Prospective evaluation of fatigue during a course of curative radiotherapy for localised prostate cancer
Prospective evaluation of fatigue during a course of curative radiotherapy for localised prostate cancer
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DOI：
10.1007/s00520-007-0229-8
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发表时间：
2007-10-01
影响因子：
3.1
通讯作者：
Fitch, Margaret
中科院分区：
文献类型：
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作者：
Danjoux, Cyril;Gardner, Sandra;Fitch, Margaret
目的采用两种不同的仪器对多伦多森尼布鲁克地区癌症中心接受治疗性放疗患者的放射性疲劳进行前瞻性评估。材料和方法连续同意说英语的男性接受局部前列腺癌的治愈性放疗纳入一项前瞻性伦理委员会批准的研究。我们采用一份11题疲劳问卷（FQ）和2题疲劳象形图（FP）来记录患者在治疗期间每周的反应。将11个FQ项目相加计算疲劳量表（FS）。在基线、第3周和第6周计算每个FQ和FP项目和平均FS的比例和95%置信区间。使用卡方检验或方差分析f检验来比较治疗组，使用配对t检验来比较基线和第6周。采用线性混合模型比较各治疗组不同时间的平均FS。结果从2000年6月至2003年6月，我们纳入了130例患者。51例行前列腺适形放疗（CRT）， 46例行全骨盆前列腺增强放疗（WP+PB）， 33例行前列腺切除术后前列腺床放疗（PBRT）。在基线上，39%（30-47%）的人报告了FQ的疲劳，60%（52-68%）的人报告了FP的疲劳。随着治疗的进展，平均疲劳程度显著增加。与FQ疲劳项目或FS相比，FP疲劳项目在治疗组之间的差异最大（第6周p=0.04）。随着时间的推移，接受较小体积（CRT或PBRT）照射的患者的FS评分低于接受较大体积（WP+PB）照射的患者。结论象形图法在治疗组间的鉴别效果优于问卷法。在繁忙的诊所中，象形图可用于筛选和监测基线疲劳患者的介入研究。
Purpose To prospectively evaluate radiation-induced fatigue among patients undergoing curative radiotherapy at the Toronto Sunnybrook Regional Cancer Centre using two different instruments.Materials and methods Consecutive consenting English speaking men receiving curative radiotherapy for localised prostate cancer were enrolled in a prospective ethics board approved study. We used an 11 questions fatigue questionnaire (FQ) based on a modified FACT-AN questionnaire and the 2 questions of the fatigue pictogram (FP) to record patients' responses weekly during treatment. The 11 FQ items were summed to calculate a fatigue scale (FS). The proportion and 95% confidence interval for each FQ and FP item and mean FS was calculated at baseline, week 3 and week 6. Chi-squared tests or analysis of variance f-tests were used to compare treatment groups and paired t-tests to compare baseline to week 6. A linear mixed model was used to compare the mean FS for treatment groups across time.Results From June 2000 to June 2003, we enrolled 130 patients. Fifty-one received conformal radiotherapy to the prostate (CRT), 46 received whole pelvis and prostate boost radiotherapy (WP+PB) and 33 received post prostatectomy radiotherapy to the prostate bed (PBRT). At baseline, 39% (30-47%) reported some fatigue for the FQ and 60% (52-68%) for the FP tiredness item. As treatment progressed, the mean fatigue increased significantly. The FP tiredness item best differentiated between treatment groups (p=0.04 at week 6) compared to the FQ tiredness item or FS. Those receiving irradiation to smaller volumes (CRT or PBRT) reported lower FS scores than those treated to larger volumes (WP+PB) across time.Conclusion The pictogram was better than the questionnaire in differentiating between treatment groups. The pictogram could be used to screen and monitor patients with baseline fatigue for interventional studies in a busy clinic.