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Japanese Journal of Clinical Oncology Advance Access published online on November 25, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp155
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© The Author (2009). Published by Oxford University Press. All rights reserved

Disturbance of the Growth Hormone–Insulin-like Growth Factor-1 Axis Associated with Poor Performance Status in Patients with Solid Tumors

Isamu Okamoto1, Masaki Munakata2, Masaki Miyazaki1, Taroh Satoh1, Takenori Takahata2, Yasushi Takamatsu3, Osamu Muto2, Kazuhiko Koike4, Kunihiko Ishitani4, Taketo Mukaiyama5, Yuh Sakata2, Kazuhiko Nakagawa1 and Kazuo Tamura3

1 Department of Medical Oncology, Kinki University School of Medicine, Osaka
2 Department of Medical Oncology and Internal Medicine, Misawa City Hospital, Misawa
3 Division of Medical Oncology, Infectious Disease and Endocrinology, Department of Medicine, School of Medicine, Fukuoka University, Fukuoka
4 Higashi Sapporo Hospital, Sapporo
5 Department of Cancer Palliative Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

For reprints and all correspondence: Isamu Okamoto, Department of Medical Oncology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan. E-mail: chi-okamoto{at}dotd.med.kindai.ac.jp

Received July 23, 2009; accepted October 13, 2009

Objective: Hormonal imbalance characterized by excessive production of growth hormone (GH) and a low circulating concentration of insulin-like growth factor (IGF)-1 has been demonstrated in individuals with various serious conditions. However, little is known about changes in the GH–IGF-1 axis in cancer patients.

Methods: We prospectively examined the circulating levels of several hormones in 58 patients with solid tumors who were classified according to Eastern Cooperative Oncology Group performance status (PS): PS 0–1, n = 15; PS 2, n = 15; PS 3, n = 15; and PS 4, n = 13. The relations of hormone concentrations, with a focus on the GH–IGF-1 system, to PS were evaluated by Spearman's rank correlation test and regression analysis.

Results: The circulating levels of IGF-1, IGF-binding protein-3 and thyroid hormones (total T3 and T4) were inversely correlated with PS score. The concentration of GH was increased irrespective of PS but not statistically significant. The ratio of IGF-I to GH was inversely correlated with PS. The levels of GH and IGF-1 in all patients were also inversely correlated.

Conclusions: The present study suggests that the GH–IGF-1 axis is disturbed in patients with cancer.

Key Words: growth hormone • insulin-like growth factor-1 • performance status


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