Yan-Bo Ji1, Chun-Lu Bo2, Xiu-Juan Xue1, En-Ming Weng3, Guang-Chao Gao4, Bei-Bei Dai4, Kai-Wen Ding5, Cui-Ping Xu6. 1. Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, China. 2. School of Nursing, Cheeloo Health Science Center, Shandong University, Jinan, Shandong Province, China. 3. Yanggu No. 2 People's Hospital, Liaocheng, Shandong Province, China. 4. School of Nursing, Taishan Medical College, Tai'an, Shandong Province, China. 5. School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China. 6. Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, China. Electronic address: xcp775@126.com.
Abstract
CONTEXT: Pain, fatigue, depression, and sleep disturbance are common in patients with cancer and usually co-occur as a symptom cluster. However, the mechanism underlying this symptom cluster is unclear. OBJECTIVES: This study aimed to identify subgroups of cluster symptoms, compare demographic and clinical characteristics between subgroups, and examine the associations between inflammatory cytokines and cluster symptoms. METHODS: Participants were 170 Chinese inpatients with cancer from two tertiary hospitals. Inflammatory markers including interleukin-6 (IL-6), interleukin-1 receptor antagonist, and tumor necrosis factor alpha were measured. Intergroup differences and associations of inflammatory cytokines with the cluster symptoms were examined with one-way analyses of variance and logistic regression. RESULTS: Based on cluster analysis, participants were categorized into Subgroup 1 (all low symptoms), Subgroup 2 (low pain and moderate fatigue), or Subgroup 3 (moderate-to-high on all symptoms). The three subgroups differed significantly in Eastern Cooperative Oncology Group (ECOG) performance status, sex, residence, current treatment, education, economic status, and inflammatory cytokines levels (all P < 0.05). Compared with Subgroup 1, Subgroup 3 had a significantly poorer ECOG physical performance status and higher IL-6 levels, were more often treated with combined chemoradiotherapy, and were more likely to be rural residents. IL-6 and ECOG physical performance status were significantly associated with 1.246-fold (95% CI 1.114-1.396) and 31.831-fold (95% CI 6.017-168.385) increased risk of Subgroup 3. CONCLUSION: Our findings suggest that IL-6 levels are associated with cluster symptoms in cancer patients. Clinicians should identify patients at risk for more severe symptoms and formulate novel target interventions to improve symptom management.
CONTEXT: Pain, fatigue, depression, and sleep disturbance are common in patients with cancer and usually co-occur as a symptom cluster. However, the mechanism underlying this symptom cluster is unclear. OBJECTIVES: This study aimed to identify subgroups of cluster symptoms, compare demographic and clinical characteristics between subgroups, and examine the associations between inflammatory cytokines and cluster symptoms. METHODS:Participants were 170 Chinese inpatients with cancer from two tertiary hospitals. Inflammatory markers including interleukin-6 (IL-6), interleukin-1 receptor antagonist, and tumor necrosis factor alpha were measured. Intergroup differences and associations of inflammatory cytokines with the cluster symptoms were examined with one-way analyses of variance and logistic regression. RESULTS: Based on cluster analysis, participants were categorized into Subgroup 1 (all low symptoms), Subgroup 2 (low pain and moderate fatigue), or Subgroup 3 (moderate-to-high on all symptoms). The three subgroups differed significantly in Eastern Cooperative Oncology Group (ECOG) performance status, sex, residence, current treatment, education, economic status, and inflammatory cytokines levels (all P < 0.05). Compared with Subgroup 1, Subgroup 3 had a significantly poorer ECOG physical performance status and higher IL-6 levels, were more often treated with combined chemoradiotherapy, and were more likely to be rural residents. IL-6 and ECOG physical performance status were significantly associated with 1.246-fold (95% CI 1.114-1.396) and 31.831-fold (95% CI 6.017-168.385) increased risk of Subgroup 3. CONCLUSION: Our findings suggest that IL-6 levels are associated with cluster symptoms in cancerpatients. Clinicians should identify patients at risk for more severe symptoms and formulate novel target interventions to improve symptom management.
Authors: Pei-Lin Yang; Robert L Burr; Diana T Buchanan; Kenneth C Pike; Kendra J Kamp; Margaret M Heitkemper Journal: J Clin Sleep Med Date: 2020-10-15 Impact factor: 4.062
Authors: Jason W Boland; Victoria Allgar; Elaine G Boland; Mike I Bennett; Stein Kaasa; Marianne Jensen Hjermstad; Miriam Johnson Journal: Eur J Clin Pharmacol Date: 2019-12-21 Impact factor: 2.953
Authors: R Lobefaro; S Rota; L Porcu; C Brunelli; S Alfieri; E Zito; I Taglialatela; M Ambrosini; A Spagnoletti; M Zimatore; G Fatuzzo; F Lavecchia; C Borreani; G Apolone; F De Braud; M Platania Journal: ESMO Open Date: 2022-03-31