INTRODUCTION:Fatigue after treatment for breast cancer (BC) is common, but poorly understood. We examined the fatigue levels during first year after radiotherapy (RT) according to the extent of RT (local or locoregional), hormonal therapy (HT) and chemotherapy (CT). The impact of comorbidity was also explored. Moreover, we compared fatigue levels in patients with the general population (GenPop) data.
MATERIAL AND METHODS:BC patients (n = 250) referred for post-operative RT at St. Olavs Hospital, Trondheim, Norway, were enrolled. Fatigue was measured by the EORTC QLQ-C30-fatigue subscale, ranging from 0 to 100, before RT (baseline), after RT, and at three, six, and 12 months. Clinical and treatment-related factors were recorded at baseline. GenPop data was available from a previous survey (n = 652). Linear mixed models and analysis of covariance were applied.
RESULTS:Compliance ranged from 87% to 98%. At baseline, mean value (SD) of fatigue in BC patients was 26.8 (23.4). The level increased during RT (mean change 8.3, 95% CI 5.5-11.1), but declined thereafter and did not differ significantly from pre-treatment levels at subsequent time points. In age-adjusted analyses, locoregional RT accounted for more overall fatigue than local RT (mean difference 6.6, 95% CI 1.2-12.0), but the association was weakened and not statistical significant when adjusting for CT and HT. Similar pattern was seen for CT and HT. The course of fatigue differed significantly by CT (p < 0.001, interaction test). At baseline, fatigue levels were higher in patients with than without CT, but at subsequent time points similar levels were evident, indicating a temporary adverse effect of CT. Comorbidity was significantly associated with increased level of fatigue, independent of other factors (mean difference 8.1, 95% CI 2.2-14.1). BC-patients were not significantly more fatigued than GenPop, except for immediately after ending RT, and then only among those without comorbidity (mean 35.9 vs. 25.8, p < 0.001).
CONCLUSION:Comorbidity seems to be a more important determinant for fatigue levels than the cancer treatment.
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【One-year course of fatigue after post-operative radiotherapy in Norwegian breast cancer patients--comparison to general population.].
【挪威乳腺癌患者术后放疗后的一年疲劳过程-与普通人群相比。】
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DOI：10.3109/0284186X.2012.742563文章类型：杂志文章
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简介：乳腺癌（BC）治疗后的疲劳很普遍，但了解甚少。我们根据放疗（局部或局部），激素治疗（HT）和化学疗法（CT）的程度，检查了放疗（RT）后第一年的疲劳水平。还探讨了合并症的影响。此外，我们将一般人群（GenPop）数据的患者的疲劳水平进行了比较。
材料与方法：招募了在挪威特隆赫姆的圣奥拉夫斯医院接受手术后放疗的BC患者（n = 250）。疲劳通过EORTC QLQ-C30疲劳分量表进行测量，范围为0至100，RT前（基线），RT后以及3、6和12个月。在基线记录临床和治疗相关因素。 GenPop数据可从以前的调查中获得（n = 652）。应用线性混合模型和协方差分析。
结果：依从性从87％到98％不等。基线时，BC患者的疲劳平均值（SD）为26.8（23.4）。在放疗期间该水平升高（平均变化8.3，95％CI 5.5-11.1），但此后下降，并且在随后的时间点与治疗前水平无显着差异。在年龄校正的分析中，局部RT比局部RT引起的总体疲劳要多（平均差异6.6，95％CI 1.2-12.0），但是当校正CT和HT时，关联性减弱并且没有统计学意义。 CT和HT观察到相似的模式。 CT的疲劳过程明显不同（p <0.001，相互作用测试）。在基线时，有CT的患者的疲劳水平高于没有CT的患者，但是在随后的时间点，相似的水平也很明显，表明CT的暂时不良反应。与其他因素无关，合并症与疲劳程度增加显着相关（平均差异8.1，95％CI 2.2-14.1）。 BC患者没有比GenPop明显疲劳，除了RT结束后立即缓解，然后才出现在没有合并症的患者中（平均35.9 vs. 25.8，p <0.001）。
结论：合并症似乎是比癌症治疗更为重要的疲劳程度决定因素。
材料与方法：招募了在挪威特隆赫姆的圣奥拉夫斯医院接受手术后放疗的BC患者（n = 250）。疲劳通过EORTC QLQ-C30疲劳分量表进行测量，范围为0至100，RT前（基线），RT后以及3、6和12个月。在基线记录临床和治疗相关因素。 GenPop数据可从以前的调查中获得（n = 652）。应用线性混合模型和协方差分析。
结果：依从性从87％到98％不等。基线时，BC患者的疲劳平均值（SD）为26.8（23.4）。在放疗期间该水平升高（平均变化8.3，95％CI 5.5-11.1），但此后下降，并且在随后的时间点与治疗前水平无显着差异。在年龄校正的分析中，局部RT比局部RT引起的总体疲劳要多（平均差异6.6，95％CI 1.2-12.0），但是当校正CT和HT时，关联性减弱并且没有统计学意义。 CT和HT观察到相似的模式。 CT的疲劳过程明显不同（p <0.001，相互作用测试）。在基线时，有CT的患者的疲劳水平高于没有CT的患者，但是在随后的时间点，相似的水平也很明显，表明CT的暂时不良反应。与其他因素无关，合并症与疲劳程度增加显着相关（平均差异8.1，95％CI 2.2-14.1）。 BC患者没有比GenPop明显疲劳，除了RT结束后立即缓解，然后才出现在没有合并症的患者中（平均35.9 vs. 25.8，p <0.001）。
结论：合并症似乎是比癌症治疗更为重要的疲劳程度决定因素。
