Cytokines and Symptoms in Lung Cancer treatment

描述(申请人提供)：肺癌、结直肠癌和食道癌患者经历与侵袭性癌症治疗有关的多种严重症状。通常这些症状是同时出现的。其中一些最常见的症状，特别是与癌症相关的疲劳，非常难以治疗，是患者和家人痛苦的主要来源。开发治疗或预防这些症状的新方法，特别是副作用最小的治疗方法，是当务之急，但这取决于对导致症状表现的机制的更好理解。先前的人类和动物研究表明，高水平的血清细胞因子可能是导致多种症状的机制之一(Cleeland等人，2003)。例如，已知白介素6在肺癌和结直肠癌中升高，并在治疗后下降。我们提议进行一项研究，纵向评估正在接受放化疗的TTR期或ETI期肺癌、结直肠癌和食道癌患者的症状和血清一组细胞因子(IL-1RA、IL-6、IL-8、EL-10、IL-12和肿瘤坏死因子-α)的水平，以(1)表征IL-6与治疗期间症状的关系，(2)确定相关细胞因子(S)(重点是IL-6)作为严重疲劳和治疗期间出现的其他症状的高风险指标。 这项研究将使用一种新的基于服务器的(交互式语音响应)每周症状评估，使用M.D.Anderson症状清单，在三到四分钟内，患者可以使用他们的家庭电话或医院房间的电话来评估他们的症状和与症状相关的干扰。于治疗前、治疗中及治疗后一个月每周进行一次临床访视，采集细胞因子样本。纵向方法，如混合效应模型，将被用来评估细胞因子和症状之间关系的强度和性质。这些初步研究可能导致对与疾病相关和与治疗相关的癌症症状的潜在机制进行额外的多学科动物和临床研究。

DESCRIPTION (provided by applicant): Patients with lung cancer, colorectal cancer and esophageal cancer experience multiple severe symptoms related to aggressive cancer treatment. Typically these symptoms occur together. Some of the most prevalent of these symptoms, especially cancer-related fatigue, are very difficult to treat and are a major source of distress for patients as well as families. Development of new methods for treating or preventing these symptoms, especially treatments with minimal side effects, is a high priority, but depends on a better understanding of the mechanisms responsible for symptom expression. Previous human and animal studies suggest that high serum levels of cytokines might be one mechanism underlying multiple symptoms (Cleeland, et al, 2003). Interleukin (IL)-6, for example, is known to be elevated in lung and colorectal cancer and to decrease in response to treatment. We propose a study to longitudinally assess the symptoms and the serum levels of a panel of cytokines (IL-1RA, IL-6, IL-8, EL-10, LL-12, and TNF-alpha) in patients with stage TTR or ETI lung, colorectal and esophageal cancer who are undergoing chemoradiation therapy, to (1) characterize the relationship between IL-6 and symptoms over the time of treatment and (2) identify related cytokine(s) (focusing on IL-6) as indicators of high risk for severe fatigue and other symptoms that develop during therapy. This study will use a novel server-based (interactive voice response) assessment of symptoms on a weekly basis using the M.D. Anderson Symptom Inventory, hi three or four minutes, patients can use their home phones or phones in hospital rooms to rate their symptoms and symptom-related interference. Cytokine sample will be collected before therapy, weekly clinic visit during therapy and at one-month post therapy. Longitudinal methods, such as mixed effect modeling, will be used to assess the strength and nature of the relationship between cytokines and symptoms. These pilot studies may lead to additional multi-disciplinary animal and clinical studies of the mechanisms underlying disease-related and treatment-related cancer symptoms.