Department of Medical Psychology, Amsterdam Public Health Research Institute, Academic Medical Center University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, Netherlands.
Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands.
J Cancer Surviv. 2018 Feb;12(1):38-46. doi: 10.1007/s11764-017-0641-0. Epub 2017 Sep 9.
Little research has been done to identify possible cancer-related fatigue (CRF) subtypes and to classify cancer survivors accordingly. We aimed to identify CRF subtypes in a large population-based sample of (long term) stage I-III colorectal cancer survivors. We also identified factors associated with the CRF subtypes.
Respondents completed the Multidimensional Fatigue Inventory and other validated questionnaires on anxiety and reduced positive affect (anhedonia), sleep quality, and lifestyle factors (body mass index and physical activity). Latent class analysis was used to derive the CRF subtypes. Factors associated with the derived CRF subtypes were determined with multinomial logistic regression.
Three CRF classes were identified: class 1 (no fatigue and distress, n = 644, 56%), class 2 (low fatigue, moderate distress, n = 256, 22%), and class 3 (high fatigue, moderate distress, n = 256, 22%). Multinomial logistic regression results show that survivors in class 3 were more likely to be female, were treated with radiotherapy, have comorbid diabetes mellitus, and be overweight/obese than survivors in class 1 (reference). Survivors in classes 2 and 3 were also more likely to have comorbid heart condition, report poorer sleep quality, experience anhedonia, and report more anxiety symptoms when compared with survivors in class 1.
Three distinct classes of CRF were identified which could be differentiated with sleep quality, anxiety, anhedonia, and lifestyle factors.
The identification of CRF subtypes with distinct characteristics suggests that interventions should be targeted to the CRF subtype.
很少有研究能够确定可能的癌症相关疲劳（CRF）亚型，并据此对癌症幸存者进行分类。我们的目的是在大量基于人群的Ⅰ-Ⅲ期结直肠癌幸存者样本中确定 CRF 亚型。我们还确定了与 CRF 亚型相关的因素。
受访者完成了多维疲劳量表和其他经过验证的问卷，包括焦虑和减少积极情绪（快感缺失）、睡眠质量和生活方式因素（体重指数和身体活动）。采用潜在类别分析得出 CRF 亚型。采用多项逻辑回归确定与衍生的 CRF 亚型相关的因素。
确定了三种 CRF 类型：第 1 类（无疲劳和困扰，n=644，56%）、第 2 类（低疲劳，中度困扰，n=256，22%）和第 3 类（高疲劳，中度困扰，n=256，22%）。多项逻辑回归结果表明，第 3 类幸存者中女性、接受放射治疗、合并糖尿病和超重/肥胖的比例高于第 1 类幸存者（参考）。与第 1 类幸存者相比，第 2 类和第 3 类幸存者还更有可能合并心脏疾病，报告睡眠质量较差，经历快感缺失，报告更多的焦虑症状。
确定了三种不同的 CRF 类型，可以通过睡眠质量、焦虑、快感缺失和生活方式因素进行区分。
具有不同特征的 CRF 亚型的识别表明，干预措施应该针对 CRF 亚型。
