Fatigue, serum cytokine levels, and blood cell counts during radiotherapy of patients with breast cancer
Fatigue, serum cytokine levels, and blood cell counts during radiotherapy of patients with breast cancer
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DOI：
10.1016/s0360-3016(01)01657-1
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发表时间：
2001-11-01
影响因子：
7
通讯作者：
Molls, M
中科院分区：
文献类型：
--
作者：
Geinitz, H;Zimmermann, FB;Molls, M
目的：为了评估乳腺癌患者的辅助放疗（RT）过程中的疲劳水平及其与焦虑，抑郁，血清细胞因子和血细胞计数levels.Methods和材料的关系：41例乳腺癌患者接受保乳手术后辅助RT进行了前瞻性研究。所有患者均接受RT，未伴随化疗。在RT前、RT第1 - 5周和RT完成后2个月，患者使用两种标准化自我评估工具（疲劳评估问卷和疲劳强度视觉模拟量表）评定疲劳程度。采用医院焦虑抑郁量表评定焦虑抑郁水平。A分类血细胞计数和血清水平的细胞因子白细胞介素（IL）-1 β，IL-6，和肿瘤坏死因子-α测定平行的疲劳assessments.Results：疲劳强度与视觉模拟量表评估增加（p <0.001），直到治疗第4周，并保持升高，直到第5周。RT后两个月，数值已降至治疗前水平。通过疲劳评估问卷测量的疲劳在治疗期间未显著增加，但在治疗第4周和第5周期间，身体（p = 0.035）和认知（p = 0.015）疲劳的分项评分升高。情感疲劳没有显著变化。焦虑，与医院焦虑和抑郁量表评定，RT期间下降（p = 0.002），但医院焦虑和抑郁量表抑郁评分没有显着变化。IL-1 β、IL-6和肿瘤坏死因子-α水平在治疗期间没有变化，与疲劳无关。治疗期间外周血细胞水平显著下降，治疗后2个月仍较低。直到治疗第5周，淋巴细胞减少至其初始值的近50%。血红蛋白水平没有相关性与fatigue.Conclusions：我们观察到在乳腺癌患者的辅助RT疲劳增加。治疗后2个月，疲劳恢复至治疗前水平。没有证据表明焦虑、抑郁、IL-1 β、IL-6、肿瘤坏死因子-α的血清水平或血红蛋白水平下降是治疗诱导的疲劳的原因。(C)2001 Elsevier Science Inc.
Purpose: To assess the level of fatigue during the course of adjuvant radiotherapy (RT) of breast cancer patients and its relation to anxiety, depression, serum cytokines, and blood count levels.Methods and Materials: Forty-one patients who received adjuvant RT after breast-conserving surgery were prospectively studied. All patients underwent RT without concomitant chemotherapy. Patients rated their fatigue with two standardized self-assessment instruments, the Fatigue Assessment Questionnaire and a visual analog scale on fatigue intensity, before RT, during weeks 1-5 of RT, and 2 months after RT completion. In addition, the anxiety and depression levels were assessed with the Hospital Anxiety and Depression Scale. A differential blood cell count and the serum levels of the cytokines interleukin (IL)-1 beta, IL-6, and tumor necrosis factor-alpha were determined in parallel to the fatigue assessments.Results: Fatigue intensity as assessed with the visual analog scale increased (p < 0.001) until treatment week 4 and remained elevated until week 5. Two months after RT, the values had fallen to the pretreatment levels. Fatigue measured xvith the Fatigue Assessment Questionnaire did not increase significantly during treatment, but the subscores on physical (p = 0.035) and cognitive (p = 0.015) fatigue were elevated during treatment weeks 4 and 5. Affective fatigue did not change significantly. Anxiety, as rated with the Hospital Anxiety and Depression Scale, declined during RT (p = 0.002), but the Hospital Anxiety and Depression Scale depression score did not change significantly. IL-1 beta, IL-6, and tumor necrosis faetor-alpha levels did not change during therapy and did not correlate with fatigue. Peripheral blood cell levels declined significantly during therapy and were still low 2 months after treatment. Until treatment week 5, lymphocytes were reduced to almost 50% of their initial values. Hemoglobin levels did not correlate with fatigue.Conclusions: We observed an increase in fatigue during adjuvant RT of patients with breast cancer. Fatigue returned to pretreatment levels 2 months after treatment. No evidence was found that anxiety, depression, serum levels of IL-1 beta, EL-6, tumor necrosis factor-alpha, or declining hemoglobin levels were responsible for the treatment-induced fatigue. (C) 2001 Elsevier Science Inc.