title: The relationship between interleukin-6, tumor necrosis factor-α, and fatigue in terminally ill cancer patients.
abstract: Although many cancer patients receiving palliative care experience distressing levels of fatigue, no well-designed studies have investigated contributing factors in Korean patients. We conducted a cross-sectional study using the Brief Fatigue Inventory-K (BFI-K) to measure fatigue while assessing a variety of possible correlates. Ninety patients with incurable cancer in the terminal stage (median survival: 27 days) participated in a structured interview and questionnaire related to their medical conditions and underwent blood sampling for laboratory data and cytokines, including interleukin (IL)-6 and tumor necrosis factor (TNF)-α. Body mass index, dyspnea, the Eastern Cooperative Oncology Group performance status, and levels of albumin, blood urea nitrogen (BUN), total bilirubin, and C-reactive protein were significantly associated with fatigue. However, levels of the two proinflammatory cytokines, IL-6 and TNF-α, were not significantly correlated with the BFI-K score. In stepwise multiple linear regression, fatigue was related to elevated BUN (β = 0.376, p = 0.002), severe pain intensity (β = 0.349, p = 0.004), and impaired performance status (β = 0.268, p = 0.027), but not related to levels of inflammatory cytokines. In conclusion, the diagnostic work-up and therapeutic plan for patients with cancer-related fatigue should include an evaluation of laboratory parameters, pain severity, and physical performance.
authors.affiliation: Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Sang Mi
authors.initials: SM
authors.lastname: Kwak
authors.forename: Youn Seon
authors.initials: YS
authors.lastname: Choi
authors.forename: Ho Min
authors.initials: HM
authors.lastname: Yoon
authors.forename: Dae Gyun
authors.initials: DG
authors.lastname: Kim
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Song
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Lee
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Yeom
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Koh
authors.forename: Jeanno
authors.initials: J
authors.lastname: Park
authors.forename: Myung Ah
authors.initials: MA
authors.lastname: Lee
authors.forename: Sang-Yeon
authors.initials: SY
authors.lastname: Suh
mesh_terms: D000368:Aged; D001806:Blood Urea Nitrogen; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications*; D010146:Pain / Q000150:complications*; D010166:Palliative Care; D011795:Surveys and Questionnaires; D019452:Terminally Ill; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha