2010 Fiscal Year Final Research Report
Development of monitoring indicators for fatigue management in breast cancer patients undergoing outpatient chemotherapy
| Project/Area Number |
21792236
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Clinical nursing
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| Research Institution | Oita University of Nursing and Health Sciences |
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Principal Investigator |
FUKUDA Hiromi 大分県立看護科学大学, 看護学部, 講師 (00347709)
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| Project Period (FY) |
2009 – 2010
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| Keywords | かん看護学 |
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| Research Abstract |
Fatigue is one of the most common symptoms in breast cancer patients undergoing outpatient chemotherapy. The purpose of the present study was to examine the usefulness of urinary cytokines as indicators of fatigue including subjective fatigue. Factors affecting fatigue were clarified, and appropriate timing and methods of intervention for fatigue were considered. The present study investigated the first course of chemotherapy in breast cancer patients being treated with one of epirubicin / cyclophosphamide (EC), chemotherapy. 5-fluorouracil / epirubicin / cyclophosphamide (FEC), and taxotere / cyclophosphamide (TC) as a postoperative chemotherapy regimen. The percentage of subjects whose urinary cytokine levels were measurable was 40% for interleukin (IL)-1beta, 40% for IL-8, and 60% for tumor necrosis factor (TNF)-alpha. Comparison of cytokine levels before treatment and seven to ten days after the initiation of treatment revealed a significant difference in TNF-alpha levels before to
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after administration of EC. Other chemotherapy treatments yielded no statistically significant differences in cytokine levels before to after treatment. In addition, subjective fatigue and other symptoms were investigated using the Common Terminology Criteria for Adverse Events v3.0 Japanese JCOG/JSCO version. The severity of other symptoms including fatigue was grade 1 or less in 60-80% of the subjects in all of the postoperative chemotherapy regimens. In addition, subjects with symptom severity of grade 2 or 3 at the initiation of treatment exhibited improvement of symptoms during the course of treatment. Among factors affecting fatigue, subjects had poor appetite, nausea, difficulty in sleeping, pain, anxiety, depression, and related symptoms after the start of treatment, though the symptoms varied depending on the type and course of treatment. Furthermore, in FEC therapy, cytokine levels exhibited significant correlations with anxiety and depression, suggesting an association between them and symptoms affecting fatigue. Coping with fatigue in breast cancer patients undergoing outpatient chemotherapy requires fatigue support based on the type and timing of treatment. Less
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