Danjoux Cyril, Gardner Sandra, Fitch Margaret
Radiation Oncologist, Toronto Sunnybrook Regional Cancer Centre, 2075 Bayview Avenue, Toronto, M4N 3M5, Canada.
Support Care Cancer. 2007 Oct;15(10):1169-76. doi: 10.1007/s00520-007-0229-8. Epub 2007 Mar 1.
To prospectively evaluate radiation-induced fatigue among patients undergoing curative radiotherapy at the Toronto Sunnybrook Regional Cancer Centre using two different instruments.
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.
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.
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.
使用两种不同工具对多伦多桑尼布鲁克地区癌症中心接受根治性放疗的患者的辐射诱发疲劳进行前瞻性评估。
连续同意参与研究的讲英语的男性患者，因局限性前列腺癌接受根治性放疗，被纳入一项经伦理委员会批准的前瞻性研究。我们使用基于改良FACT - AN问卷的11个问题的疲劳问卷（FQ）以及疲劳象形图（FP）的2个问题，在治疗期间每周记录患者的回答。将11个FQ项目相加计算出疲劳量表（FS）。计算每个FQ和FP项目在基线、第3周和第6周时的比例及95%置信区间以及平均FS。使用卡方检验或方差分析F检验比较治疗组，使用配对t检验比较基线与第6周的数据。使用线性混合模型比较各治疗组随时间变化的平均FS。
2000年6月至2003年6月，我们纳入了130例患者。51例接受前列腺适形放疗（CRT），46例接受全盆腔及前列腺增量放疗（WP + PB），33例接受前列腺切除术后前列腺床放疗（PBRT）。在基线时，39%（30 - 47%）的患者在FQ中报告有一定程度的疲劳，在FP疲劳项目中这一比例为60%（52 - 68%）。随着治疗进展，平均疲劳程度显著增加。与FQ疲劳项目或FS相比，FP疲劳项目在区分治疗组方面表现最佳（第6周时p = 0.04）。在整个时间段内，接受较小照射体积（CRT或PBRT）的患者报告的FS得分低于接受较大照射体积（WP + PB）的患者。
在区分治疗组方面，象形图比问卷表现更好。象形图可用于繁忙诊所中对有基线疲劳的患者进行筛查和监测，以开展干预性研究。
