Association between fatigue and other cancer-related symptoms in patients with advanced cancer.
Association between fatigue and other cancer-related symptoms in patients with advanced cancer.
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晚期癌症患者疲劳与其他癌症相关症状之间的关联。
DOI：
10.1007/s00520-008-0466-5
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Bruera,Eduardo
中科院分区：
文献类型：
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作者：
Yennurajalingam,Sriram;Palmer,JLynn;Zhang,Tao;Poulter,Valerie;Bruera,Eduardo
工作目标尽管疲劳是晚期癌症患者最常经历的慢性症状，但对该人群中疲劳的关联和相关性的研究却很少。因此，本研究的目的是确定通过慢性病治疗疲劳功能评估 (FACIT-F) 测量的疲劳分数是否与年龄、性别、诊断的癌症类型、疼痛和使用埃德蒙顿症状评估量表 (ESAS) 测量的其他癌症相关症状相关。材料和方法我们回顾性审查了 FACIT-F（当分数较高表示疲劳程度较低时）和 ESAS（当疲劳分数较低时）表示较低的疲劳强度）对 268 名晚期癌症患者进行评分，这些患者之前曾参加过疲劳疗法的临床试验。为了确定变量之间的关联，我们对数据进行了单变量和多变量分析。结果我们发现疲劳评分与性别、种族 (p= 0.31) 或诊断的癌症类型之间没有单变量关联。表现状态与疲劳相关（p< 0.0001）。然而，在多变量分析中，我们发现疲劳与疼痛（r= −0.20，p= 0.0012）、恶心（r= −0.13，p= 0.04）、焦虑（r= −0.27，p< 0.0001）、疲劳和抑郁之间存在显着关联。 (r= −0.19,p= 0.0019)、嗜睡(r= −0.24,p= 0.0002)、呼吸困难(r= −0.17,p= 0.007)、厌食(r= −0.29,p< 0.0001)、失眠（r= −0.25，p< 0.0001）和幸福感（r= −0.37，p< 0.0001）。使用向后逐步逻辑回归分析，与疲劳相关的独立相关因素包括幸福感 (p= .0003)、困倦 (0.006)、厌食 (0.01) 和焦虑 (0.03)。然而，该模型只能解释疲劳强度变化的 21%。 结论 尽管我们发现疲劳与心理症状（焦虑和抑郁）和身体症状（疼痛、呼吸困难、失眠、厌食和嗜睡）的严重程度显着相关，但仍需要更多研究来证实这些确实是疲劳的主要关联，从而使医生能够更好地描述接受姑息治疗的患者的疲劳特征。
Goals of workAlthough fatigue is the chronic symptom most commonly experienced by patients with advanced cancer, little research has been done on the associations and correlates of fatigue in this population. The aim of this study was, therefore, to determine whether fatigue scores, as measured by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), are associated with age, gender, type of cancer diagnosed, pain, and other cancer-related symptoms measured using the Edmonton Symptom Assessment Scale (ESAS).Materials and methodsWe retrospectively reviewed the FACIT-F (when a higher score denotes lower fatigue) and ESAS (when a lower fatigue score denotes lower fatigue intensity) scores of 268 patients with advanced cancer who had been previously enrolled in clinical trials of therapies for fatigue. To determine associations between variables, we performed univariate and multivariate analyses on the data.ResultsWe found no univariate association between fatigue score and gender, ethnicity (p= 0.31), or type of cancer diagnosed. Performance status was associated with fatigue (p< 0.0001). On multivariate analysis, we found, however, significant association between fatigue and pain (r= −0.20,p= 0.0012), nausea (r= −0.13,p= 0.04), anxiety (r= −0.27,p< 0.0001), fatigue and depression (r= −0.19,p= 0.0019), drowsiness (r= −0.24,p= 0.0002), dyspnea (r= −0.17,p= 0.007), anorexia (r= −0.29,p< 0.0001), insomnia (r= −0.25,p< 0.0001), and feelings of well-being (r= −0.37,p< 0.0001). Using backward stepwise logistic regression analysis, independent correlative factors associated with fatigue include well-being (p= .0003), drowsiness (0.006), anorexia (0.01), and anxiety (0.03). However, this model only explained 21% of the variation in the intensity of fatigue.ConclusionsAlthough we found that fatigue is significantly associated with the severity of psychological symptoms (anxiety and depression) and physical symptoms (pain, dyspnea, insomnia, anorexia, and drowsiness), additional research is required to confirm that these are indeed the main associations of fatigue and, by doing so, enable physicians to better characterize fatigue in patients receiving palliative care.