Anorexia-Cachexia Syndrome을 가진 말기 암 환자에서 비타민 C 사용여부에 따른 사이토카인 변화 비교

Abstract

Purpose : Anorexia-cachexia syndrome is one of the most common symptoms and main cause of death in terminal cancer patients. This symptom is due to the enlarged cancer mass as well as tumor released cytokines. Some doctors have suggested that vitamin C was preferentially toxic to tumor cells in vitro and in vivo, and improved clinical symptoms in terminal cancer patients. Therefore, we measured cytokines in serum of terminal cancer patients to determine whether vitamin C treatment improved the anorexia-cachexia syndrome. Methods : We investigated that 49 terminal cancer patients admitted to the department of family medicine, National Health Insurance Corporation Ilsan Hospital from March 1, 2002 to August 31, 2002. The study was done on 22 patients who were given 10 g/day of vitamin C injusions during 1 week and 27 patients who were not infused. We measured the cytokines levels (IL-1β, IL-6, and TNF-α) before and after 1 week between terminal cancer patients treated vitamin C and without vitamin C. Results : Out of 49 patients, patients treated with vitamin C infusions were 22 (12 male, 10 female), and these without vitamin C were 27 (18 male, 9 female). In patients treated with vitamin C, IL-1β were 6.19±5.17 before day and 8.76±5.72 after 1 week, IL-6 were 3.07±8.09 before day and 1.31±2.36 after 1 week, and TNF-α were 2.74±14.24 before day and 0.50±2.00 after 1 week. In patients treated without vitamin C, IL-1β were 2.50±3.58 before day and 6.49±12.01 after 1 week, IL-6 were 1.00±2.19 before day and 17.16±81.55 after 1 week, and TNF-α were 1.19±2.98 before day and 1.27±1.52 after 1 week. The level of cytokines in patients treated with vitamin C decreased more than those without vitamin C. However, this represented no statistical value (P=0.0598 in IL-1β, P=0.1664 in IL-6, P=0.5395 in TNF-α). Conclusion : In terminal cancer, even if there was no statistical difference in the cytokines levels between patients treated with vitamin C and those not treated, those who were treated had a decrease all cytokines levels. Vitamin C is very safe with almost no side effects. Therefore, vitamin C treatment in terminal cancer patients can be seen as beneficial and helpful for clinical symptoms.