ScienceDirect - Biological Psychology : The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer

Biological Psychology
Volume 69, Issue 1, April 2005, Pages 85-96
Current Trends in Women's Health Research

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doi:10.1016/j.biopsycho.2004.11.007

The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer

Paul J. Mills^a^,^d^,^e^,^,, Barbara Parker^b^,^d^,^f, Joel E. Dimsdale^a^,^d^,^e, Georgia Robins Sadler^c^,^d and Sonia Ancoli-Israel^a^,^d^,^e^,^f

^aDepartment of Psychiatry, University of California, San Diego (UCSD), Medical Center, 200 West Arbor Drive, San Diego, CA 92103-0804, USA ^bDepartment of Medicine, University of California, San Diego, 200 West Arbor Drive, San Diego, CA 92103-0804, USA ^cDepartment of Surgery, University of California, San Diego, 200 West Arbor Drive, San Diego, CA 92103-0804, USA ^dRebecca and John Moores UCSD Cancer Center, USA ^eUCSD General Clinical Research Center, USA ^fVeterans Affairs San Diego Healthcare System, USA

Available online 8 January 2005.

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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.

Keywords: Breast cancer; Chemotherapy; sICAM-1; VEGF; IL-6; Depression; Fatigue; Quality of life

Abbreviations: sICAM-1, soluble intercellular adhesion molecule-1; VEGF, vascular endothelial growth factor (VEGF); IL-6, interleukin-6; MFSI, Multidimensional Fatigue Symptom Inventory; CESD, Center of Epidemiological Studies-Depression; FACT-B, Functional Assessment of Cancer Therapy; FOSQ, Functional Outcomes of Sleep Questionnaire