Cytokines and Symptoms in Lung Cancer treatment

描述（由申请人提供）：肺癌、结直肠癌和食管癌患者经历与积极癌症治疗相关的多种严重症状。这些症状通常同时出现。其中一些最常见的症状，特别是癌症相关的疲劳，非常难以治疗，是患者和家庭痛苦的主要来源。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，是一个高度优先事项，但取决于对症状表达机制的更好理解。先前的人类和动物研究表明，细胞因子的高血清水平可能是多种症状的一种潜在机制（Cleeland等人，2003）。例如，已知白细胞介素（IL）-6在肺癌和结肠直肠癌中升高，并且响应于治疗而降低。我们提出了一项研究，纵向评估症状和血清水平的一组细胞因子（IL-1RA、IL-6、IL-8、EL-10、LL-12和TNF-α），（1）表征IL-6与治疗期间症状之间的关系，以及（2）鉴定相关细胞因子（重点是IL-6）作为治疗期间出现的严重疲劳和其他症状的高风险指标。 本研究将使用一种新的基于服务器（交互式语音应答）的症状评估，每周使用医学博士安德森症状量表，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干扰有关的干扰。将在治疗前、治疗期间每周门诊访视和治疗后1个月采集细胞因子样本。纵向方法，如混合效应模型，将用于评估细胞因子和症状之间关系的强度和性质。这些初步研究可能会导致额外的多学科动物和临床研究的机制，疾病相关和治疗相关的癌症症状。

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.