University of Edinburgh, Edinburgh, United Kingdom.
J Pain Symptom Manage. 2011 Jul;42(1):1-11. doi: 10.1016/j.jpainsymman.2010.10.261. Epub 2011 Mar 12.
Pain, depression, and fatigue are common symptoms in cancer populations. They often coexist and have been suggested as a specific symptom cluster. Systemic inflammation (SI) may be a possible common mechanism.
This study examined whether pain, depression, and fatigue exist as a symptom cluster in advanced cancer patients with cachexia and might be related to the presence of SI.
Secondary data analysis was undertaken of two clinical trials in patients with cancer cachexia (n = 654). Pain, depression, and fatigue were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. Plasma C-reactive protein (CRP) was measured as a marker of SI in a subgroup (n = 436). Multivariate analysis and a series of regression analyses were undertaken relating pain, depression, fatigue, and CRP.
Pain, depression, and fatigue clustered, with between two and four times as many patients having all three symptoms as would be expected if the symptoms only coexist by chance (P < 0.001). CRP was not related to the symptom cluster. There was a strong relationship between the pattern of symptoms and physical functioning (P < 0.001).
Pain, depression, and fatigue is an identifiable symptom cluster in a cohort of cachexic cancer patients and is associated with reduced physical functioning.
疼痛、抑郁和疲劳是癌症患者常见的症状。它们常常同时存在，并被认为是一种特定的症状群。全身炎症（SI）可能是一种可能的共同机制。
本研究旨在探讨在患有恶病质的晚期癌症患者中，疼痛、抑郁和疲劳是否存在作为一个症状群，并且可能与 SI 的存在有关。
对两项癌症恶病质患者临床试验的二级数据分析（n = 654）。使用欧洲癌症研究与治疗组织生活质量问卷-C30 评估疼痛、抑郁和疲劳。在亚组（n = 436）中测量血浆 C 反应蛋白（CRP）作为 SI 的标志物。进行了多变量分析和一系列回归分析，以研究疼痛、抑郁、疲劳和 CRP 之间的关系。
疼痛、抑郁和疲劳聚类，同时出现这三种症状的患者数量是仅根据机会同时存在的预期的两到四倍（P < 0.001）。CRP 与症状群无关。症状模式与身体功能之间存在很强的关系（P < 0.001）。
在一组恶病质的癌症患者中，疼痛、抑郁和疲劳是一个可识别的症状群，并且与身体功能下降有关。
