Evidence map›Paper›PMID 42723304›Full record

SynthesisPsycho-oncology2026

Inflammatory Correlates and Prospective Associations of Cancer-Related Fatigue: A Systematic Review and Meta-Analysis.

Lina Wu, Xingyu Xiong, Zhaohui Zhang, Shouzhen Cheng

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Psycho-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Lina WuSchool of Nursing, Sun Yat-sen University, Guangzhou, China.ORCID https://orcid.org/0000-0002-7280-0803
Xingyu XiongThe First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Zhaohui ZhangThe First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Shouzhen ChengThe First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Funding

Natural Science Foundation of Guangdong Province 2025A1515010640 (K0213689)
6 · The paper itself

Abstract

backgroundCancer-related fatigue (CRF) is a prevalent and disabling symptom across the cancer continuum and is increasingly conceptualized as a biobehavioral symptom with inflammatory underpinnings. However, evidence linking specific circulating inflammatory biomarkers to CRF remains fragmented and inconsistent.

aimsTo compare biomarker-CRF associations across cross-sectional and prospective observational studies.

methodsPubMed, Web of Science, Cochrane Library, Embase, Scopus, and PsycINFO were searched from inception to 17 November 2025. Random-effects meta-analyses were stratified by study design and effect-size metric; non-comparable estimates were synthesized narratively. Certainty was assessed using GRADE.

resultsForty-two studies (11,629 participants) were included. Cross-sectional CRF was positively associated with C-reactive protein (CRP; r = 0.30, 95% CI 0.21-0.38). Positive associations were also observed for interleukin-6 (IL-6; r = 0.17, 95% CI 0.06-0.29) and tumor necrosis factor (TNF; r = 0.13, 95% CI 0.01-0.24). Interleukin-1 receptor antagonist was likewise associated with CRF (IL-1ra; r = 0.23, 95% CI 0.09-0.36). Prospectively, CRP was associated with subsequent CRF in odds ratio (OR = 1.20, 95% CI 1.05-1.37) and standardized regression syntheses (β = 0.26, 95% CI 0.09-0.43). Evidence for IL-6, TNF, IL-1β, and IL-8 was less stable or inconclusive. Certainty was high for four evidence bodies, moderate for four, low for one, and very low for one.

conclusionCurrent evidence supports systemic inflammation as a clinically relevant biological correlate of CRF, with CRP/hsCRP showing a comparatively more replicable signal across study designs. However, observational evidence does not establish causality or clinical utility. Standardized longitudinal and intervention studies are needed to evaluate temporal relationships, predictive performance, and clinical applicability.

Indexed as

FatigueInflammationNeoplasmsBiomarkersC-Reactive ProteinCross-Sectional StudiesHumansInterleukin-6Prospective StudiesTumor Necrosis Factor-alphaBiomarkersC-Reactive ProteinInterleukin-6Tumor Necrosis Factor-alphabiomarkerscancercancer‐related fatigueC‐reactive proteininflammationmeta‐analysis

Identifiers

PMID42723304
PMCPMC13562817

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.