The course of cancer related fatigue up to ten years in early breast cancer patients: What impact in clinical practice?
The course of cancer related fatigue up to ten years in early breast cancer patients: What impact in clinical practice?
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DOI：
10.1016/j.breast.2017.04.012
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发表时间：
2017-08-01
期刊：
影响因子：
3.9
通讯作者：
Pugliese, Patrizia
中科院分区：
文献类型：
--
作者：
Fabi, Alessandra;Falcicchio, Chiara;Pugliese, Patrizia
关于癌症病程沿着的癌症相关疲劳（CRF）以及可以预测乳腺癌（BC）幸存者中CRF发展和持续性的风险因素知之甚少。这项前瞻性研究检测了CRF的发生率、发病时间、持续时间、对生活质量的影响和心理困扰。78名早期BC患者，采用EORTC QLQC 30和HAD问卷评估接受化疗（CT）后或未接受激素治疗的患者的QoL和心理困扰。疲劳调查采用混合法、结构化访谈法和心理测量法。术后低疲劳程度（9%），CT检查时（49%）和CT检查结束时（47%）疲劳程度增加，1年后疲劳程度维持（31%），10年后疲劳程度下降。CRF的患病率在CT结束时较高，在随访时较低。在CT检查结束时以及1年和2年后，CRF的持续性分别与20%、11%和5%的焦虑相关，与15%、10%和5%的抑郁相关。CRF和心理困扰之间的关系进行了观察; CT前抑郁和焦虑的患者在后期疲劳发作的风险较高。疲劳与生活质量的关系在CT检查结束时被注意到。我们的研究显示了疲劳在早期BC患者中的时间趋势，从手术，CT和随访。识别与疲劳相关的生物、心理、社会预测因素可能有助于对疲劳风险较高的患者进行早期干预。(C)2017作者爱思唯尔有限公司出版
Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors.This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress.Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF.Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT.Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue. (C) 2017 The Authors. Published by Elsevier Ltd.