Fatigue in patients with adjuvant radiation therapy for breast cancer: long-term follow-up
Fatigue in patients with adjuvant radiation therapy for breast cancer: long-term follow-up
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DOI：
10.1007/s00432-003-0540-9
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发表时间：
2004-06-01
影响因子：
3.6
通讯作者：
Molls, M
中科院分区：
文献类型：
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作者：
Geinitz, H;Zimmermann, FB;Molls, M
目的.本研究的目的是评估局部乳腺癌患者辅助放疗（RT）后2.5年的疲劳，并评估其与治疗前和治疗后即刻疲劳值的关系。分析疲劳与心理困扰和功能障碍的相关性，以及慢性疲劳的预处理预测因子。方法.在一组41例患者中，在辅助放射治疗期间评估了疲劳，在本研究中评估了38例RT后2.5年（t2）时存活且无癌症的患者。患者收到疲劳评估问卷（FAQ）、疲劳强度视觉模拟量表（VAS-F）以及癌症相关困扰（VAS-D）、医院焦虑和抑郁量表（HADS）以及简短的36项健康调查表（SF-36）中的三个问题。所有38名患者都返回了问卷。将这些值与治疗前（t0）和治疗后即刻水平（RT后2个月，t1）进行比较。结果RT后2.5年的慢性疲劳水平与治疗前值之间无显著差异。与治疗后即刻水平相比，FAQ总体评分和HADS焦虑评分显着增加。癌症相关的痛苦与疲劳评分密切相关。功能障碍患者的疲劳值略高。年龄或激素治疗与慢性疲劳水平无关。治疗前疲劳和治疗前HADS焦虑和抑郁评分是RT后2.5年疲劳的良好预测因子，解释了60%（FAQ）和49%（VAS-F）的方差。结论.在保守手术的乳腺癌患者中，RT后2.5年的疲劳没有增加到RT前的基线水平以上。慢性疲劳与心理困扰密切相关。治疗前疲劳、焦虑或抑郁水平升高的患者有慢性疲劳的风险。
Purpose. The aim of this study was to evaluate fatigue 2.5 years after adjuvant radiation therapy (RT) in patients with localized breast cancer and to assess its relation to pre- and immediate post-treatment fatigue values. The association of fatigue with psychological distress and functional impairment was analyzed as well as pretreatment predictors for chronic fatigue. Methods. Of a set of 41 patients whose fatigue was evaluated during adjuvant radiation therapy, 38 patients alive and free of cancer at 2.5 years (t2) after RT were assessed in this study. Patients received the Fatigue Assessment Questionnaire (FAQ), a visual analog scale on fatigue intensity (VAS-F) as well as on cancer-related distress (VAS-D), the Hospital Anxiety and Depression Scale (HADS), and three questions of the Short-Form 36-Item Health Survey (SF-36) per mail. All 38 patients returned their questionnaires. The values were compared to pretreatment (t0) and immediate post-treatment levels (2 months after RT, t1). Results. There was no significant difference between chronic fatigue levels at 2.5 years after RT and pretreatment values. When compared to immediate post-treatment levels the FAQ global score and the HADS anxiety score displayed a significant increase. Cancer-related distress correlated closely with fatigue scores. Patients with functional impairment had slightly higher fatigue values. Age or hormonal therapy were not associated with chronic fatigue levels. Pretreatment fatigue and pretreatment HADS anxiety and depression scores were good predictors of fatigue at 2.5 years after RT explaining 60% (FAQ) and 49% (VAS-F) of its variance. Conclusions. Fatigue 2.5 years after RT did not increase above baseline levels before RT in conservatively operated breast cancer patients. Chronic fatigue correlated closely with psychological distress. Patients with pretreatment elevated fatigue, anxiety or depression levels are at risk for chronic fatigue.