The relationship between interleukin-6, tumor necrosis factor-α, and fatigue in terminally ill cancer patients

Sang Mi Kwak, Youn Seon Choi, Ho Min Yoon, Dae Gyun Kim, Seung Hun Song, Young Jae Lee, Chang Hwan Yeom, Su Jin Koh, Jeanno Park, Myung Ah Lee, Sang Yeon Suh

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


Although many cancer patients receiving palliative care experience distressing levels of fatigue, no well-designed studies have investigated contributing factors in Korean patients. We conducted a cross-sectional study using the Brief Fatigue Inventory-K (BFI-K) to measure fatigue while assessing a variety of possible correlates. Ninety patients with incurable cancer in the terminal stage (median survival: 27 days) participated in a structured interview and questionnaire related to their medical conditions and underwent blood sampling for laboratory data and cytokines, including interleukin (IL)-6 and tumor necrosis factor (TNF)-α. Body mass index, dyspnea, the Eastern Cooperative Oncology Group performance status, and levels of albumin, blood urea nitrogen (BUN), total bilirubin, and C-reactive protein were significantly associated with fatigue. However, levels of the two proinflammatory cytokines, IL-6 and TNF-α, were not significantly correlated with the BFI-K score. In stepwise multiple linear regression, fatigue was related to elevated BUN (β = 0.376, p = 0.002), severe pain intensity (β = 0.349, p = 0.004), and impaired performance status (β = 0.268, p = 0.027), but not related to levels of inflammatory cytokines. In conclusion, the diagnostic work-up and therapeutic plan for patients with cancer-related fatigue should include an evaluation of laboratory parameters, pain severity, and physical performance.

Original languageEnglish
Pages (from-to)275-282
Number of pages8
JournalPalliative Medicine
Issue number3
Publication statusPublished - 2012 Apr
Externally publishedYes

Bibliographical note

Funding Information:
This work was partially supported by the Korean Academy of Family Physicians Grant No. 08-01-3.


  • Blood urea nitrogen
  • cytokine
  • fatigue
  • pain
  • physical performance
  • terminal cancer

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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