The effect of chemotherapy to C-reactive protein level and life quality in cancer patients

BACKGROUND: C- reactive protein is a beta globuline which is produced by the liver and adipose tissue. It is an acute phase reactant and a good marker of inflammation. In our daily practice it is used in the supporting lots of disease diagnosis and also used in folow up of the diseases. Most recent studies showed that in cancer patients, serum CRP level can be used for interpret the disease invasion, quality of life, prognosis and evaluation of the chemotherapy responce. We investigate the relationship between serum CRP, quality of life and invasion of the disease and also the effect of chemotherapy to quality of life and serum CRP level.METHODS: Patients are chosen between the volunteers who did not take chemotherapy before and apply to the T.C. İstanbul Bilim Üniversity Avrupa Florance Nightingale Hospital Medical Oncology Clinic in the years 2009-2010. After a physical examination, for each patient who do not have a recent infection a blood test (for CRP) and EORTC QLQ-C30 (versiyon 3.0) questionnaire is performed. The same steps were repeated for each patient when they came for the third chemotherapy seance. Measurement of CRP is done by the Cobas Integra 400/800 machine with the turibidimetrik (latex) way. Statistical analysis is done with the help of SPSS 16.0 software.RESULTS: Study began with 57 patients but 2 of them died before taking the third chemotherapy dose. 36 progresed , 19 non-progressed, 25 female 30 male total 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 pancreas cancer, 1 patient had bone cancer, 3 patients had testis cancer and 1 patient had neuro-endocrin tumor. The average age of the progressed disease group was 55,7±11,7 while the average of non-progressed group was 52,6±13. Between two groups there wasn?t any significant differance ( p=0,370 ). The CRP levels of progressed and non-progressed cases are compared. Before chemotherapy ( p=0,359 ) and after chemotherapy (p=0,344 ) no significant differance is found. Also we could not determine a significant decrease within the CRP level of progressed ( p=0,907 ) and non-progressed ( p=0,113 ) patients when we compare them before and after the chemotherapy. The patients who had high levels of serum CRP, had increased fatigue, pain, diarrhea, insomnia, nausea and vomiting while decereased global health status, emotional functioning, role functioning and appetite score. After the chemotherapy, while there is a significant improvement in the global health status( p=0,017 ), role functioning( p=0,010 ), emotional functioning( p=0,00 ) and social functioning( p=0,043 ), there is a significant decrease in the pain score( p=0,005 ).CONCLUSIONS: Although we could not find significant decrease within the serum CRP levels with chemotherapy, we find out a correlation between high serum CRP levels and low life quality. With the result of these data, we may evaluate the serum CRP level as a marker of life quality. But we need more number of patient and statistical sudies that CRP is an independent variable as a marker of life quality.We find out a corrolation between chemotherapy and quality of life. The average life quality of the patients taking chemotherapy is increased. Contrary to popular belief, we can say that, chemotherapy is not a factor that decereases quality of life. Espacially within the first three seance, we can consider the quality of life increases.