Cancer-Related Fatigue in Women With Breast Cancer: Outcomes of a 5-Year Prospective Cohort Study
Cancer-Related Fatigue in Women With Breast Cancer: Outcomes of a 5-Year Prospective Cohort Study
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DOI：
10.1200/jco.2011.34.6148
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发表时间：
2012-05-20
影响因子：
45.3
通讯作者：
Lloyd, Andrew R.
中科院分区：
文献类型：
--
作者：
Goldstein, David;Bennett, Barbara K.;Lloyd, Andrew R.
目的癌症治疗后，长期和致残性疲劳是普遍存在的，但癌症相关性疲劳（CRF）的早期自然病史尚未被系统地检查以记录症状的一致存在。因此，与癌症、手术和辅助治疗的关系尚不清楚。患者和方法对接受辅助治疗的早期乳腺癌妇女进行前瞻性队列研究。女性（n = 218）在手术后入组，并在治疗结束、1、3、6、9、12个月和5年时进行观察。采用结构化访谈和自我报告问卷来记录身体和心理健康状况以及残疾和医疗保健利用情况。对持续6个月的CRF患者进行评估，以排除其他医学和精神原因引起的疲劳。通过logistic回归寻找持续性疲劳、情绪障碍和医疗保健利用的预测因子。结果术后CRF发生率为24% (n = 51)，治疗结束时为31% (n = 69)；6个月时有11% （n = 24）和6% （n = 12）的患者持续存在。在每个时间点，大约三分之一的患者有共病性情绪障碍。持续性CRF是由肿瘤大小预测的，而不是人口学、心理、外科或血液学参数。CRF与显著的残疾和医疗保健利用相关。结论crf是一种常见病，但其病程一般具有自限性。许多先前报道的高持续性慢性肾功能衰竭发生率可能归因于与癌症或治疗无关的因素。中华临床杂志（英文版）：1805- 1801。(c) 2012年由美国临床肿瘤学会发布
PurposeProlonged and disabling fatigue is prevalent after cancer treatment, but the early natural history of cancer-related fatigue (CRF) has not been systematically examined to document consistent presence of symptoms. Hence, relationships to cancer, surgery, and adjuvant therapy are unclear.Patients and MethodsA prospective cohort study of women receiving adjuvant treatment for early-stage breast cancer was conducted. Women (n = 218) were enrolled after surgery and observed at end treatment and at 1, 3, 6, 9, and 12 months as well as 5 years. Structured interviews and self-report questionnaires were used to record physical and psychologic health as well as disability and health care utilization. Patients with CRF persisting for 6 months were assessed to exclude alternative medical and psychiatric causes of fatigue. Predictors of persistent fatigue, mood disturbance, and health care utilization were sought by logistic regression.ResultsThe case rate for CRF was 24% (n = 51) postsurgery and 31% (n = 69) at end of treatment; it became persistent in 11% (n = 24) at 6 months and 6% (n = 12) at 12 months. At each time point, approximately one third of the patients had comorbid mood disturbance. Persistent CRF was predicted by tumor size but not demographic, psychologic, surgical, or hematologic parameters. CRF was associated with significant disability and health care utilization.ConclusionCRF is common but generally runs a self-limiting course. Much of the previously reported high rates of persistent CRF may be attributable to factors unrelated to the cancer or its treatment. J Clin Oncol 30:1805-1812. (c) 2012 by American Society of Clinical Oncology