title: The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer.
abstract: Chemotherapy for breast cancer leads to increased fatigue, poor mood, and reduced quality of life. Few studies have examined possible changes in inflammation during chemotherapy as potential contributors to this phenomenon. This study examined the relationship among circulating levels of soluble intercellular adhesion molecule-1 (sICAM-1), vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) and fatigue, depressed mood, and quality of life before and during anthracycline-based chemotherapy. Twenty-nine women diagnosed with stage I-IIIA breast cancer (mean age 49.5 years, S.D.+/-11) were studied prior to cycle 1 of chemotherapy and 2.5 months later at the start of cycle 4 of chemotherapy. Chemotherapy led to a significant increase in sICAM-1 (P<0.05) and VEGF (P<0.01) levels, as well as increased ratings of fatigue (P<0.01), depressed mood (P<0.03), and poorer quality of life (P<0.01). Multiple regression analyses revealed that elevated VEGF (P<0.01) and sICAM-1 (P<0.02) were related to the increased fatigue and/or poorer quality of life as a result of chemotherapy. Pre-chemotherapy levels of VEGF and pre-chemotherapy ratings of quality of life predicted quality of life in response to chemotherapy (P<0.001). The findings contribute to the literature by showing that both pre-chemotherapy and chemotherapy-induced changes in inflammation are related to changes in fatigue and quality of life in response to chemotherapy.
authors.affiliation: Department of Psychiatry, University of California, San Diego (UCSD), Medical Center, 200 West Arbor Drive, San Diego, CA 92103-0804, USA. pmills@ucsd.edu
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mills
authors.forename: Barbara
authors.initials: B
authors.lastname: Parker
authors.forename: Joel E
authors.initials: JE
authors.lastname: Dimsdale
authors.forename: Georgia Robins
authors.initials: GR
authors.lastname: Sadler
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology / Q000523:psychology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003863:Depression / Q000139:chemically induced / Q000276:immunology / Q000523:psychology; D005221:Fatigue / Q000139:chemically induced* / Q000276:immunology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000139:chemically induced* / Q000276:immunology; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011788:Quality of Life / Q000523:psychology; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D018943:Anthracyclines; D015850:Interleukin-6; D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1