Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 19:8:100099.
doi: 10.1016/j.cpnec.2021.100099. eCollection 2021 Nov.

Associations of meaning of illness with psychosocial, clinical, and immunological characteristics in patients with Leptomeningeal metastasis

Julie G Walker  1 , Terri S Armstrong  2   3 , Barbara J O'Brien  1 , Mark R Gilbert  2 , Rebecca L Casarez  3 , Christopher Fagundes  4 , Cobi J Heijnen  5 , Clark R Andersen  6 , Ying Yuan  6 , Jimin Wu  6 , Geri LoBiondo-Wood  3
Affiliations

Associations of meaning of illness with psychosocial, clinical, and immunological characteristics in patients with Leptomeningeal metastasis

Julie G Walker et al. Compr Psychoneuroendocrinol. .

Abstract

Background: Leptomeningeal metastasis (LM) creates symptoms related to both the disease within the nervous system and treatment toxicities. Biologic processes, such as inflammation and behavioral processes, such as the meaning ascribed to illness (Meaning of Illness: MoI), can impact physical and psychosocial symptoms. The aim of this study was to understand the relationships among MoI, physical and psychosocial symptoms, and inflammation in patients with LM.

Methods: Thirty enrolled participants completed the MD Anderson Symptom Inventory-Brain Tumor with spine experimental symptoms added. Meaning of illness, quality of life (QoL), and depression were captured by validated instruments. Interleukin (IL)-6 and tumor necrosis factor (TNF)-α in serum and cerebrospinal fluid (CSF) were measured by ELISA. Correlations were performed to assess relationships among the variables.

Results: Participants were primarily white (73%), female (63%). Median age was 54 years (34-83). Breast (50%) and lung (20%) were most common diagnosis. Higher MoI scores were associated with better QoL (p < .01) and fewer depressive symptoms (p < .01). All CSF samples contained IL-6 and all but one sample had elevated IL-6. Higher levels of IL-6 in the CSF were associated with greater symptom burden (p < .01) and interference of symptoms in daily life (p = .02) but not MoI.

Conclusions: MoI was associated with QoL and depression. High levels of IL-6 in the CSF were associated with more severe symptoms. This study provides the groundwork for future research, including interventional studies to improve QoL in patients with LM.

Keywords: Cytokine; Depression; Leptomeningeal metastasis; Meaning of illness; Quality of life; Symptoms.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

    1. Mack F., Baumert B.G., Schafer N., Hattingen E., Scheffler B., Herrlinger U., Glas M. Therapy of leptomeningeal metastasis in solid tumors. Cancer Treat Rev. 2016;43:83–91. - PubMed
    1. Franzoi M.A., Hortobagyi G.N. Leptomeningeal carcinomatosis in patients with breast cancer. Crit. Rev. Oncol. Hematol. 2019;135:85–94. - PubMed
    1. Wang N., Bertalan M.S., Brastianos P.K. Leptomeningeal metastasis from systemic cancer: review and update on management. Cancer Cytopathol. 2018;124:21–35. - PMC - PubMed
    1. Gong L., Xiong M., Huang Z., Miao L., Fan Y. Icotinib might be effective for the treatment of leptomeningeal carcinomatosis in non-small cell lung cancer with sensitive EGFR mutations. Lung Cancer. 2015;89:268–273. - PubMed
    1. Hyun J.W., Jeong I.H., Joung A., Cho H.J., Kim S.H., Kim H.J. Leptomeningeal metastasis: clinical experience of 519 cases. Eur. J. Cancer. 2016;56:107–114. - PubMed

LinkOut - more resources