Fatigue and radiotherapy: (A) experience in patients undergoing treatment

被引:148
作者
Smets, EMA
Visser, MRM
Willems-Groot, AFMN
Garssen, B
Oldenburger, F
van Tienhoven, G
de Haes, JCJM
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Med Psychol, NL-1100 DE Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Radiotherapy, NL-1105 AZ Amsterdam, Netherlands
[3] Helen Dowling Inst Biopsychosocial Med, Rotterdam, Netherlands
关键词
fatigue; radiotherapy; psychological factor; physical factor; prediction;
D O I
10.1038/bjc.1998.599
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Cancer patients undergoing radiotherapy frequently report fatigue. However, knowledge of the importance of fatigue for these patients and of the factors associated with their fatigue is limited. The aim of the current investigation was to gain more insight into fatigue as related to radiotherapy by answering the following questions. First, how is the experience of fatigue best described? Secondly, to what extent is fatigue related to sociodemographic, medical (including treatment), physical and psychological factors? Finally, is it possible to predict which patients will suffer from fatigue after completion of radiotherapy? Patients with different types of cancer receiving radiotherapy with curative intent (n=250) were interviewed before and within 2 weeks of completion of radiotherapy. During treatment, patients rated their fatigue at 2-weekly intervals. Results indicate a gradual increase in fatigue over the period of radiotherapy and a decrease after completion of treatment. Fatigue scores obtained after radiotherapy were only slightly, although significantly, higher than pretreatment scores. After treatment, 46% of the patients reported fatigue among the three symptoms that caused them most distress. Significant associations were found between post-treatment fatigue and diagnosis, physical distress, functional disability, quality of sleep, psychological distress and depression. No association was found between fatigue and treatment or personality characteristics. Multivariate regression analysis demonstrated that the intensity of pretreatment fatigue was the best predictor of fatigue after treatment. In view of this finding, a regression analysis was performed to gain more insight into the variables predicting pretreatment fatigue, The degree of functional disability and impaired quality of sleep were found to explain 38% of the variance in fatigue before starting radiotherapy. Fatigue in disease-free patients 9 months after treatment is described in paper (B) in this issue.
引用
收藏
页码:899 / 906
页数:8
相关论文
共 31 条
[1]   THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER QLQ-C30 - A QUALITY-OF-LIFE INSTRUMENT FOR USE IN INTERNATIONAL CLINICAL-TRIALS IN ONCOLOGY [J].
AARONSON, NK ;
AHMEDZAI, S ;
BERGMAN, B ;
BULLINGER, M ;
CULL, A ;
DUEZ, NJ ;
FILIBERTI, A ;
FLECHTNER, H ;
FLEISHMAN, SB ;
DEHAES, JCJM ;
KAASA, S ;
KLEE, M ;
OSOBA, D ;
RAZAVI, D ;
ROFE, PB ;
SCHRAUB, S ;
SNEEUW, K ;
SULLIVAN, M ;
TAKEDA, F .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1993, 85 (05) :365-376
[2]  
Blesch K S, 1991, Oncol Nurs Forum, V18, P81
[3]   CHEMOTHERAPEUTIC TOXICITY - THE RELATIONSHIP BETWEEN PATIENTS PRETREATMENT EXPECTATIONS AND POST-TREATMENT RESULTS [J].
CASSILETH, BR ;
LUSK, EJ ;
BODENHEIMER, BJ ;
FARBER, JM ;
JOCHIMSEN, P ;
MORRINTAYLOR, B .
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 1985, 8 (05) :419-425
[4]  
DEHAES JCJ, 1988, QUALITY LIFE CANC PA
[5]   MEASURING PSYCHOLOGICAL AND PHYSICAL DISTRESS IN CANCER-PATIENTS - STRUCTURE AND APPLICATION OF THE ROTTERDAM-SYMPTOM-CHECKLIST [J].
DEHAES, JCJM ;
VANKNIPPENBERG, FCE ;
NEIJT, JP .
BRITISH JOURNAL OF CANCER, 1990, 62 (06) :1034-1038
[6]   PSYCHOSOCIAL PROBLEMS AMONG SURVIVORS OF HODGKINS-DISEASE [J].
FOBAIR, P ;
HOPPE, RT ;
BLOOM, J ;
COX, R ;
VARGHESE, A ;
SPIEGEL, D .
JOURNAL OF CLINICAL ONCOLOGY, 1986, 4 (05) :805-814
[7]   ASSESSMENT OF FATIGUE IN CANCER AND NONCANCER PATIENTS AND IN HEALTHY-INDIVIDUALS [J].
GLAUS, A .
SUPPORTIVE CARE IN CANCER, 1993, 1 (06) :305-315
[8]   TREATMENT-RELATED FATIGUE AND SERUM INTERLEUKIN-1 LEVELS IN PATIENTS DURING EXTERNAL BEAM IRRADIATION FOR PROSTATE-CANCER [J].
GREENBERG, DB ;
GRAY, JL ;
MANNIX, CM ;
EISENTHAL, S ;
CAREY, M .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1993, 8 (04) :196-200
[9]   FATIGUE SYNDROME DUE TO LOCALIZED RADIATION [J].
GREENBERG, DB ;
SAWICKA, J ;
EISENTHAL, S ;
ROSS, D .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1992, 7 (01) :38-45
[10]  
Haylock P J, 1979, Cancer Nurs, V2, P461