Radboud University Medical Center, Nijmegen, The Netherlands.
University of Groningen, Groningen, The Netherlands.
Cancer Treat Rev. 2014 Jul;40(6):791-9. doi: 10.1016/j.ctrv.2014.01.004. Epub 2014 Feb 7.
Cancer-related fatigue (CRF) is a serious clinical problem and is one of the most common symptoms experienced by cancer patients. CRF has deleterious effects on many aspects of patient quality of life including their physical, psychological and social well-being. It can also limit their ability to function, socialise and participate in previously enjoyable activities. The aetiology of CRF is complex and multidimensional, involving many potentially contributing elements. These include tumour-related factors and comorbid medical/psychological conditions and also side effects associated with anti-cancer therapies or other medications. Barriers to the effective management of CRF exist both on the side of physicians and patients, and as a result CRF often remains unrecognised and undiscussed in clinical practice. A change of approach is required, where fatigue is treated as central to patient management during and after systemic anti-cancer treatment. In this review we summarise factors involved in the aetiology of CRF and the barriers to its effective management, as well as factors involved in the screening, diagnosis and treatment of cancer patients experiencing fatigue. Pharmacological and non-pharmacological approaches to its management are also reviewed. We suggest an algorithm for the process of managing CRF, guided by our experiences in The Netherlands, which we hope may provide a useful tool to healthcare professionals dealing with cancer patients in their daily practice. Although CRF is a serious and complex clinical problem, if it is worked through in a structured and comprehensive way, effective management has the potential to much improve patient quality of life.
癌症相关疲劳（CRF）是一个严重的临床问题，也是癌症患者最常见的症状之一。CRF 对患者生活质量的许多方面都有不良影响，包括身体、心理和社会福祉。它还可能限制他们的功能、社交和参与以前喜欢的活动的能力。CRF 的病因复杂且多维度，涉及许多潜在的致病因素。这些因素包括与肿瘤相关的因素以及合并的医疗/心理状况，还包括与抗癌治疗或其他药物相关的副作用。在医生和患者方面都存在 CRF 有效管理的障碍，因此 CRF 在临床实践中经常未被识别和讨论。需要改变方法，将疲劳作为癌症患者在接受系统抗癌治疗期间和之后的管理的核心。在这篇综述中，我们总结了 CRF 病因以及其有效管理障碍的相关因素，以及筛查、诊断和治疗出现疲劳的癌症患者的相关因素。我们还回顾了管理 CRF 的药物和非药物方法。我们根据在荷兰的经验提出了管理 CRF 的流程算法，希望能为处理癌症患者的医疗保健专业人员在日常实践中提供有用的工具。尽管 CRF 是一个严重且复杂的临床问题，但如果以结构化和全面的方式处理，有效的管理有可能大大提高患者的生活质量。
