Department of Medical Oncology, Gustave Roussy, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
Departement of Medical Oncology, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Cancer Med. 2019 May;8(5):2535-2544. doi: 10.1002/cam4.2060. Epub 2019 Mar 12.
A substantial proportion of cancer survivors experience fatigue after diagnosis. Physical activity (PA) can impact fatigue after cancer. In this study, we evaluated the prevalence and association of fatigue and the practice of PA in a population with early cancer.
Using the national population-based French cross-sectional study Vie après le cancer 2, we included 1984 patients with early breast (61.1%), prostate (21.5%), and colorectal (17.4%) cancer. Severe fatigue at 2 years postdiagnosis was defined by a score ≥40 in the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ C30) fatigue subscale. PA was defined as (a) self-reported PA before diagnosis (active/inactive) and (b) change in PA since diagnosis (increased/maintained exposure vs decreased exposure/remaining inactive). Multivariate regression examined associations of severe fatigue with PA, adjusting for baseline clinical and treatment variables.
Median age was 52 years. 51.5% of patients experienced severe fatigue 2 years post-diagnosis. 87.7% reported to be physically active before cancer diagnosis; 53.3% of patients either decreased PA or remained inactive at 2 years postdiagnosis. At 2 years postdiagnosis, severe fatigue was associated with a change in PA since diagnosis: patients with decreasing PA/remaining inactive from pre- to postdiagnosis had a higher risk of severe fatigue vs those with increasing/maintaining PA (adjusted odds ratio [95% confidence interval] 2.32 [1.85-2.90]).
Fatigue continues to be a substantial problem for cancer survivors 2 years after cancer diagnosis and is associated with PA decreasing/remaining inactive since diagnosis. Interventions to maintain or increase PA for cancer survivors should be tested to mitigate long-term fatigue after cancer.
相当一部分癌症幸存者在诊断后会经历疲劳。身体活动(PA)会影响癌症后的疲劳。在这项研究中,我们评估了早期癌症患者人群中疲劳的患病率和相关性以及身体活动的实践情况。
使用全国性基于人群的法国横断面研究 Vie après le cancer 2,我们纳入了 1984 名早期乳腺癌(61.1%)、前列腺癌(21.5%)和结直肠癌(17.4%)患者。2 年后诊断出的严重疲劳定义为欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ C30)疲劳量表评分≥40。身体活动定义为(a)诊断前自我报告的身体活动(活跃/不活跃)和(b)自诊断以来身体活动的变化(增加/保持暴露与减少暴露/保持不活跃)。多变量回归分析调整了基线临床和治疗变量后,严重疲劳与身体活动的关联。
中位年龄为 52 岁。51.5%的患者在诊断后 2 年内经历严重疲劳。87.7%的患者在癌症诊断前报告身体活跃;53.3%的患者在诊断后 2 年内减少了身体活动或保持不活跃。在诊断后 2 年时,与身体活动变化相关的严重疲劳:与诊断前至诊断后身体活动减少/保持不活跃的患者相比,增加/保持身体活动的患者发生严重疲劳的风险更高(调整后的优势比[95%置信区间]2.32[1.85-2.90])。
癌症诊断后 2 年,疲劳仍然是癌症幸存者的一个严重问题,并且与自诊断以来身体活动减少/保持不活跃相关。应测试维持或增加癌症幸存者身体活动的干预措施,以减轻癌症后长期疲劳。