Fatigue and functional impairment in early-stage non-small cell lung cancer survivors.
Fatigue and functional impairment in early-stage non-small cell lung cancer survivors.
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DOI：
10.1016/j.jpainsymman.2010.05.017
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发表时间：
2011-02
影响因子：
4.7
通讯作者：
Ostroff, Jamie S.
中科院分区：
文献类型：
--
作者：
Hung, Robert;Krebs, Paul;Coups, Elliot J.;Feinstein, Marc B.;Park, Bernard J.;Burkhalter, Jack;Ostroff, Jamie S.
关键词：
疲劳是治疗后1-6年非小细胞肺癌（NSCLC）幸存者中最常见的后遗症，并与功能限制相关。本研究检查了早期NSCLC幸存者中疲劳的患病率、严重程度和相关性。350例诊断为IA或IB期NSCLC并接受手术治疗的患者完成了一项调查，其中包括评估疲劳患病率和严重程度的简明疲劳量表（BFI）。自我报告的Karnofsky性能量表（SR-KPS）被用作功能状态的测量，并通过卡方分析与疲劳的严重程度进行比较。人口统计学，心理学和医学相关的疲劳进行了检查，使用逻辑回归。疲劳发生率为57%。41%（n = 142）的参与者有轻度疲劳，16.8%（n = 59）有中度或重度疲劳（BFI ≥ 4）。在报告中度或重度疲劳的个体中，23.7%（n=14）有显著的功能障碍（SR-KPS ≤ 70%），而2.8%（n =8）有轻度或无疲劳（χ2 = 58.1，p < 0.001）。在多变量分析中，患有肺部疾病（OR = 2.28）、抑郁症状（OR = 6.99）和焦虑症状（OR = 2.31）的NSCLC幸存者更有可能报告经历具有临床意义的疲劳，而符合体力活动指南（OR = 0.29）的患者报告的疲劳程度较低。疲劳在NSCLC幸存者中非常普遍，并与更多的功能障碍相关。治疗疲劳的综合方法包括筛查和管理焦虑和抑郁症状，以及肺部疾病，如慢性阻塞性肺病。
Fatigue is the most common sequela among non-small cell lung cancer (NSCLC) survivors 1–6 years post-treatment and is associated with functional limitations. This study examined the prevalence, severity, and correlates of fatigue among early stage NSCLC survivors. Three-hundred fifty individuals diagnosed and surgically treated for Stage IA or IB NSCLC completed a survey that included the Brief Fatigue Inventory (BFI) to assess the prevalence and severity of fatigue. The Self-Reported Karnofsky Performance Scale (SR-KPS) was used as a measure of functional status and was compared with the severity of fatigue though chi-square analyses. Demographic, psychological, and medical correlates of fatigue were examined using logistic regression. The prevalence of fatigue was 57%. Forty-one percent (n = 142) of participants had mild fatigue and 16.8% (n = 59) had moderate or severe fatigue (BFI ≥ 4). Among the individuals reporting moderate or severe fatigue, 23.7% (n=14) had significant functional impairment (SR-KPS ≤ 70%) compared to 2.8% (n =8) with mild or no fatigue (χ2 = 58.1, p < 0.001). In the multi-variate analysis, NSCLC survivors with pulmonary disease (OR = 2.28), depressive symptoms (OR = 6.99), and anxiety symptoms (OR = 2.31) were more likely to report experiencing clinically significant fatigue, while those who met physical activity guidelines (OR = 0.29) reported less fatigue. Fatigue is highly prevalent among NSCLC survivors and associated with more functional impairment. A comprehensive approach to the treatment of fatigue includes the screening and management of anxious and depressive symptoms, and pulmonary disorders such as chronic obstructive pulmonary disease.
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