Radionuclide therapy with 111In-pentetreoide in five digestive metastatic neuroendocrine tumors (DNET)

Abstract

Moderate exercise has been shown to enhance proinflam matory cytokines with decrea sed infection in athletes and healthy volunteers. Knowle dge of exercise effects in tumor patients including colorectal carcinoma, however, is limited, but could be important to under stand potentially beneficial effects. We, therefore, investigated the influence of a moderate (ME) vs. low impact (LE) postoperative exercise progra m on cytokine response in patients with colorec tal cancer with special regard to IL-I ra and IL-6, as decreased IL-I ra and increased IL-6 recently have been found to be associated with tumor progression. PATIE NTS AND METHODS: Eighteen pts. with colorectal cancer were equally randomized into a ME or LE program after surgery and chemotherapy/radiation. ME consisted of bicycle exercise (100 W, 40 min/d) for 3 weeks, LE comprised a low impact gymnastics program of the same duration. Cytokines (lL-6, IL-I ra, IL-I b. tumor necrosis factor [TNF] , TNF recep tor I and II) were assessed before and at the end of the program using ELISA assays after stimulation with lipopolysaccharide and pokeweed mitogen. RESULTS: In ME pts. IL-Ira decreased from 30,397 pg/mL (18,03 5 70,028, median, range) to 22,639 (7,814 34,726) (p < 0.02), whereas IL-6 slightly increased (12,692 , 5,803 30,379 to 15,617, 7,634 26,356 ), decreasin g the IL-l ralIL-6 ratio form 2.39 to 1.44 . In LE pts. IL-I ra and IL-6 remained unchanged (27,217, 20,871 89,3 14; 8,340, 4,830 8,661), with IL-l ralIL-6-ratio 3.26. The remaining cytokines also changed only insignificantly. CONCLUSIONS: Our data sugges t that a ME program in contras t to LE may decrease antiinflammatory response (lLra), thus shifting the cytokine balance to a more prointlammatory state as retlected by the decreased IL-ralIL -6 ratio. Whethe r this effect, however, may be clinically beneficial, has to be investigated in further trials with clinical endpoints in addition to measuring cytokine response.