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前列腺癌患者放疗后慢性疲劳早期生物标志物的探索性研究。

Exploratory Investigation of Early Biomarkers for Chronic Fatigue in Prostate Cancer Patients Following Radiation Therapy.

作者信息

Feng Li Rebekah, Wolff Brian S, Lukkahatai Nada, Espina Alexandra, Saligan Leorey N

机构信息

Author Affiliations: National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland (Drs Feng and Saligan and Ms Espina); Georgetown University, Washington, DC (Dr Wolff); University of Nevada in Las Vegas, School of Nursing, Nevada (Dr Lukkahatai).

出版信息

Cancer Nurs. 2017 May/Jun;40(3):184-193. doi: 10.1097/NCC.0000000000000381.

Abstract

BACKGROUND

Fatigue is one of the most debilitating adverse effects of cancer therapy. Identifying biomarkers early during cancer therapy may help us understand the biologic underpinnings of the persistence of fatigue following therapy.

OBJECTIVE

We aimed to identify early biomarkers of fatigue by examining correlations of levels of cytokines during external beam radiation therapy (EBRT) with persistence of fatigue 1 year following treatment completion in men with nonmetastatic prostate cancer (NM-PC).

METHODS

A sample of 34 men with nonmetastatic prostate cancer scheduled to receive EBRT were followed up at baseline (T1), midpoint of EBRT (T2), and 1 year following EBRT (T3). Demographic and clinical data were obtained by chart review. The Functional Assessment of Cancer Therapy-Fatigue was administered to measure fatigue levels. Plasma cytokine levels were determined at T1 and T2 using the Bio-Rad Bio-Plex Cytokine Assay Kits.

RESULTS

Significant correlations were observed between levels of interleukin 2 (IL-3), IL-8, IL-9, IL-10, IL-16, interferon γ-induced protein 10, interferon α2, interferon γ, and stromal cell-derived factor 1α at T2 with worsening of fatigue from T1 to T3.

CONCLUSIONS

Immunological changes prior to chronic fatigue development may reflect the long-term response to radiation therapy-induced damage.

IMPLICATIONS FOR PRACTICE

Early biomarkers for chronic fatigue related to cancer therapy will help advance our understanding of the etiology of this distressing symptom and will help nurses identify patients at risk of developing chronic fatigue after cancer treatment. This information will also aid in patient education, as well as symptom management.

摘要

背景

疲劳是癌症治疗最使人衰弱的不良反应之一。在癌症治疗早期识别生物标志物可能有助于我们理解治疗后疲劳持续存在的生物学基础。

目的

我们旨在通过检查非转移性前列腺癌(NM-PC)男性患者在体外放射治疗(EBRT)期间细胞因子水平与治疗完成后1年疲劳持续情况的相关性,来识别疲劳的早期生物标志物。

方法

对34例计划接受EBRT的非转移性前列腺癌男性患者在基线(T1)、EBRT中点(T2)以及EBRT后1年(T3)进行随访。通过查阅病历获取人口统计学和临床数据。采用癌症治疗功能评估-疲劳量表来测量疲劳水平。在T1和T2时使用伯乐Bio-Plex细胞因子检测试剂盒测定血浆细胞因子水平。

结果

在T2时观察到白细胞介素2(IL-3)、IL-8、IL-9、IL-10、IL-16、γ干扰素诱导蛋白10、α2干扰素、γ干扰素和基质细胞衍生因子1α的水平与从T1到T3疲劳加重之间存在显著相关性。

结论

慢性疲劳发展之前的免疫变化可能反映了对放射治疗诱导损伤的长期反应。

对实践的启示

与癌症治疗相关的慢性疲劳的早期生物标志物将有助于推进我们对这种令人痛苦症状病因的理解,并有助于护士识别癌症治疗后有发生慢性疲劳风险的患者。这些信息也将有助于患者教育以及症状管理。

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