The effects of chemotherapy on C-reactive protein and quality of life in cancer patients

Abstract

Objectives: We investigated the relationship between serum C- reactive protein (CRP), quality of life and stage of the disease and also the effect of chemotherapy on quality of life and serum CRP level. Methods: Chemo-naive patients who applied to the T.C. İstanbul Bilim University Avrupa Florence Nightingale Hospital Medical Oncology Clinic in the years 2009-2010 were taken into the study. After physical examination, patients who did not have any evidence of infection were eligible, they had a CRP test and were given the EORTC QLQ-C30 (version 3.0) questionnaire The same procedure was repeated at the third chemotherapy cure. Measurement of CRP was done by the Cobas Integra 400/800 machine with the turibidimetric (latex) method. Results: Study began with 57 patients, but 2 of them died before taking the third chemotherapy dose. 36 advanced, 19 early stage, 25 female, 30 male, a total of 55 patient could complete the study. 6 patients had lung cancer, 9 patients had colon cancer, 15 patients had breast cancer, 12 patients had stomach cancer, 1 patient had liver cancer, 3 patients had bile duct cancer, 4 patients had pancreatic cancer, 1 patient had bone cancer, 3 patients had testicular cancer and 1 patient had neuro-endocrine tumor. The average age of the advanced disease group was 55.7±11.7 while the average of the early-stage group was 52.6±13. Between two groups there wasn't any significant difference (p=0.370). The CRP levels of progressed and non-progressed cases were compared. Before chemotherapy (p=0.359) and after chemotherapy (p=0.344) no significant difference was found. Also we could not determine a significant decrease in the CRP level of (p=0.907) and (p=0.113) patients when we compared the crp levels before and after chemotherapy. After the chemotherapy, there is a significant improvement in the global health status (p=0.017), role functioning (p=0.010), emotional functioning (p=0.00), social functioning (p=0.043), and a significant decrease in the pain score (p=0.005). Conclusion: Although we could not find significant decrease in the serum CRP levels with chemotherapy, we found out a correlation between high serum CRP levels and low quality of life. With this result, we propose to evaluate the serum CRP level as a marker of quality of life. But we need more patients and statistics to prove that CRP is an independent variable as a marker of quality of life. We found out a correlation between chemotherapy and quality of life. The average QOL scores of the patients receiving chemotherapy was increased. In contrast to popular belief, we can say that, chemotherapy is not a factor that decreases quality of life, especially within the first three cures. © 2014 Turkish Society for Radiation Oncology.