Open AccessExploring a Link Between Fatigue and Intestinal Injury During Pelvic Radiotherapy
Author(s) -
Jakobsson Sofie,
Ahlberg Karin,
Taft Charles,
Ekman Tor
Publication year - 2010
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2010-0097
Subject(s) - medicine , orosomucoid , haptoglobin , gastroenterology , radiation therapy , diarrhea , albumin , microbiology and biotechnology , glycoprotein , biology
Background. The association between cancer‐related fatigue and pathological processes in the body is largely unknown. This study was designed to investigate a possible linkage between fatigue and intestinal injury during pelvic radiotherapy. Methods. Twenty‐nine women undergoing pelvic radiotherapy for anal or uterine cancer were prospectively followed. Fatigue and diarrhea were assessed using patient self‐reported questionnaires. Plasma citrulline concentration, as a sign of intestinal injury, and C‐reactive protein, orosomucoid, albumin, α 1 ‐antitrypsin, and haptoglobin, as signs of systemic inflammation, were analyzed. Results. Fatigue increased significantly ( p < .001) and citrulline decreased significantly ( p < .001) during treatment. A significant negative correlation ( r = −0.40; p < .05) was found between fatigue and epithelial atrophy in the intestine (as assessed by plasma citrulline) after 3 weeks of treatment and a significant positive correlation ( r = 0.75; p < .001) was found between fatigue and diarrhea. Signs of systemic inflammation were evident, with significant increases in serum orosomucoid, serum haptoglobin ( p < .05) and serum α 1 ‐antitrypsin ( p < .001) and a significant decrease in serum albumin ( p < .001). Conclusion. The present study indicates a link between fatigue and intestinal injury during pelvic radiotherapy. This observation should be considered as a preliminary finding because of the small sample size but may serve as a rationale for therapeutic interventions aimed at alleviating both fatigue and gastrointestinal symptoms during pelvic radiotherapy.