The effects of chemotherapy on C-reactive protein and quality of life in cancer patients
Mehmet Yavuz GÜRLER,1 Gökhan DEMİR,1 Fergial MOUEMİNOGLOU,2 Süheyla APAYDIN,1 Nuray LÜY1
1İstanbul Bilim Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İstanbul
2Şişli Etfal Eğitim ve Araştırma Hastanesi, Aile Hekimliği Kliniği, İstanbul
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.

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.

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).

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. Keywords : EORTC QLQ-C30; C-reactive protein; cancer; chemotherapy; life quality