Minton Ollie, Jo Foster, Jane Maher
Department of Palliative Medicine, St Georges Healthcare NHS Trust , London , UK.
Acta Oncol. 2015 May;54(5):581-6. doi: 10.3109/0284186X.2014.996660. Epub 2015 Mar 9.
Fatigue is a symptom that can occur during treatment as an acute side effect but can also result in persistent fatigue as a long-term side effect or late effect.
We undertook a narrative review of the current literature and discuss the current evidence of assessment of fatigue and we specifically focus on the role of promoting behavioural change and focused rehabilitation to minimise these long-term effects and update the literature relating to this area from 2012 to date.
We suggest there are behavioural change models that can be scaled up to enable patients to manage long-term fatigue using exercise. However, from this updated review there are limitations to the current infrastructure and evidence base that will impact on the ability to do this.
We continually need to raise awareness amongst health professionals to continue to suggest modifications to impact on fatigue at all stages of cancer treatment and into survivorship and late effects. These can range from simple brief interventions suggested in the clinic to full scale rehabilitation programmes if the correct infrastructure is available. Whichever approach is adopted we suggest exercise will be the mainstay of the treatment of fatigue in this group.
疲劳是一种症状，在治疗期间可能作为急性副作用出现，但也可能导致持续性疲劳，成为长期副作用或迟发效应。
我们对当前文献进行了叙述性综述，讨论了疲劳评估的现有证据，并特别关注促进行为改变和针对性康复在将这些长期影响降至最低方面的作用，同时更新了2012年至今该领域的相关文献。
我们认为存在一些行为改变模型，可以扩大规模，使患者能够通过运动来管理长期疲劳。然而，从本次更新的综述来看，当前的基础设施和证据基础存在局限性，这将影响到实现这一目标的能力。
我们需要持续提高卫生专业人员的认识，继续建议在癌症治疗的各个阶段以及生存和迟发效应阶段进行调整，以影响疲劳状况。这些调整范围可以从诊所建议的简单简短干预措施到具备正确基础设施时的全面康复计划。无论采用哪种方法，我们认为运动将是该群体疲劳治疗的主要手段。
