Inflammatory cytokines are associated with the development of symptom burden in patients with NSCLC undergoing concurrent chemoradiation therapy

Objectives. The aims of this study were to determine the effect of conjugated linoleic acid (CLA) supplementation on inflammatory factors and matrix metalloproteinase (MMP) enzymes in rectal cancer patients undergoing chemoradiothetrapy. Method and Material. In this randomized, double-blind, placebo-controlled pilot study, 34 volunteer patients with rectal cancer undergoing chemoradiotherapy assigned into the CLA group (n = 16), receiving 3 g CLA/d, and placebo group (n = 18) receiving placebo capsules (sunflower oil) for 6 weeks. The supplementation began 1 week before starting RT (loading period) and continued every day during treatment. Before and after intervention, serum tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), IL-6, MMP-2, MMP-9, and high-sensitivity C-reactive protein (hsCRP) were measured by enzymelinked immunosorbent assay (ELISA) kits and immunoturbidimetric method, respectively. Independent t tests and paired t tests were used to compare parameters between and within groups, respectively. Results. In the CLA group, the mean serum TNF-α, IL-1β, hsCRP, MMP-9, and MMP-2 levels reduced insignificantly. However, significant changes in TNF-α (P = 0.04), hsCRP (P = 0.03), and MMP-9 (P = 0.04) concentrations were observed in the CLA group when compared with the placebo group. The mean serum IL-6 level remained unchanged in the CLA group but increased remarkably in the placebo group. Conclusion. According to our results, CLA supplementation improved inflammatory factors, MMP-2, and MMP-9 as biomarkers of angiogenesis and tumor invasion. It seems that CLA may provide new complementary treatment by reducing tumor invasion and resistance to cancer treatment in patients with rectal cancer.

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“…38 According to our results, CLA supplementation may prevent the enhancement of IL-1β and IL-6 concentrations in patients with cancer during CRT.…”

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confidence: 96%

Effect of Conjugated Linoleic Acid Supplementation on Inflammatory Factors and Matrix Metalloproteinase Enzymes in Rectal Cancer Patients Undergoing Chemoradiotherapy

et al. 2013

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“…However, the specific symptoms within the prespecified symptom cluster were somewhat variable and included fatigue, pain, and depression (five papers: 48-50,53,54); fatigue, pain, depression, and sleep disturbance (three papers: 2,3,52); and fatigue, depression, and sleep disturbance (one paper: 56). The other two papers discussed the underlying mechanisms for multiple co-occurring symptoms without specifying a specific symptom cluster (51,55).…”

Section: Mechanistic Considerationsmentioning

confidence: 99%

“…In 10 of these papers (2,3,(48)(49)(50)(51)(52)(53)(54)(55), patients with cancer were evaluated. In the 11th paper (56), elderly individuals with impaired cardiac function or heart failure were evaluated.…”

Section: Mechanistic Considerationsmentioning

confidence: 99%

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Miaskowski

Barsevick

Berger

et al. 2017

JNCI J Natl Cancer Inst

339

330

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An overview of proceedings, findings, and recommendations from the workshop on "Advancing Symptom Science Through Symptom Cluster Research" sponsored by the National Institute of Nursing Research (NINR) and the Office of Rare Diseases Research, National Center for Advancing Translational Sciences, is presented. This workshop engaged an expert panel in an evidenced-based discussion regarding the state of the science of symptom clusters in chronic conditions including cancer and other rare diseases. An interdisciplinary working group from the extramural research community representing nursing, medicine, oncology, psychology, and bioinformatics was convened at the National Institutes of Health. Based on expertise, members were divided into teams to address key areas: defining characteristics of symptom clusters, priority symptom clusters and underlying mechanisms, measurement issues, targeted interventions, and new analytic strategies. For each area, the evidence was synthesized, limitations and gaps identified, and recommendations for future research delineated. The majority of findings in each area were from studies of oncology patients. However, increasing evidence suggests that symptom clusters occur in patients with other chronic conditions (eg, pulmonary, cardiac, and end-stage renal disease). Nonetheless, symptom cluster research is extremely limited and scientists are just beginning to understand how to investigate symptom clusters by developing frameworks and new methods and approaches. With a focus on personalized care, an understanding of individual susceptibility to symptoms and whether a "driving" symptom exists that triggers other symptoms in the cluster is needed. Also, research aimed at identifying the mechanisms that underlie symptom clusters is essential to developing targeted interventions.Patients with chronic conditions, such as cancer and other rare diseases, experience an array of multiple co-occurring symptoms (eg, pain, fatigue, sleep disturbance). When these symptoms remain underdiagnosed and undertreated, they have a negative impact on patient-reported outcomes (PROs) including functional performance, cognitive status, and quality of life (QOL). A reduction in symptom burden in these patients has the potential to improve their capacity to live well over their entire lives. To achieve this goal, a transformation is needed in how multiple co-occurring symptoms are assessed and managed in order to improve patient outcomes and stimulate a reduction in health care utilization and costs. A strategic plan that advances REVIEW

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“…research about patients with cancer, there is growing literature that links inflammation and fatigue during [18][19][20][21] and after 22-26 cancer treatment, although little is known about mechanisms underlying fatigue immediately after treatment completion, a time when fatigue levels are typically at their peak. 27 There has been minimal examination of inflammatory correlates of depressive symptoms or sleep disturbance in cancer populations, and no studies have comprehensively examined fatigue, depression, and sleep and their association with inflammatory markers in patients with cancer to assess potential common underlying pathways.…”

Section: Journal Of Clinical Oncology O R I G I N a L R E P O R T Volmentioning

confidence: 99%

“…In addition, the role of cancer treatments as potential inducers of inflammation and behavioral symptoms has not been carefully assessed. Chemotherapy is of particular interest, because it has been associated with acute increases in inflammatory markers 18,[28][29][30] and fatigue, 4,31,32 which may persist long into survivorship. 3,33,34 Determining the mechanisms underlying these common, disabling adverse effects of cancer treatment is critical for the development of targeted interventions for prevention and treatment.…”

Section: Journal Of Clinical Oncology O R I G I N a L R E P O R T Volmentioning

confidence: 99%

Inflammation and Behavioral Symptoms After Breast Cancer Treatment: Do Fatigue, Depression, and Sleep Disturbance Share a Common Underlying Mechanism?

Bower¹,

Ganz²,

Irwin³

et al. 2011

JCO

425

349

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A B S T R A C T PurposeFatigue, depression, and sleep disturbance are common adverse effects of cancer treatment and frequently co-occur. However, the possibility that inflammatory processes may underlie this constellation of symptoms has not been examined. Patients and MethodsWomen (N ϭ 103) who had recently finished primary treatment (ie, surgery, radiation, chemotherapy) for early-stage breast cancer completed self-report scales and provided blood samples for determination of plasma levels of inflammatory markers: soluble tumor necrosis factor (TNF) receptor II (sTNF-RII), interleukin-1 receptor antagonist, and C-reactive protein. ResultsSymptoms were elevated at the end of treatment; greater than 60% of participants reported clinically significant problems with fatigue and sleep, and 25% reported elevated depressive symptoms. Women treated with chemotherapy endorsed higher levels of all symptoms and also had higher plasma levels of sTNF-RII than women who did not receive chemotherapy (all P Ͻ .05). Fatigue was positively associated with sTNF-RII, particularly in the chemotherapy-treated group (P Ͻ .05). Depressive symptoms and sleep problems were correlated with fatigue but not with inflammatory markers. ConclusionThis study confirms high rates of behavioral symptoms in breast cancer survivors, particularly those treated with chemotherapy, and indicates a role for TNF-␣ signaling as a contributor to postchemotherapy fatigue. Results also suggest that fatigue, sleep disturbance, and depression may stem from distinct biologic processes in post-treatment survivors, with inflammatory signaling contributing relatively specifically to fatigue.

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Inflammatory cytokines are associated with the development of symptom burden in patients with NSCLC undergoing concurrent chemoradiation therapy

Cited by 159 publications

References 34 publications

Effect of Conjugated Linoleic Acid Supplementation on Inflammatory Factors and Matrix Metalloproteinase Enzymes in Rectal Cancer Patients Undergoing Chemoradiotherapy

Effect of Conjugated Linoleic Acid Supplementation on Inflammatory Factors and Matrix Metalloproteinase Enzymes in Rectal Cancer Patients Undergoing Chemoradiotherapy

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Inflammation and Behavioral Symptoms After Breast Cancer Treatment: Do Fatigue, Depression, and Sleep Disturbance Share a Common Underlying Mechanism?

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