Ghoshal Arunangshu, Salins Naveen, Deodhar Jayita, Damani Anuja, Muckaden Mary Ann
Department of Palliative Medicine, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Palliat Care. 2016 Oct-Dec;22(4):416-426. doi: 10.4103/0973-1075.191766.
Fatigue is one of the most common symptoms seen in patients with advanced cancer. It is known to influence the Quality of Life (QoL) of patients. This study examines the interrelationship of fatigue and QoL in patients with advanced cancer on palliative care.
A prospective cohort study was conducted in the outpatient clinic of the Department of Palliative Medicine from January to June 2014. Patients with advanced cancer registered with hospital palliative care unit, meeting the inclusion criteria (Eastern Cooperative Oncology Group [ECOG] ≤3, Edmonton Symptom Assessment Scale [ESAS] fatigue score ≥1), and willing to participate in the study were assessed for symptom burden (ESAS) and QoL (European Organization for Research and Treatment of Cancer QoL Core 15-Palliative module [EORTC-QoL PAL15]). All study patients received standard palliative care consultation and management. They were followed up in person or telephonically within 15-30 days from the first consult for assessment of outcomes.
Of a total of 500 cases assessed at baseline, 402 were available for follow-up (median age of 52 years; 51.6% male). On the EORTC-QoL PAL15 scale, overall QoL, emotional functioning, and constipation were found to be significantly associated with severity of fatigue at baseline ( < 0.05). Statistically significant improvement in fatigue score was observed ( < 0.001) at follow-up. Improvement in physical functioning and insomnia were significantly associated with better fatigue outcomes.
Fatigue improved with the standard palliative care delivered at our specialty palliative care clinic. Certain clinical, biochemical factors and QoL aspects were associated with fatigue severity at baseline, improvement of which lead to lesser fatigue at follow-up.
疲劳是晚期癌症患者最常见的症状之一。已知其会影响患者的生活质量（QoL）。本研究探讨晚期癌症姑息治疗患者疲劳与生活质量之间的相互关系。
2014年1月至6月在姑息医学科门诊进行了一项前瞻性队列研究。对在医院姑息治疗病房登记、符合纳入标准（东部肿瘤协作组[ECOG]≤3，埃德蒙顿症状评估量表[ESAS]疲劳评分≥1）且愿意参与研究的晚期癌症患者进行症状负担（ESAS）和生活质量（欧洲癌症研究与治疗组织生活质量核心15项-姑息治疗模块[EORTC-QoL PAL15]）评估。所有研究患者均接受标准的姑息治疗咨询和管理。在首次咨询后的15 - 30天内对他们进行亲自或电话随访以评估结果。
在基线评估的总共500例病例中，402例可进行随访（中位年龄52岁；男性占51.6%）。在EORTC-QoL PAL15量表上，发现总体生活质量、情绪功能和便秘与基线时的疲劳严重程度显著相关（<0.05）。随访时观察到疲劳评分有统计学意义的改善（<0.001）。身体功能和失眠的改善与更好的疲劳结果显著相关。
在我们的专科姑息治疗诊所提供的标准姑息治疗使疲劳得到改善。某些临床、生化因素和生活质量方面与基线时的疲劳严重程度相关，这些方面的改善导致随访时疲劳减轻。
