Fatigue after breast cancer treatment: Biobehavioral predictors of fatigue trajectories.
Fatigue after breast cancer treatment: Biobehavioral predictors of fatigue trajectories.
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DOI：
10.1037/hea0000652
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Ganz PA
中科院分区：
文献类型：
--
作者：
Bower JE;Wiley J;Petersen L;Irwin MR;Cole SW;Ganz PA
疲劳是癌症治疗的常见副作用，但幸存者的疲劳严重程度和持久性存在相当大的差异。本研究旨在描述乳腺癌治疗后疲劳的纵向轨迹，并确定不同疲劳轨迹的预测因素。来自身心研究的女性（N=191）在早期乳腺癌的初级治疗后和治疗后6年（M = 4.3年）的定期随访中完成了评估。增长混合模型被用来描述疲劳轨迹，人口，医疗和生物行为的危险因素进行了检查，作为轨迹组的预测。确定了5种轨迹，分别为高疲劳、恢复疲劳、晚期疲劳、低疲劳和极低疲劳。高剂量组和恢复组（40%的样本）在治疗后表现出疲劳增加，在恢复期下降，但在高剂量组持续存在。在双变量分析中，轨迹组在抑郁症状、睡眠障碍、儿童期逆境、体重指数和炎症标志物可溶性TNF受体II型方面存在显著差异，这些在高水平和/或恢复组中更高。在多变量模型中，抑郁症状和童年逆境将High和Recovery与其他组区分开来。恢复组的化疗率高于高或晚期组，而高组的内分泌治疗率高于恢复组。乳腺癌治疗后的疲劳有明显的纵向轨迹。心理因素与不良疲劳轨迹密切相关，并且与治疗暴露一起可能增加癌症相关疲劳的风险。
Fatigue is a common side effect of cancer treatment, but there is considerable variability in fatigue severity and persistence among survivors. This study aimed to characterize longitudinal trajectories of fatigue after breast cancer treatment and to identify predictors of varying fatigue trajectories. Women (N=191) from the Mind-Body Study completed assessments after primary treatment for early-stage breast cancer and at regular follow-ups that occurred up to 6 years after treatment (M = 4.3 years). Growth mixture models were used to characterize fatigue trajectories, and demographic, medical, and biobehavioral risk factors were examined as predictors of trajectory group. Five trajectories were identified, characterized as High, Recovery, Late, Low, and Very Low fatigue. The High and Recovery groups (40% of sample) evidenced elevated fatigue at post-treatment that declined in Recovery but persisted in the High group. In bivariate analyses, trajectory groups differed significantly on depressive symptoms, sleep disturbance, childhood adversity, body mass index, and the inflammatory marker soluble TNF receptor type II, which were higher in the High and/or Recovery groups. In multivariate models, depressive symptoms and childhood adversity distinguished High and Recovery from other groups. Rates of chemotherapy were higher in the Recovery than in the High or Late group, whereas rates of endocrine therapy were higher in the High than in the Recovery group. There are distinct longitudinal trajectories of fatigue after breast cancer treatment. Psychological factors are strongly associated with adverse fatigue trajectories, and together with treatment exposures may increase risk for cancer-related fatigue.
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影响因子：
6.2
作者：
Andrykowski, Michael A.;Donovan, Kristine A.;Laronga, Christine;Jacobsen, Paul B.
通讯作者：
Jacobsen, Paul B.
影响因子：
4.2
作者：
Donovan, Kristine A.;Small, Brent J.;Jacobsen, Paul B.
通讯作者：
Jacobsen, Paul B.
乳腺癌治疗后的行为症状：一种生物行为方法。
影响因子：
--
作者：
Fagundes C;LeRoy A;Karuga M
通讯作者：
Karuga M
影响因子：
45.3
作者：
Bower, Julienne E.;Ganz, Patricia A.;Cole, Steven W.
通讯作者：
Cole, Steven W.
影响因子：
4.2
作者：
Dunn, Laura B.;Cooper, Bruce A.;Miaskowski, Christine
通讯作者：
Miaskowski, Christine