TY - JOUR
T1 - Longitudinal associations between inflammatory markers and fatigue up to two years after colorectal cancer treatment
AU - Querido, Nadira R
AU - Kenkhuis, Marlou Floor
AU - van Roekel, Eline H
AU - Breukink, Stéphanie O
AU - van Duijnhoven, Fränzel J B
AU - Janssen-Heijnen, Maryska Lg
AU - Keulen, Eric T P
AU - Ueland, Per Magne
AU - Vogelaar, F Jeroen
AU - Wesselink, Evertine
AU - Bours, Martijn Jl
AU - Weijenberg, Matty P
N1 - Funding Information:
The EnCoRe study was supported by a grant from Kankeronderzoekfonds Limburg as part of Health Foundation Limburg (grant 00005739, to M.P. Weijen-berg), from Stichting Alpe d’Huzes within the research program “Leven met kanker” of the Dutch Cancer Society grants UM 2010-4867 (to M.P. Weijenberg), and UM 2012-5653 (to M.P. Weijenberg), and by ERA-NET on Translational Cancer Research [TRANSCAN: Dutch Cancer Society (UM 2014–6877, to M.P. Weijenberg)]. The measurement of inflammatory markers was funded by a grant from Alpe d’Huzes/ Dutch Cancer Society (UW2013-6397, to F.J.B. van Duijnhoven). M.F. Kenkhuis is supported by a grant from WKOF/World Cancer Research Fund International (WCRF) (grant number 2017/1619, to M.J.L. Bours). E.H. van Roekel is supported by the WKOF, as part of the World Cancer Research Fund International grant program (grant number 2016/1620, to M.P. Weijenberg).
Funding Information:
E.H. van Roekel reports grants from Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International during the conduct of the study. P.M. Ueland is a member of the steering board of the nonprofit Foundation, which owns Bevital, and R&D director of Bevital, the company that carried out biochemical analyses. No other potential conflict of interest relevant to this article was reported. M.P. Weijenberg reports grants from Dutch Cancer Society, World Cancer Research Fund International/WKOF; and grants from Health Foundation Limburg/ Kanker Onderzoek Fonds Limburg (KOFL) during the conduct of the study. No disclosures were reported by the other authors.
Publisher Copyright:
© 2022 American Association for Cancer Research.
PY - 2022/8
Y1 - 2022/8
N2 - BACKGROUND: Fatigue is often reported by colorectal cancer survivors (CRC) and largely impacts their quality of life. Inflammation has been linked to fatigue mainly in breast cancer patients. Therefore, we investigated how inflammation is longitudinally associated with fatigue in CRC survivors, up to 2 years post-treatment.METHODS: A total of 257 patients from the ongoing Energy for life after ColoRectal cancer (EnCoRe) cohort study were included in the analysis. Plasma levels of IL6, IL8, IL10, TNFα, hsCRP, and fatigue were measured at 6 weeks, 6, 12, and 24 months post-treatment. Fatigue was measured through the validated Checklist Individual Strength (CIS total, 20-140), consisting of four subscales - subjective fatigue (8-56), motivation (4-28), physical activity (3-21), and concentration (5-35), and the EORTC QLQ-C30 fatigue subscale (0-100). Linear mixed-models were used to assess the confounder-adjusted longitudinal associations between inflammatory markers and overall fatigue along with the subscales.RESULTS: Mean levels of CIS fatigue decreased from 62.9 at 6 weeks to 53.0 at 24 months. In general, levels of inflammatory markers also decreased over time. No statistically significant longitudinal associations were found between IL6, IL8, IL10, TNFα, and fatigue. Higher levels of hsCRP were associated with more CIS fatigue (β per SD 3.21, 95% CI 1.42; 5.01) and EORTC fatigue (β 2.41, 95% CI 0.72; 4.10).CONCLUSION: Increased levels of hsCRP are longitudinally associated with more post-treatment fatigue in CRC survivors.IMPACT: These findings suggest that low-grade inflammation may play a role in fatigue reported by CRC survivors up to 2 years post-treatment.
AB - BACKGROUND: Fatigue is often reported by colorectal cancer survivors (CRC) and largely impacts their quality of life. Inflammation has been linked to fatigue mainly in breast cancer patients. Therefore, we investigated how inflammation is longitudinally associated with fatigue in CRC survivors, up to 2 years post-treatment.METHODS: A total of 257 patients from the ongoing Energy for life after ColoRectal cancer (EnCoRe) cohort study were included in the analysis. Plasma levels of IL6, IL8, IL10, TNFα, hsCRP, and fatigue were measured at 6 weeks, 6, 12, and 24 months post-treatment. Fatigue was measured through the validated Checklist Individual Strength (CIS total, 20-140), consisting of four subscales - subjective fatigue (8-56), motivation (4-28), physical activity (3-21), and concentration (5-35), and the EORTC QLQ-C30 fatigue subscale (0-100). Linear mixed-models were used to assess the confounder-adjusted longitudinal associations between inflammatory markers and overall fatigue along with the subscales.RESULTS: Mean levels of CIS fatigue decreased from 62.9 at 6 weeks to 53.0 at 24 months. In general, levels of inflammatory markers also decreased over time. No statistically significant longitudinal associations were found between IL6, IL8, IL10, TNFα, and fatigue. Higher levels of hsCRP were associated with more CIS fatigue (β per SD 3.21, 95% CI 1.42; 5.01) and EORTC fatigue (β 2.41, 95% CI 0.72; 4.10).CONCLUSION: Increased levels of hsCRP are longitudinally associated with more post-treatment fatigue in CRC survivors.IMPACT: These findings suggest that low-grade inflammation may play a role in fatigue reported by CRC survivors up to 2 years post-treatment.
U2 - 10.1158/1055-9965.EPI-22-0077
DO - 10.1158/1055-9965.EPI-22-0077
M3 - Article
C2 - 35654354
SN - 1055-9965
VL - 31
SP - 1638
EP - 1649
JO - Cancer Epidemiology Biomarkers & Prevention
JF - Cancer Epidemiology Biomarkers & Prevention
IS - 8
ER -