1 Department of Mathematical Sciences, Faculty of Science, Københavns Universitet2 Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet3 The University Hospitals Centre for Health Care Research (UCSF), Copenhagen University Hospital , Copenhagen4 Bispebjerg University Hospital5 Copenhagen University Hospital, Rigshospitalet6 The Centre of Inflammation and Metabolism, Rigshospitalet7 Department of Mathematical Sciences, Faculty of Science, Københavns Universitet8 Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet
Abstract Context: Testicular germ cell cancer (GCC) patients treated with cisplatin-etoposide-bleomycin chemotherapy (BEP) have excellent prognosis but have an increased risk of late-occurring morbidities, which may be associated with changes in the inflammatory profile. Objective: The objective of the study was to explore plasma cytokine concentrations in GCC patients randomized to resistance training or usual care during BEP, in comparison with healthy controls. Design/Setting: This was a randomized controlled trial in GCC patients enrolled from an oncology clinic, including a healthy reference group for comparison purposes. Outcome Measures:Plasma granulocyte macrophage colony-stimulating factor, interferon-γ, IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12, and TNF-α were measured in fasting blood samples from GCC patients randomized to resistance training (INT; n = 15) or usual care (CON; n = 15) and healthy age-matched controls (REF; n = 19). Clinical toxicity assessments and patient-reported end points were also recorded. Results: CON and INT were balanced at baseline. Compared with REF, CON had higher concentrations of IL-10, IL-6, and interferon-γ, and INT had higher concentrations of IL-6, IL-8 and TNF-α (all P < .05). At the end of therapy, concentrations of IL-6, IL-8, and IL-10 increased in both GCC groups (all P < .01). Three months after therapy, all cytokine concentrations were comparable with the pretreatment levels in both GCC-groups but remained elevated compared with REF (P < .05). Changes in TNF-α correlated with pulmonary toxicity (P < .01). At the end of therapy, IL-6 concentrations correlated with quality of life (P < .05) and fatigue (P < .01). Conclusion: GCC patients treated with BEP display consistently elevated levels of systemic inflammatory markers compared with healthy controls. Resistance training during therapy has no impact on plasma cytokine concentrations.
Journal of Clinical Endocrinology and Metabolism, 2014, Vol 99, Issue 8, p. 2967-2976