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Individual Genetic Variation Might Predict Acute Skin Reactions in Women Undergoing Adjuvant Breast Cancer Radiotherapy
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Oncology, Ryhov County Hospital, Jönköping, Sweden .
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Futurum-The Academy for Healthcare, Region Jönköping County, Jönköping, Sweden.
Department of Oncology, Ryhov County Hospital, Jönköping, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Laboratory medicine, Region Jönköping County, Jönköping, Sweden.
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2018 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 38, no 12, p. 6763-6770Article in journal (Refereed) Published
Abstract [en]

Adverse skin reactions during radiotherapy (RT) are common. The aim of this study was to explore whether genetic variation might be linked to acute radiation skin reactions (ARSR). Materials and Methods: One hundred and nineteen women undergoing adjuvant RT for breast cancer were included. The symptoms of itching, burning and irritation were self-reported twice using the visual analogue scale. Assessments used the Radiation Therapy Oncology Group scoring system for acute RT skin reaction (RTOG scale). Blood-based single nucleotide polymorphism (SNP) analysis was performed. Thirty SNPs of well-defined functional genes were investigated. Results: All women were assessed with ARSR. After RT, the women self-reported itching (n=97), burning (n=64) and irritation (n=96). Two SNPs in X-Ray Repair Cross Complementing 2 gene (XRCC2) rs2040639 and interferon gamma (IFNG) rs2069705 genes were found to be associated with ARSR. Conclusion: An association between two SNPs and ARSR was found. The possibility of using these SNPs as prognostic biomarkers for ARSR as tools to improve the care of patients needs further investigation.

Place, publisher, year, edition, pages
The International Institute of Anticancer Research , 2018. Vol. 38, no 12, p. 6763-6770
Keywords [en]
Radiotherapy; breast cancer; skin reactions; single nucleotide polymorphism
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-153515DOI: 10.21873/anticanres.13047ISI: 000451742800022PubMedID: 30504388OAI: oai:DiVA.org:liu-153515DiVA, id: diva2:1274625
Note

Funding Agencies|Uppsala University; Knut & Alice Wallenberg Foundation of Uppsala, Sweden; Foundation for Clinical Cancer Research in Jonkoping; Futurum Academy for Health and Care, Region Jonkoping County, Sweden; FORSS-Medical Research Council of Southeast Sweden

Available from: 2019-01-02 Created: 2019-01-02 Last updated: 2019-11-20Bibliographically approved
In thesis
1. Prediction of side effects from anticancer treatment with the purpose of increasing quality of life
Open this publication in new window or tab >>Prediction of side effects from anticancer treatment with the purpose of increasing quality of life
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Cancer and its treatments can cause a variety of symptoms. Some of these symptoms are related to the disease and others are seen as a consequence of the treatment. Since patients experience side effects to different degrees despite undergoing the same treatment, it is hypothesized that there is a genetic factor. The individual variation that exists between different patients regarding nausea triggered by chemotherapy, radiotherapy induced skin reactions as well as sleep disorders associated with cancer could partly be explained by genetic differences. We have in these studies confirmed these individual differences. Previous nursing research has mainly focused on the symptoms themselves. The focus in this thesis are the following three main symptoms; nausea and vomiting related to chemotherapy, acute skin inflammation following radiotherapy and sleep problems associated with cancer diagnosis and -treatment.

The aim of this thesis was to find biological markers that can identify the risk of and/or protective factors for nausea and/or vomiting (CINV) as well as understand its heterogeneity (Study 1 and 2). It also aimed to understand the individual factors behind acute radiation skin reactions (ARSR) (Study 3) and sleeping disturbances in patients treated for cancer (Study 4), permitting a more individualized care and optimized health-related quality of life (HRQoL).

In Study 1 and 2 the patients themselves had to document in a diary their experience of nausea and vomiting and well-being. Well-being was considered as synonymous with quality of life. We found a variability and heterogeneity of those symptoms (Study 1). Three genetic markers, FAS/CD95, RB1/LPAR6 and CCL2 that could explain the individual differences and assess the risk of chemotherapy-induced nausea were found in Study 2.

Acute radiation skin reactions (ARSR) along with itching and burning sensation associated with radiotherapy (RT) was assessed by the patients themselves (Study 3) with help of the VAS- and RTOG scales, scoring for visible redness. We found two possible genetic markers, XRCC2 and IFNG. Also, individual differences in symptoms behavior were found.

Sleep disturbances were common and were reported with obvious individual differences [1]. For data collection were used a sleep questionnaire, the Medical Outcomes Study Sleep Scale (MOS), open ended questions and EORTC QLQ- C30 questionnaire of quality of life. Sleep, which is important for all primary body functions, is often affected in connection with cancer diagnosis and -treatment.

Through collaboration between nursing staff and specialists in basic science, we have found that biological markers can help in creating individualized care. Knowledge of individual variations in the severity of chemo- or radiotherapy-induced side effects is important in order to better personalize the treatment and care, improve the treatment results and alleviate or prevent the side effects of oncological treatments. By linking symptoms to biological markers, it will hopefully be able to increase the patients’ total health-related quality of life, this being the main goal of this thesis.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. p. 93
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1716
National Category
Cancer and Oncology Nursing Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-162101 (URN)10.3384/diss.diva-162101 (DOI)9789179299569 (ISBN)
Public defence
2019-12-12, Originalet, Qulturum, Länssjukhuset Ryhov, Jönköping, 09:00 (Swedish)
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Available from: 2019-11-19 Created: 2019-11-19 Last updated: 2020-02-06Bibliographically approved

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Oliva, DelmyNilsson, MatsAndersson, Bengt-ÅkeLewin, NongnitLewin, Freddi
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Medical and Health SciencesDepartment of Clinical and Experimental Medicine
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