represented using the dichotomy index I (in-bed activity) < O (out-of-bed activity). The median I < O was used as the cutoff point, with an I < O of greater than or equal to 85.59% and less than 85.59% indicating robust and disrupted rest-activity rhythms, respectively. Data were analyzed using the Cox regression model with time-dependent repeated measurements of a covariate. Results In the time-dependent multivariate Cox model, a disrupted rest-activity rhythm was independently associated with a higher risk of death than was a robust rest-activity rhythm (hazard ratio, 16.05; P = .009). Conclusion A time-varying rest-activity rhythm is incrementally associated with mortality in older adults with lung cancer and represents a rigorous and independent prognostic factor for their survival. Implications for Practice Clinicians may need to pay more attention to the rest-activity rhythms of older adults with lung cancer during disease progression. Future studies should account for the variation in rest-activity rhythm over time.

Circadian and chemotherapy-related changes in urinary modified nucleosides excretion in patients with metastatic colorectal cancer

“…Indeed, progression-free survival and overall survival were significantly improved in metastatic colorectal cancer patients whose I < O exceeded 97.5% 14 . This finding has been confirmed in other oncological clinical settings 36 , 37 .…”

Inter- and intra-patient circadian variabilities in eight urinary modified nucleosides excretion in patients with metastatic colorectal cancer

“…Indeed, progression-free survival and overall survival were significantly improved in metastatic colorectal cancer patients whose I<O exceeded 97.5% [14]. This finding has been confirmed in other oncological clinical settings [45,46].…”

Sleep During Oncological Treatment – A Systematic Review and Meta-Analysis of Associations With Treatment Response, Time to Progression and Survival

“…A total of 13 different cancer diagnoses were represented in the 26 studies. The most frequently investigated cancers were colorectal cancer reported in six studies ( Mormont et al, 2000 ; Maisey et al, 2002 ; Innominato et al, 2009 , 2012 , 2015 ; Lévi et al, 2014 ), non-small cell lung cancer in six studies ( Naughton et al, 2002 ; Braun et al, 2011 ; Zhao et al, 2013 ; Chang and Lin, 2014 ; Gottfried et al, 2020 ; Kuo et al, 2020 ), and breast cancer in five studies ( Geels et al, 2000 ; Kramer et al, 2000 ; Zhao et al, 2013 ; Chang and Lin, 2014 ; Palesh et al, 2014 ). In four studies, the sample consisted of mixed cancer populations ( Zhao et al, 2013 ; Chang and Lin, 2014 ; Collins et al, 2017 ; Chandra et al, 2019 ).…”

“…g Sensitivity analysis, including only studies based on the EORTC QLQ-C30 questionnaire. h Sensitivity analysis omitting Kuo et al (2020) , an outlier with a HR (5.57) approaching (93%) two standard deviations from the pooled HR.…”