title: A Pilot Study of Proinflammatory Cytokines and Fatigue in Women With Breast Cancer During Chemotherapy.
abstract: Fatigue remains a prevalent, persistent, and debilitating side effect of chemotherapy for stage I and II breast cancer patients. Severity of fatigue varies among patients. Evidence suggests that proinflammatory cytokines contribute to the development of fatigue.
  
  
  
  The aim of this study is to investigate predictors of fatigue and cytokine levels in women undergoing chemotherapy for stage I or II breast cancer.
  
  
  
  Piper Fatigue Scales and blood samples for interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were collected at baseline and days 7, 14, and 21 for each chemotherapy cycle. Descriptive statistics, general linear mixed models, and graphic analysis were used to analyze the data.
  
  
  
  The predominantly white convenience sample was composed of 11 women with stage I or II breast cancer who were 37 to 72 years old (mean, 52 years). Predictors of fatigue were type of chemotherapy drugs, time, and IL-6 levels. A predictor of IL-6 and TNF-α levels was whether chemotherapy was administered at the visit. Type of chemotherapy significantly predicted TNF-α levels. Fatigue patterns were characterized by chaotic pattern of peaks and troughs unique to each woman.
  
  
  
  Women with stage I and II breast cancer experienced variability in the severity of fatigue and levels of IL-6 and TNF-α throughout their treatment trajectories. The presence and role of genetic variants related to cancer-related fatigue may explain the individual variation and warrant further research.
  
  
  
  These findings highlight the importance of symptom assessments including fatigue at each clinic visit and individualized interventions throughout the cancer trajectory.
authors.affiliation: Author Affiliations: College of Nursing and Health Innovation (Dr Raudonis) and Office of Information Technology, University of Texas at Arlington (Dr Rowe); Baylor Scott and White Health, Dallas, Texas (Ms Kelley); and Texas Health Harris Methodist Hospital, Fort Worth (Ms Ellis).
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Raudonis
authors.forename: Ingrid H
authors.initials: IH
authors.lastname: Kelley
authors.forename: Nancy
authors.initials: N
authors.lastname: Rowe
authors.forename: Jenny
authors.initials: J
authors.lastname: Ellis
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005221:Fatigue / Q000097:blood / Q000139:chemically induced*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D000970:Antineoplastic Agents; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha