Trajectories of fatigue in patients with breast cancer before, during, and after radiation therapy.
Trajectories of fatigue in patients with breast cancer before, during, and after radiation therapy.
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DOI：
10.1097/ncc.0b013e3181c75f2a
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发表时间：
2010-05
期刊：
影响因子：
2.6
通讯作者：
Miaskowski C
中科院分区：
文献类型：
--
作者：
Dhruva A;Dodd M;Paul SM;Cooper BA;Lee K;West C;Aouizerat BE;Swift PS;Wara W;Miaskowski C
疲劳是与放射治疗 (RT) 相关的一个重要问题。这项研究研究了从模拟时到 RT 完成后四个月期间晚上和早晨的疲劳如何变化，并调查了特定的人口统计和疾病特征以及症状的基线严重程度是否可以预测初始疲劳水平和疲劳轨迹的特征。 73 名乳腺癌女性在开始 RT 和 Lee 疲劳量表之前的六个月内完成了问卷调查，评估睡眠障碍、抑郁、焦虑和疼痛。使用描述性统计和分层线性模型进行数据分析。在疲劳轨迹中发现了大量的个体差异。基线时的夜间疲劳受到家中有孩子和抑郁的负面影响。对于有工作的女性来说，夜间疲劳的情况更为严重。基线晨间疲劳受到年龄较小、体重指数较低、睡眠障碍和特质焦虑程度的影响。对于疾病阶段较高和合并症较多的患者来说，早晨疲劳的轨迹更差。患有乳腺癌的女性中发现的疲劳的个体间和每日变异性与患有前列腺癌的男性中发现的相似。然而，这两个队列之间个体间疲劳变异的预测因素是不同的。昼夜变化和早晚疲劳的不同预测因素表明了不同的潜在机制。在未来干预研究的设计中需要考虑疲劳的各种预测因素。
Fatigue is a significant problem associated with radiation therapy (RT). This study examined how evening and morning fatigue changed from the time of simulation to four months after the completion of RT and investigated whether specific demographic and disease characteristics and baseline severity of symptoms predicted initial levels of fatigue and characteristics of the trajectories of fatigue. Seventy-three women with breast cancer completed questionnaires that assessed sleep disturbance, depression, anxiety, and pain prior to the initiation of RT and the Lee Fatigue Scale, over six months. Descriptive statistics and hierarchical linear modeling were used for data analysis. Large amounts of inter-individual variability were found in the trajectories of fatigue. Evening fatigue at baseline was negatively influenced by having children at home and depression. The trajectory of evening fatigue was worse for women who were employed. Morning fatigue at baseline was influenced by younger age, lower body mass index, and the degree of sleep disturbance and trait anxiety. Trajectories of morning fatigue were worse for patients with a higher disease stage and more medical co-morbidities. Inter-individual and diurnal variability in fatigue found in women with breast cancer is similar to that found in a men with prostate cancer. However, the predictors of inter-individual variability in fatigue between these two cohorts were different. Diurnal variability and different predictors for morning and evening fatigue suggest different underlying mechanisms. The various predictors of fatigue need to be considered in the design of future intervention studies.