Time Course and Predictors for Cancer-Related Fatigue in a Series of Oropharyngeal Cancer Patients Treated with Chemoradiation Therapy
Time Course and Predictors for Cancer-Related Fatigue in a Series of Oropharyngeal Cancer Patients Treated with Chemoradiation Therapy
复制标题
DOI：
10.1634/theoncologist.2011-0437
复制
发表时间：
2012-04-01
期刊：
影响因子：
5.8
通讯作者：
Lee, Nancy Y.
中科院分区：
文献类型：
--
作者：
Spratt, Daniel E.;Sakae, Mayuko;Lee, Nancy Y.
背景癌症相关性疲劳（CRF）是癌症患者中非常普遍和被低估的症状。本研究的目的是分析CRF仅在一个队列的口咽癌患者接受放疗（RT）。2008年1月至2010年6月，87例连续口咽癌患者接受了明确的RT。94%的患者同时接受化疗。总体或临床肿瘤体积的计划靶体积的中位处方剂量为70戈伊（确定性病例，n = 84）和66戈伊（术后病例，n = 3），均在6.5周内输送。一个标准化的12点数字评分量表评估CRF患者访视之前，期间和之后RT。存活患者的中位随访时间为14个月。RT后1-2周疲劳达到峰值，50%的患者在RT后2年内仍高于基线。完成治疗时的平均疲劳评分或RT后1年的最大疲劳评分显著差于基线。发生疼痛的患者有显著性趋势，与基线相比疲劳的最大差异更高相关。Karnofsky行为状态评分、体重变化和情绪障碍与CRF无关。在这个统一的口咽癌患者队列中，疲劳是一种常见的治疗相关症状。RT与CRF恶化高度相关。疼痛控制有可能帮助缓解疼痛患者的CRF，需要使用更大的数据集进行确认。肿瘤学家2012;17：569-576
Background. Cancer-related fatigue (CRF) is a highly prevalent and underestimated symptom in cancer patients. This study aims to analyze CRF solely in a cohort of oropharyngeal cancer patients who underwent treatment with radiotherapy (RT).Methods. In January 2008 to June 2010, 87 consecutive oropharyngeal carcinoma patients underwent definitive RT. Concurrent chemotherapy was used for 94% of patients. The median prescription dose to the planning target volume of the gross or clinical tumor volume was 70 Gy for definitive cases (n = 84) and 66 Gy for postoperative cases (n = 3), both delivered over 6.5 weeks. A normalized 12-point numeric rating scale assessed CRF from patient visits before, during, and after RT.Results. The median follow-up of living patients was 14 months. Fatigue peaked 1-2 weeks post-RT and remained higher than baseline for up to 2 years post-RT in 50% of patients. The average fatigue score at the time of completion of therapy or maximum thereafter up to 1 year post-RT was significantly worse than baseline. Patients who experienced pain had a trend toward significance with association for a higher maximum difference in fatigue from baseline. Karnofsky performance status score, weight change, and mood disorders did not correlate with CRF.Conclusions. Fatigue was a common treatment-related symptom in this uniform cohort of patients with oropharyngeal cancer. RT was highly correlated with worsening of CRF. Pain control has the potential to help mitigate CRF in patients experiencing pain, and will need to be confirmed using larger datasets. The Oncologist 2012;17:569-576