Symptom Clusters and Oxidative Stress in Patients With High-Grade Brain Cancers: A Longitudinal Study

Thursday, 27 July 2017: 3:50 PM

Sanghee Kim, PhD
College of Nursing, Keimyung University, Daegu, Korea, Republic of (South)

Background: Cancer treatments can increase the levels of oxidative stress because of the mechanisms of cancer drugs and radiotherapy. Patients with cancer experience many concurrent symptoms, commonly referred to as “symptom clusters,” during the treatment periods. However, the relationship between oxidative stress and the symptom clusters have not been identified in patients with high-grade brain cancer.

Purpose: The purpose of this study was to identify a relationship between the symptom clusters and the levels of oxidative stress in patients with high-grade brain cancers undergoing concurrent chemoradiotherapy (CCRT).

Methods: Patients with high-grade primary brain cancers were asked to report their symptoms using the Memorial Symptom Assessment Scale, and the level of oxidative stress was evaluated on the basis of lipid ratios such as the total cholesterol (TC) to high-density lipoprotein (HDL)-cholesterol (TC/HDL-c), low-density lipoprotein (LDL)-cholesterol to HDL-cholesterol (LDL-c/HDL-c), and triglycerides to HDL-cholesterol (TG/HDL-c). This prospective longitudinal survey was conducted before CCRT was initiated, and at 2–3 weeks and 4–6 weeks after the initiation of CCRT.

Results: A total of 48 patients with newly diagnosed primary malignant brain cancers were enrolled. Six symptom clusters were identified, and two symptom clusters were present at each time point (i.e., the "negative emotion and neurocognition" cluster was reported before CCRT, "negative emotion and decreased vitality" and "gastrointestinal and decreased sensation" clusters were noted at 2–3 weeks, and "body image and decreased vitality" and "gastrointestinal" clusters were identified at 4–6 weeks). The lipid ratio was an indicator of the level of risk for oxidative stress at 2–3 weeks and 4–6 weeks. The symptom clusters at 2–3 weeks and 4–6 weeks demonstrated a significant relationship with the lipid ratio.

Conclusion: Symptom clusters and levels of oxidative stress in patients with high-grade brain cancer were altered during CCRT. In addition, the levels of oxidative stress correlated with symptom clusters, and these correlations could change during the course of CCRT. Therefore, oxidative stress in patients with high-grade brain cancer should be considered for symptom management during CCRT.