Greenberg D B, Gray J L, Mannix C M, Eisenthal S, Carey M
Department of Psychiatry, Massachusetts General Hospital Cancer Center, Boston 02114.
J Pain Symptom Manage. 1993 May;8(4):196-200. doi: 10.1016/0885-3924(93)90127-h.
To define changes in sleep and subjective fatigue associated with localized radiation treatment, and to determine their relationship to interleukin-1B (IL-1), we prospectively followed 15 men, none of whom were depressed during 8 wk of radiation treatment for localized prostate cancer. Each patient rated fatigue daily on a visual analogue scale, recorded hours slept, and completed the Beck Depression Inventory weekly. Serum IL-1, taken at baseline and Fridays, was measured by quantitative enzyme immunoassay. Ranked weekly mean fatigue scores for each subject increased at week 4 (mean, 17 fractions, 1.8 Gy) then plateaued and rose in weeks 6 and 7. In week 6, the last week of full volume radiation, subjects slept most compared to all other weeks including week 7 when treatment was coned down. Ranked serum IL-1 tended to rise between weeks 1 and 4, as fatigue scores rose. These data suggest that localized radiation treatment is associated with increased fatigue and sleep requirement independent of depressive symptoms. Relative serum IL-1 changes may be one signal for the systemic reaction and subjective fatigue associated with the acute effects of radiation.
为了明确与局部放疗相关的睡眠和主观疲劳变化，并确定它们与白细胞介素-1β（IL-1）的关系，我们前瞻性地随访了15名男性，他们在接受局部前列腺癌放疗的8周期间均无抑郁症状。每位患者每天用视觉模拟量表评估疲劳程度，记录睡眠时间，并每周完成贝克抑郁量表。在基线和每周五采集血清IL-1，采用定量酶免疫测定法进行检测。每位受试者的每周平均疲劳评分在第4周（平均，17分次，1.8 Gy）升高，然后趋于平稳，并在第6周和第7周再次升高。在第6周，即全量放疗的最后一周，与包括第7周（缩野放疗时）在内的所有其他周相比，受试者睡眠最多。随着疲劳评分升高，血清IL-1在第1周和第4周之间有升高趋势。这些数据表明，局部放疗与疲劳增加和睡眠需求增加有关，且与抑郁症状无关。血清IL-1的相对变化可能是与放疗急性效应相关的全身反应和主观疲劳的一个信号。
