Cytokines, fatigue, and cutaneous erythema in early stage breast cancer patients receiving adjuvant radiation therapy

Vitaliana De Sanctis, Linda Agolli, Vincenzo Visco, Flavia Monaco, Roberta Muni, Alessandra Spagnoli, Barbara Campanella, Maurizio Valeriani, Giuseppe Minniti, Mattia F. Osti, Claudio Amanti, Patrizia Pellegrini, Serena Brunetti, Anna Costantini, Marco Alfò, Maria Rosaria Torrisi, Paolo Marchetti, Riccardo Maurizi Enrici

Research output: Contribution to journalArticle

Abstract

We investigated the hypothesis that patients developing high-grade erythema of the breast skin during radiation treatment could be more likely to present increased levels of proinflammatory cytokines which may lead, in turn, to associated fatigue. Forty women with early stage breast cancer who received adjuvant radiotherapy were enrolled from 2007 to 2010. Fatigue symptoms, erythema, and cytokine levels (IL-1β, IL-2, IL6, IL-8, TNF-α, and MCP-1) were registered at baseline, during treatment, and after radiotherapy completion. Seven (17.5%) patients presented fatigue without associated depression/anxiety. Grade ≥2 erythema was observed in 5 of these 7 patients. IL-1β, IL-2, IL-6, and TNF-α were statistically increased 4 weeks after radiotherapy (P <0.05). After the Heckman two-step analysis, a statistically significant influence of skin erythema on proinflammatory markers increase (P = 0.00001) was recorded; in the second step, these blood markers showed a significant impact on fatigue (P = 0.026). A seeming increase of fatigue, erythema, and proinflammatory markers was observed between the fourth and the fifth week of treatment followed by a decrease after RT. There were no significant effects of hormone therapy, breast volume, and anemia on fatigue. Our study seems to suggest that fatigue is related to high-grade breast skin erythema during radiotherapy through the increase of cytokines levels.

Original languageEnglish
Article number523568
JournalBioMed Research International
Volume2014
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Medicine(all)

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    De Sanctis, V., Agolli, L., Visco, V., Monaco, F., Muni, R., Spagnoli, A., Campanella, B., Valeriani, M., Minniti, G., Osti, M. F., Amanti, C., Pellegrini, P., Brunetti, S., Costantini, A., Alfò, M., Torrisi, M. R., Marchetti, P., & Enrici, R. M. (2014). Cytokines, fatigue, and cutaneous erythema in early stage breast cancer patients receiving adjuvant radiation therapy. BioMed Research International, 2014, [523568]. https://doi.org/10.1155/2014/523568