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Kyei KA, Anim-Sampong S, Akoe EA, Daniels J, Obeng-Mensah T, Antwi WK, Ainuson-Quampah J. Radiation-induced dermatitis among breast cancer patients undergoing adjuvant radiotherapy in Ghana. Transl Oncol 2024; 46:102028. [PMID: 38861854 DOI: 10.1016/j.tranon.2024.102028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/14/2024] [Accepted: 06/05/2024] [Indexed: 06/13/2024] Open
Abstract
The aim of the study was to investigate radiation-induced epidermal desquamation among breast cancer patients undergoing radiotherapy with 6MV linac and Co-60 teletherapy units. METHOD: Quantitative data was collected using self-administered closed ended questionnaires addressing the desquamation in relation to some patient-and treatment-related factors. The Radiation Therapy Oncology Group (RTOG) criteria for acute skin toxicity was used to grade the toxicity. Chi square and logistic regression analyses were respectively used to test statistical significance and evaluate the effects of the various factors on radiation induced epidermal desquamation RESULTS: Majority of the participants had high BMIs (overweight: 39.5 %; obese: 50 %). Patients with BMI ≥ 25 kg/m2 presented with wet desquamation (RTOG grade 2). A chi-square analysis showed a significant difference (p = 0.02) between BMI and severity of desquamation. There was no significant difference between type of treatment machine and cumulative incidence dose of desquamation (p= 0.251). The logistic regression analysis showed that patients who had undergone mastectomy (OR = 0.562) were less likely to develop wet desquamation (RTOG grade 2) on the Co-60 machine within the 20-30 Gy threshold (OR=0.981) compared to those on the linear accelerator. Patients with lower BMI (OR = 0.412,[ < 25 vs ≥30]; OR = 0.286, [25-29.9 vs ≥30]) were also less likely to develop wet desquamation compared to those with higher BMI. CONCLUSION: Radiation-induced epidermal desquamation is a common side effect of breast cancer patients undergoing radiotherapy. BMI has an effect on the severity of desquamation experienced during breast irradiation.
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Affiliation(s)
- K A Kyei
- Dept. of Radiography, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana; National Centre for Radiotherapy Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana.
| | - S Anim-Sampong
- Dept. of Radiography, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana
| | - E A Akoe
- National Centre for Radiotherapy Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - J Daniels
- National Centre for Radiotherapy Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - T Obeng-Mensah
- National Centre for Radiotherapy Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - W K Antwi
- Dept. of Radiography, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana
| | - J Ainuson-Quampah
- Dept. of Radiography, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana
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2
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Patron M, Neset M, Mielkozorova M, Bisson DG, Vigouroux M, Cata JP, Ingelmo PM, Ouellet JA, Haglund L, Komarova SV. Markers of Tissue Deterioration and Pain on Earth and in Space. J Pain Res 2024; 17:1683-1692. [PMID: 38742243 PMCID: PMC11089065 DOI: 10.2147/jpr.s450180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/25/2024] [Indexed: 05/16/2024] Open
Abstract
Purpose Pain is an understudied physiological effect of spaceflight. Changes in inflammatory and tissue degradation markers are often associated with painful conditions. Our aim was to evaluate the changes in markers associated with tissue deterioration after a short-term spaceflight. Patients and Methods Plasma levels of markers for systemic inflammation and tissue degeneration markers were assessed in two astronauts before and within 24 h after the 17-day Axiom Space AX-1 mission. Results After the spaceflight, C-reactive protein (CRP) was reduced in both astronauts, while INFγ, GM-CSF, TNFα, BDNF, and all measured interleukins were consistently increased. Chemokines demonstrated variable changes, with consistent positive changes in CCL3, 4, 8, 22 and CXCL8, 9, 10, and consistent negative change in CCL8. Markers associated with tissue degradation and bone turnover demonstrated consistent increases in MMP1, MMP13, NTX and OPG, and consistent decreases in MMP3 and MMP9. Conclusion Spaceflight induced changes in the markers of systemic inflammation, tissue deterioration, and bone resorption in two astronauts after a short, 17-day, which were often consistent with those observed in painful conditions on Earth. However, some differences, such as a consistent decrease in CRP, were noted. All records for the effect of space travel on human health are critical for improving our understanding of the effect of this unique environment on humans.
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Affiliation(s)
- Madalina Patron
- Shriners Hospital for Children, Montreal, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Mattias Neset
- Shriners Hospital for Children, Montreal, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Mariia Mielkozorova
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Daniel G Bisson
- Shriners Hospital for Children, Montreal, Canada
- Orthopaedic Research Laboratory, Department of Surgery, McGill University, Montreal, Canada
| | - Marie Vigouroux
- Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada
| | - Juan Pablo Cata
- Department of Anesthesia and Perioperative Medicine, The University of Texas – MD Anderson Cancer Center, Houston, TX, USA
- Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA
| | - Pablo M Ingelmo
- Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Center, Montreal, Canada
| | - Jean A Ouellet
- Shriners Hospital for Children, Montreal, Canada
- Orthopaedic Research Laboratory, Department of Surgery, McGill University, Montreal, Canada
| | - Lisbet Haglund
- Shriners Hospital for Children, Montreal, Canada
- Orthopaedic Research Laboratory, Department of Surgery, McGill University, Montreal, Canada
| | - Svetlana V Komarova
- Shriners Hospital for Children, Montreal, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
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3
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Purswani JM, Bigham Z, Adotama P, Oh C, Xiao J, Maisonet O, Teruel JR, Gutierrez D, Tattersall IW, Perez CA, Gerber NK. Risk of Radiation Dermatitis in Patients With Skin of Color Who Undergo Radiation to the Breast or Chest Wall With and Without Regional Nodal Irradiation. Int J Radiat Oncol Biol Phys 2023; 117:468-478. [PMID: 37060928 DOI: 10.1016/j.ijrobp.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/20/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
PURPOSE Acute radiation dermatitis (ARD) is common after radiation therapy for breast cancer, with data indicating that ARD may disproportionately affect Black or African American (AA) patients. We evaluated the effect of skin of color (SOC) on physician-reported ARD in patients treated with radiation therapy. METHODS AND MATERIALS We identified patients treated with whole breast or chest wall ± regional nodal irradiation or high tangents using 50 Gy in 25 fractions from 2015 to 2018. Baseline skin pigmentation was assessed using the Fitzpatrick scale (I = light/pale white to VI = black/very dark brown) with SOC defined as Fitzpatrick scale IV to VI. We evaluated associations among SOC, physician-reported ARD, late hyperpigmentation, and use of oral and topical treatments for RD using multivariable models. RESULTS A total of 325 patients met eligibility, of which 40% had SOC (n = 129). On multivariable analysis, Black/AA race and chest wall irradiation had a lower odds of physician-reported grade 2 or 3 ARD (odds ratio [OR], 0.110; 95% confidence interval [CI], 0.030-0.397; P = .001; OR, 0.377; 95% CI, 0.161-0.883; P = .025), whereas skin bolus (OR, 8.029; 95% CI, 3.655-17.635; P = 0) and planning target volume D0.03cc (OR, 1.001; 95% CI, 1.000-1.001; P = .028) were associated with increased odds. On multivariable analysis, SOC (OR, 3.658; 95% CI, 1.236-10.830; P = .019) and skin bolus (OR, 26.786; 95% CI, 4.235-169.432; P = 0) were associated with increased odds of physician-reported late grade 2 or 3 hyperpigmentation. There was less frequent use of topical steroids to treat ARD and more frequent use of oral analgesics in SOC versus non-SOC patients (43% vs 63%, P < .001; 50% vs 38%, P = .05, respectively). CONCLUSIONS Black/AA patients exhibited lower odds of physician-reported ARD. However, we found higher odds of late hyperpigmentation in SOC patients, independent of self-reported race. These findings suggest that ARD may be underdiagnosed in SOC when using the physician-rated scale despite this late evidence of radiation-induced skin toxicity.
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Affiliation(s)
- Juhi M Purswani
- Department of Radiation Oncology, New York University Langone Health and Perlmutter Cancer Center, New York, New York
| | - Zahna Bigham
- Tufts University Graduate School of Biomedical Sciences, Boston, Massachusetts
| | - Prince Adotama
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Cheongeun Oh
- Department of Population Health, New York University Langone Health and Perlmutter Cancer Center, New York, New York
| | - Julie Xiao
- Department of Radiation Oncology, New York University Langone Health and Perlmutter Cancer Center, New York, New York
| | - Olivier Maisonet
- Department of Radiation Oncology, New York University Langone Health and Perlmutter Cancer Center, New York, New York
| | - Jose R Teruel
- Department of Radiation Oncology, New York University Langone Health and Perlmutter Cancer Center, New York, New York
| | - Daniel Gutierrez
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Ian W Tattersall
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Carmen A Perez
- Department of Radiation Oncology, New York University Langone Health and Perlmutter Cancer Center, New York, New York
| | - Naamit K Gerber
- Department of Radiation Oncology, New York University Langone Health and Perlmutter Cancer Center, New York, New York.
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Liu Z, Xiao L. Toward a Value-Based Therapy Recommendation Model. Healthcare (Basel) 2023; 11:2362. [PMID: 37628559 PMCID: PMC10454734 DOI: 10.3390/healthcare11162362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Patient value is an important factor in clinical decision making, but conventionally, it is not incorporated in the decision processes. Clinical decision making has some clinical guidelines as a reference. There are very few value-based clinical guidelines, but knowledge about how values affect decision making is mentioned in some scattered studies in the literature. We use a literature review method to extract evidence and integrate it as part of the decision-making model. In this paper, a value-based therapy recommendation comprehensive model is proposed. A literature analysis is conducted to collect value-based evidence. The patients' values are defined and classified with fine granularity. Categorized values and candidate therapies are used in combination as filtering keywords to build this literature database. The literature analysis method generates a literature database used as a source of arguments for influencing decision making based on values. Then, a formalism model is put forward to integrate the value-based evidence with clinical evidence, and the literature databases and clinical guidelines are collected and analyzed to populate the evidence repository. During the decision-making processes, the evidence repository is utilized to match patients' clinical information and values. Decision-makers can dynamically adjust the relative importance of the two pieces of evidence to obtain a treatment plan that is more suitable for the patient. A prototype system was implemented using a case study for breast cancer and validated for feasibility and effectiveness through controlled experiments.
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Affiliation(s)
| | - Liang Xiao
- School of Computer Science, Hubei University of Technology, Wuhan 430068, China;
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5
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Calapai M, Puzzo L, Bova G, Vecchio DA, Blandino R, Barbagallo A, Ammendolia I, Cardia L, De Pasquale M, Calapai F, Esposito E, Trimarchi F, Di Mauro D, Calapai G, Mannucci C. Effects of Physical Exercise and Motor Activity on Oxidative Stress and Inflammation in Post-Mastectomy Pain Syndrome. Antioxidants (Basel) 2023; 12:antiox12030643. [PMID: 36978891 PMCID: PMC10045007 DOI: 10.3390/antiox12030643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
It is estimated that 10–50% of interventions can generate persistent post-surgical pain. Chronic post-mastectomy pain is a condition persisting for at least three months after surgery. It has been shown that physical activity in the cancer patient allows the improvement of the pain symptom. The aim of this study was to evaluate the effects of physical activity on the intensity and interference of chronic pain in the quality of life of women underwent mastectomy needed for breast cancer removal. The secondary objective was to measure the effects of physical activity on inflammatory and oxidative markers in the same population. A Numeric Rating Scale (NRS) was used to assess pain intensity, and Brief Inventory Pain (BIP) was used for assessing interference of pain in quality of life. Physical activity was measured with the International Physical Activity Questionnaire (IPAQ). Inflammatory mediators such as interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, c-reactive protein (CRP), and biomarkers of oxidative stress malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) were evaluated in the blood of patients. All the evaluations were performed after three and six months after surgery. Results showed that adequate physical activity can diminish intensity and interference of pain and that these effects are associated with a reduction of blood biomarkers of inflammation.
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Affiliation(s)
- Marco Calapai
- Breast Unit, San Vincenzo Hospital, Azienda Sanitaria Provinciale Messina, 98039 Messina, Italy
| | - Luisa Puzzo
- Breast Unit, San Vincenzo Hospital, Azienda Sanitaria Provinciale Messina, 98039 Messina, Italy
| | - Giuseppe Bova
- Pain Therapy Unit, San Vincenzo Hospital, Azienda Sanitaria Provinciale Messina, 98039 Messina, Italy
| | - Daniele Alfio Vecchio
- Breast Unit, San Vincenzo Hospital, Azienda Sanitaria Provinciale Messina, 98039 Messina, Italy
| | - Rosario Blandino
- Breast Unit, San Vincenzo Hospital, Azienda Sanitaria Provinciale Messina, 98039 Messina, Italy
| | - Alessia Barbagallo
- Pain Therapy Unit, San Vincenzo Hospital, Azienda Sanitaria Provinciale Messina, 98039 Messina, Italy
| | - Ilaria Ammendolia
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
- Department of Chemical, Biological, Pharmacological and Environmental Sciences, University of Messina, 98125 Messina, Italy
| | - Luigi Cardia
- Department of Human Pathology of Adult and Childhood “Gaetano Barresi”, University of Messina, 98125 Messina, Italy
| | - Maria De Pasquale
- Department of Human Pathology of Adult and Childhood “Gaetano Barresi”, University of Messina, 98125 Messina, Italy
| | - Fabrizio Calapai
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
- Department of Chemical, Biological, Pharmacological and Environmental Sciences, University of Messina, 98125 Messina, Italy
| | - Emanuela Esposito
- Department of Chemical, Biological, Pharmacological and Environmental Sciences, University of Messina, 98125 Messina, Italy
- Genetics and Pharmacogenetics Unit, A.O.U. “G. Martino”, University of Messina, 98125 Messina, Italy
| | - Fabio Trimarchi
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Debora Di Mauro
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Gioacchino Calapai
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
- Correspondence: ; Tel.: +39-0902213646
| | - Carmen Mannucci
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
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6
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Habberstad R, Aass N, Mollnes TE, Damås JK, Brunelli C, Rossi R, Garcia-Alonso E, Kaasa S, Klepstad P. Inflammatory Markers and Radiotherapy Response in Patients With Painful Bone Metastases. J Pain Symptom Manage 2022; 64:330-339. [PMID: 35803553 DOI: 10.1016/j.jpainsymman.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022]
Abstract
CONTEXT Inflammation is proposed to influence tumor response in radiotherapy (RT). Clinical studies to investigate the relationship between inflammatory markers and RT response is warranted to understand the variable RT efficacy in patients with painful bone metastases. OBJECTIVES To evaluate the association between inflammatory markers and analgesic response to RT in patients with painful bone metastases. METHODS Adult patients from 7 European study sites undergoing RT for painful bone metastases were included in this prospective and longitudinal analysis. The association between RT response and 17 inflammatory markers at baseline, as well as the association between RT response and the changes observed in inflammatory markers between baseline and three and eight weeks after RT, was analyzed with univariate regression analyses. Baseline analyses were adjusted for potential clinical predictors of RT response. RESULTS None of the inflammatory markers were significantly associated with an upcoming RT response in the analysis of 448 patients with complete baseline data. In patients available for follow-up, the three-week change in TNF (P 0.017), IL-8 (P 0.028), IP-10 (P 0.032), eotaxin (P 0.043), G-CSF (P 0.033) and MCP-1 (P 0.002) were positively associated with RT response, while the three-week change in CRP (P 0.006) was negatively associated. CONCLUSION Results from this study show an association between RT response and change in pro-inflammatory mediators and indicate that inflammation may be important to achieve an analgesic RT response in patients with painful bone metastases. None of the investigated inflammatory markers were found to be pre-treatment predictors of RT response.
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Affiliation(s)
- Ragnhild Habberstad
- European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU (R.H., P.K.), Norwegian University of Science and Technology and St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway; Cancer Clinic, St. Olavs hospital (R.H.), Trondheim University Hospital, Trondheim, Norway.
| | - Nina Aass
- European Palliative Care Research Centre (PRC), Department of Oncology (N.A., S.K.), Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tom Eirik Mollnes
- Department of Immunology (T.E.M.), Oslo University Hospital, Oslo, Norway; Research Laboratory, Nordland Hospital (T.E.M.), Bodø, Norway; KG Jebsen Thrombosis Research and Expertise Center, Faculty of Health Sciences (T.E.M.), University of Tromsø, Tromsø, Norway; Centre of Molecular Inflammation Research, Department of Cancer Research and Molecular Medicine (T.E.M., J.K.D.), Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Kristian Damås
- Centre of Molecular Inflammation Research, Department of Cancer Research and Molecular Medicine (T.E.M., J.K.D.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Infectious Diseases, St. Olav's Hospital (J.K.D.), Trondheim, Norway
| | - Cinzia Brunelli
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori (C.B.), Milano, Italy
| | - Romina Rossi
- Palliative Care Unit IRCCS- Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori"-IRST-Srl, Meldola, Italy
| | - Elena Garcia-Alonso
- Radiation Oncology Department Arnau de Vilanova University Hospital (E.G.A.). IRB Lleida, España
| | - Stein Kaasa
- European Palliative Care Research Centre (PRC), Department of Oncology (N.A., S.K.), Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål Klepstad
- European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU (R.H., P.K.), Norwegian University of Science and Technology and St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging (P.K.), Norwegian University of Science and Technology (NTNU) Trondheim, Norway; Department of Anesthesiology and Intensive Care Medicine, St Olavs Hospital (P.K.), Trondheim University Hospital, Trondheim, Norway
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7
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Abdelkarem OAI, Choudhury A, Burnet NG, Summersgill HR, West CML. Effect of Race and Ethnicity on Risk of Radiotherapy Toxicity and Implications for Radiogenomics. Clin Oncol (R Coll Radiol) 2022; 34:653-669. [PMID: 35431121 DOI: 10.1016/j.clon.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/21/2022] [Accepted: 03/16/2022] [Indexed: 11/03/2022]
Abstract
AIMS Patient factors affect the risk of radiotherapy toxicity, but many are poorly defined. Studies have shown that race affects cancer incidence, survival, drug response, molecular pathways and epigenetics. Effects on radiosensitivity and radiotherapy toxicity are not well studied. The aim of the present study was to identify the effects of race and ethnicity on the risk of radiotherapy toxicity. MATERIALS AND METHODS A systematic review was carried out of PubMed, Ovid Medline and Ovid Embase with no year limit. PRISMA 2020 guidelines were followed. Two independent assessors reviewed papers. RESULTS Of 607 papers screened, 46 fulfilled the inclusion criteria. Papers were published between 1996 and 2021 and involved 30-28,354 individuals (median 433). Most involved patients with prostate (33%), breast (26%) and lung (9%) cancer. Both early and late toxicities were studied. Some studies reported a higher risk of toxicity in White men with prostate cancer compared with other races and ethnicities. For breast cancer patients, some reported an increased risk of toxicity in White women compared with other race and ethnic groups. In general, it was difficult to draw conclusions due to insufficient reporting and analysis of race and ethnicity in published literature. CONCLUSIONS Reporting of race and ethnicity in radiotherapy studies must be harmonised and improved and frameworks are needed to improve the quality of reporting. Further research is needed to understand how ancestral heritage might affect radiosensitivity and risk of radiotherapy toxicity.
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Affiliation(s)
- O A I Abdelkarem
- Chemical Pathology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt; Translational Radiobiology Group, Division of Cancer Sciences, Manchester Academic Health Science Centre, The University of Manchester, Christie Hospital NHS Foundation Trust, Manchester, UK
| | - A Choudhury
- Proton Beam Therapy Centre, The Christie NHS Foundation Trust, Manchester, UK
| | - N G Burnet
- Proton Beam Therapy Centre, The Christie NHS Foundation Trust, Manchester, UK
| | - H R Summersgill
- Translational Radiobiology Group, Division of Cancer Sciences, Manchester Academic Health Science Centre, The University of Manchester, Christie Hospital NHS Foundation Trust, Manchester, UK
| | - C M L West
- Translational Radiobiology Group, Division of Cancer Sciences, Manchester Academic Health Science Centre, The University of Manchester, Christie Hospital NHS Foundation Trust, Manchester, UK.
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8
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Bower JE, Ganz PA, Irwin MR, Cole SW, Carroll J, Kuhlman KR, Petersen L, Garet D, Asher A, Hurvitz SA, Crespi CM. Acute and chronic effects of adjuvant therapy on inflammatory markers in breast cancer patients. JNCI Cancer Spectr 2022; 6:6651075. [PMID: 35900175 PMCID: PMC9420043 DOI: 10.1093/jncics/pkac052] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/20/2022] [Accepted: 05/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background Inflammation contributes to poor behavioral, functional, and clinical outcomes in cancer survivors. We examined whether standard cancer treatments—radiation and chemotherapy—led to acute and persistent changes in circulating markers of inflammation in breast cancer patients. Methods A total of 192 women diagnosed with early stage breast cancer provided blood samples before and after completion of radiation and/or chemotherapy and at 6-, 12-, and 18-month posttreatment follow-ups. Samples were assayed for circulating inflammatory markers, including tumor necrosis factor-α (TNF-α) and interleukin (IL)–6, downstream markers of their activity (soluble TNF receptor type II [sTNF-RII], C reactive protein), and other inflammatory mediators (IL-8, interferon-γ [IFN-γ]). Analyses evaluated within-group changes in inflammatory markers in 4 treatment groups: no radiation or chemotherapy (n = 39), radiation only (n = 77), chemotherapy only (n = 18), and chemotherapy with radiation (n = 58). Results Patients treated with chemotherapy showed statistically significant increases in circulating concentrations of TNF-α, sTNF-RII, IL-6, and IFN-γ from pre- to posttreatment, with parameter estimates in standard deviation units ranging from 0.55 to 1.20. Those who received chemotherapy with radiation also showed statistically significant increases in IL-8 over this period. Statistically significant increases in TNF-α, sTNF-RII, IL-6, IFN-γ, and IL-8 persisted at 6, 12, and 18 months posttreatment among patients treated with chemotherapy and radiation (all P < .05). Patients treated with radiation only showed a statistically significant increase in IL-8 at 18 months posttreatment; no increases in any markers were observed in patients treated with surgery only. Conclusions Chemotherapy is associated with acute increases in systemic inflammation that persist for months after treatment completion in patients who also receive radiation therapy. These increases may contribute to common behavioral symptoms and other comorbidities in cancer survivors.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, University of California, Los Angeles; Los Angeles, California, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; Los Angeles, California, United States.,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Los Angeles, California, United States.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Los Angeles, California, United States
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Los Angeles, California, United States.,Schools of Medicine and Public Health, University of California, Los Angeles; Los Angeles, California, United States
| | - Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; Los Angeles, California, United States.,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Los Angeles, California, United States
| | - Steve W Cole
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; Los Angeles, California, United States.,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Los Angeles, California, United States.,Department of Medicine, University of California, Los Angeles; Los Angeles, California, United States
| | - Judith Carroll
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; Los Angeles, California, United States.,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Los Angeles, California, United States
| | - Kate R Kuhlman
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Los Angeles, California, United States.,Department of Psychological Science of California, University of California, Irvine; Irvine, California, United States
| | - Laura Petersen
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Los Angeles, California, United States
| | - Deborah Garet
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Los Angeles, California, United States
| | - Arash Asher
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California, United States
| | - Sara A Hurvitz
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Los Angeles, California, United States.,Department of Medicine, University of California, Los Angeles; Los Angeles, California, United States
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Los Angeles, California, United States.,Department of Biostatistics, University of California, Los Angeles; Los Angeles, California, United States
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Obeng-Gyasi S, Graham N, Kumar S, Lee JW, Jacobus S, Weiss M, Cella D, Zhao F, Ip EH, O'Connell N, Hong F, Peipert DJ, Gareen IIF, Timsina LR, Gray R, Wagner LI, Carlos RC. Examining allostatic load, neighborhood socioeconomic status, symptom burden and mortality in multiple myeloma patients. Blood Cancer J 2022; 12:53. [PMID: 35365604 PMCID: PMC8975964 DOI: 10.1038/s41408-022-00648-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/06/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this study is to examine the association between neighborhood socioeconomic status (nSES) and baseline allostatic load (AL) and clinical trial endpoints in patients enrolled in the E1A11 therapeutic trial in multiple myeloma (MM). Study endpoints were symptom burden (pain, fatigue, and bother) at baseline and 5.5 months, non-completion of induction therapy, overall survival (OS) and progression-free survival (PFS). Multivariable logistic and Cox regression examined associations between nSES, AL and patient outcomes. A 1-unit increase in baseline AL was associated with greater odds of high fatigue at baseline (adjusted OR [95% CI] = 1.21 [1.08–1.36]) and a worse OS (adjusted hazard ratio, [95% CI] = 1.21 [1.06–1.37]). High nSES was associated with worse baseline bother (middle OR = 4.22 [1.11–16.09] and high 4.49 [1.16–17.43]) compared to low nSES. There was no association between AL or nSES and symptom burden at 5.5 months, non-completion of induction therapy or PFS. Additionally, there was no association between nSES and OS. AL may have utility as a predictive marker for OS among patients with MM and may allow individualization of treatment. Future studies should standardize and validate AL patients with MM.
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Affiliation(s)
| | - Noah Graham
- Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston, MA, USA
| | | | - Ju-Whei Lee
- Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston, MA, USA
| | - Susanna Jacobus
- Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston, MA, USA
| | | | - David Cella
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - Fengmin Zhao
- Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston, MA, USA
| | - Edward H Ip
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Nathaniel O'Connell
- Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston, MA, USA
| | - Fangxin Hong
- Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston, MA, USA
| | - Devin J Peipert
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - IIana F Gareen
- Brown University Department of Epidemiology and Center for Statistical Sciences, Providence, RI, USA
| | - Lava R Timsina
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert Gray
- Dana-Farber Cancer Institute, ECOG-ACRIN Biostatistics Center, Boston, MA, USA
| | - Lynne I Wagner
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Ruth C Carlos
- University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
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10
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Wu MC, Lu TC, Cheng MT, Chen YC, Liao ECW, Sung CW, Tay J, Ko CH, Fang CC, Huang CH, Tsai CL. Pain trajectories in the emergency department: Patient characteristics and clinical outcomes. Am J Emerg Med 2022; 55:111-116. [DOI: 10.1016/j.ajem.2021.09.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/15/2021] [Indexed: 10/18/2022] Open
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11
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Evenepoel M, Haenen V, De Baerdemaecker T, Meeus M, Devoogdt N, Dams L, Van Dijck S, Van der Gucht E, De Groef A. Pain Prevalence During Cancer Treatment: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2022; 63:e317-e335. [PMID: 34563628 DOI: 10.1016/j.jpainsymman.2021.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 12/28/2022]
Abstract
CONTEXT Pain is one of the most complex and prevalent symptoms in the cancer population. Despite the protective role of acute cancer-related pain, it is also an important predictor for the likelihood of developing chronic pain after cancer treatment. OBJECTIVES Since the last systematic review on pain prevalence rates during cancer treatment dates already from 2016, the aim of the present systematic review was to provide an overview of pain prevalence rates during cancer treatment since this previous review. METHODS A systematic search of the literature, including studies between 2014 and 2020, was conducted using the databases Pubmed, Embase, Scopus, Web of Science and Cochrane. Studies reporting pain prevalence rates during or within three months after curative cancer treatment was included. Title/abstract and full-text was screened double-blinded, followed by independent evaluation of the risk of bias. All prevalence rates were pooled within meta-analyses and a meta-regression was performed to clarify the amount of heterogeneity. RESULTS Of the 9052 studies, 12 studies were included in the meta-analysis of which 10 included breast cancer and two lung cancer patients. The pooled pain prevalence rate was 40% (95%CI 0.29-0.51), with a heterogeneity of 96%. Out of the meta-regression, only the covariate "method of pain measurement" significantly clarified the heterogeneity (P < 0.05), resulting in a residual heterogeneity of 94.88%. CONCLUSION Five years after the last systematic review published on this topic, pain is still very prevalent during cancer treatment. However, the pain prevalence rates were also very heterogeneous. These two findings emphasize the need for further research on the development of adequate pain assessment and pain management approaches during cancer treatment.
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Affiliation(s)
- Margaux Evenepoel
- Department of Rehabilitation Sciences and Physiotherapy (M.E., V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), MOVANT, University of Antwerp, Antwerp, Belgium
| | - Vincent Haenen
- Department of Rehabilitation Sciences and Physiotherapy (M.E., V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), MOVANT, University of Antwerp, Antwerp, Belgium; Department of Rehabilitation Sciences (V.H., T.D.B., N.D., L.D., E.V.G., A.D.G.), KU Leuven, University of Leuven, Leuven, Belgium; Pain in Motion International Research Group (V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), Brussels, Belgium
| | - Tom De Baerdemaecker
- Department of Rehabilitation Sciences (V.H., T.D.B., N.D., L.D., E.V.G., A.D.G.), KU Leuven, University of Leuven, Leuven, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy (M.E., V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), MOVANT, University of Antwerp, Antwerp, Belgium; Pain in Motion International Research Group (V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), Brussels, Belgium; Department of Rehabilitation Sciences (M.M.), Ghent University, Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences (V.H., T.D.B., N.D., L.D., E.V.G., A.D.G.), KU Leuven, University of Leuven, Leuven, Belgium; Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation (N.D.), Center for Lymphoedema, UZ Leuven - University Hospitals Leuven, Leuven, Belgium
| | - Lore Dams
- Department of Rehabilitation Sciences and Physiotherapy (M.E., V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), MOVANT, University of Antwerp, Antwerp, Belgium; Department of Rehabilitation Sciences (V.H., T.D.B., N.D., L.D., E.V.G., A.D.G.), KU Leuven, University of Leuven, Leuven, Belgium; Pain in Motion International Research Group (V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), Brussels, Belgium
| | - Sophie Van Dijck
- Department of Rehabilitation Sciences and Physiotherapy (M.E., V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), MOVANT, University of Antwerp, Antwerp, Belgium; Pain in Motion International Research Group (V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), Brussels, Belgium
| | - Elien Van der Gucht
- Department of Rehabilitation Sciences and Physiotherapy (M.E., V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), MOVANT, University of Antwerp, Antwerp, Belgium; Department of Rehabilitation Sciences (V.H., T.D.B., N.D., L.D., E.V.G., A.D.G.), KU Leuven, University of Leuven, Leuven, Belgium; Pain in Motion International Research Group (V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), Brussels, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences and Physiotherapy (M.E., V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), MOVANT, University of Antwerp, Antwerp, Belgium; Department of Rehabilitation Sciences (V.H., T.D.B., N.D., L.D., E.V.G., A.D.G.), KU Leuven, University of Leuven, Leuven, Belgium; Pain in Motion International Research Group (V.H., M.M., L.D., S.V.D., E.V.G., A.D.G.), Brussels, Belgium.
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12
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Post-Mastectomy Pain: An Updated Overview on Risk Factors, Predictors, and Markers. Life (Basel) 2021; 11:life11101026. [PMID: 34685397 PMCID: PMC8540201 DOI: 10.3390/life11101026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 12/29/2022] Open
Abstract
After breast surgery, women frequently develop chronic post-mastectomy pain (PMP). PMP refers to the occurrence of pain in and around the area of the mastectomy lasting beyond three months after surgery. The nature of factors leading to PMP is not well known. When PMP is refractory to analgesic treatment, it negatively impacts the lives of patients, increasing emotional stress and disability. For this reason, optimizing the quality of life of patients treated for this pathology has gained more importance. On the basis of the findings and opinions above, we present an overview of risk factors and predictors to be used as potential biomarkers in the personalized management of individual PMP. For this overview, we discuss scientific articles published in peer-reviewed journals written in the English language describing risk factors, predictors, and potential biomarkers associated with chronic pain after breast surgery. Our overview confirms that the identification of women at risk for PMP is fundamental to setting up the best treatment to prevent this outcome. Clinical practice can be planned through the interpretation of genotyping data, choosing drugs, and tailoring doses for each patient with the aim to provide safer and more effective individual analgesic treatment.
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13
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Zhao C, Hu W, Xu Y, Wang D, Wang Y, Lv W, Xiong M, Yi Y, Wang H, Zhang Q, Wu Y. Current Landscape: The Mechanism and Therapeutic Impact of Obesity for Breast Cancer. Front Oncol 2021; 11:704893. [PMID: 34350120 PMCID: PMC8326839 DOI: 10.3389/fonc.2021.704893] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/05/2021] [Indexed: 12/22/2022] Open
Abstract
Obesity is defined as a chronic disease induced by an imbalance of energy homeostasis. Obesity is a widespread health problem with increasing prevalence worldwide. Breast cancer (BC) has already been the most common cancer and one of the leading causes of cancer death in women worldwide. Nowadays, the impact of the rising prevalence of obesity has been recognized as a nonnegligible issue for BC development, outcome, and management. Adipokines, insulin and insulin-like growth factor, sex hormone and the chronic inflammation state play critical roles in the vicious crosstalk between obesity and BC. Furthermore, obesity can affect the efficacy and side effects of multiple therapies such as surgery, radiotherapy, chemotherapy, endocrine therapy, immunotherapy and weight management of BC. In this review, we focus on the current landscape of the mechanisms of obesity in fueling BC and the impact of obesity on diverse therapeutic interventions. An in-depth exploration of the underlying mechanisms linking obesity and BC will improve the efficiency of the existing treatments and even provide novel treatment strategies for BC treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Haiping Wang
- Department of Plastic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Zhang
- Department of Plastic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiping Wu
- Department of Plastic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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14
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Kim YJ, Jeong J, Park K, Sohn KY, Yoon SY, Kim JW. Mitigation of Hematopoietic Syndrome of Acute Radiation Syndrome by 1-Palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) is Associated with Regulation of Systemic Inflammation in a Murine Model of Total-Body Irradiation. Radiat Res 2021; 196:55-65. [PMID: 33914879 DOI: 10.1667/rade-20-00288.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/02/2021] [Indexed: 01/08/2023]
Abstract
The growing risk of accidental radiation exposure due to increased usage of ionizing radiation, such as in nuclear power, industries and medicine, has increased the necessity for the development of radiation countermeasures. Previously, we demonstrated the therapeutic potential of the acetylated diacylglycerol, 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG), as a radiation countermeasure by mitigating radiation-associated mortality and hematopoietic acute radiation syndrome (H-ARS) in BALB/c mice after a lethal dose (LD70/30) of gamma-ray total-body irradiation (TBI). In this study, we show that PLAG mitigates symptoms of H-ARS, as characterized by mature blood cell recovery and restoration of bone marrow cellularity, by regulating systemic inflammation. Log-rank test demonstrated that high levels of WBCs, lymphocytes and neutrophils on day 10 post-TBI resulted in significantly improved survival rate. PLAG significantly enhanced the nadir values of all major blood cell types as well as bone marrow cellularity. A single TBI at LD70/30 induced an immediate increase in the blood levels of CXCL1 (12.5 fold), CXCL2 (1.5 fold), IL-6 (86.9 fold), C-reactive protein (CRP; 1.3 fold) and G-CSF (15.7 fold) at 6 h post-TBI, but the cytokine levels returned to baseline level afterward. When the irradiated mice started to die around 15 days post-TBI, they exhibited a second surge in blood levels of CXCL1 (49.3 fold), CXCL2 (87.1 fold), IL-6 (208 fold), CRP (3.6 fold) and G-CSF (265.7 fold). However, PLAG-treated groups showed a significant decrease in these same blood levels (P < 0.001). Considering the inverse correlation between inflammatory cytokine levels and hematological nadirs, PLAG exerts its therapeutic effects on H-ARS by regulating inflammatory cytokine production. These data suggest that PLAG has high potential as a radiation countermeasure to mitigate H-ARS after accidental exposure to radiation.
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Affiliation(s)
- Yong-Jae Kim
- Division of Global New Drug Development, Enzychem Lifesciences, Daejeon 34013, Republic of Korea
| | - Jinseon Jeong
- Division of Global New Drug Development, Enzychem Lifesciences, Daejeon 34013, Republic of Korea
| | - Kaapjoo Park
- Division of Global New Drug Development, Enzychem Lifesciences, Daejeon 34013, Republic of Korea
| | - Ki-Young Sohn
- Division of Global New Drug Development, Enzychem Lifesciences, Daejeon 34013, Republic of Korea
| | - Sun Young Yoon
- Division of Global New Drug Development, Enzychem Lifesciences, Daejeon 34013, Republic of Korea
| | - Jae Wha Kim
- Division of Biomaterials Research, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
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15
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Calapai F, Mondello E, Mannucci C, Sorbara EE, Gangemi S, Quattrone D, Calapai G, Cardia L. Pain Biomarkers in Cancer: An Overview. Curr Pharm Des 2021; 27:293-304. [PMID: 33138755 DOI: 10.2174/1381612826666201102103520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/09/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Pain is a common symptom in oncologic patients and its management is generally guided with reference to pain individually perceived by patients and expressed through self-reported scales. However, the utility of these tools is limited as it strongly depends on patients' opinions. For this reason, more objective instruments are desirable. OBJECTIVE In this overview, scientific articles indicating potential markers to be used for pain management in cancer were collected and discussed. METHODS Research was performed on principal electronic scientific databases by using the words "pain", "cancer", "markers" and "biomarkers" as the main keywords, and findings describing potential biomarkers for the management of cancer pain were reported. RESULTS Studies on pain markers not specific for cancer typology (inflammatory, genetic markers predicting response to analgesic drugs, neuroimaging markers) and pain markers for specific types of cancer (bone cancer, breast cancer, lung cancer, head and neck cancer, prostate cancer, cancer in pediatrics) have been presented and commented on. CONCLUSION This overview supports the view of the involvement of inflammatory mediators in the mechanisms underlying cancer pain. Only a small amount of data from research up till today is available on markers that can help in the management of pain, except for pro-inflammatory cytokines and other inflammatory indexes such as C-reactive protein (CRP). However, biomarkers are a promising strategy useful to predict pain intensity and to objectively quantify analgesic response in guiding decisions regarding individual-tailored treatments for cancer patients.
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Affiliation(s)
- Fabrizio Calapai
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging - University of Messina, Messina, Italy
| | - Epifanio Mondello
- Anesthesia, Intensive Care and Pain Therapy, Policlinico "G. Martino" - University of Messina, Messina, Italy
| | - Carmen Mannucci
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging - University of Messina, Messina, Italy
| | - Emanuela E Sorbara
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging - University of Messina, Messina, Italy
| | - Sebastiano Gangemi
- School and Division of Allergy and Clinical Immunology, Department of Experimental Medicine, University of Messina, Messina, Italy
| | - Domenico Quattrone
- Pain Therapy Unit, Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli" - Reggio Calabria, Italy
| | - Gioacchino Calapai
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging - University of Messina, Messina, Italy
| | - Luigi Cardia
- IRCCS Centro Neurolesi Bonino- Pulejo, Messina, Italy
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