Gamma Knife Center, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
J Neurooncol. 2019 Sep;144(2):377-384. doi: 10.1007/s11060-019-03240-w. Epub 2019 Jul 26.
Fatigue is a common and distressing symptom in cancer patients which negatively affects patients' daily functioning and health-related quality of life. The aim of this study was to assess multidimensional fatigue in patients with brain metastases (BM) before, and after Gamma Knife radiosurgery (GKRS).
Patients with BM, an expected survival > 3 months, and a Karnofsky Performance Status ≥ 70 and 104 Dutch non-cancer controls were recruited. The Multidimensional Fatigue Inventory (MFI), measuring general fatigue, physical fatigue, mental fatigue, reduced activity and reduced motivation, was used. Baseline levels of fatigue between patients and controls were compared using independent-samples t-tests. The course of fatigue over time, and clinical and psychological predictors thereof, were analyzed using linear mixed models (within-group analyses).
Ninety-two, 67 and 53 patients completed the MFI at baseline, and 3 and 6 months after GKRS. Before GKRS, patients with BM experienced significantly higher levels of fatigue on all subscales compared to controls (medium to large effect sizes). Over 6 months, general and physical fatigue increased significantly (p = .009 and p < .001), and levels of mental fatigue decreased significantly (p = .027). No significant predictors of the course of fatigue over time could be identified.
Fatigue is a major problem for patients with BM. Different patterns over time were observed for the various aspects of fatigue in patients with BM. Information on the various aspects of fatigue is important because fatigue may negatively affect patients' functional independence, health-related quality of life, and adherence to therapy.
疲劳是癌症患者常见且令人痛苦的症状，会对患者的日常功能和健康相关生活质量产生负面影响。本研究旨在评估脑转移瘤（BM）患者在伽玛刀放射外科治疗（GKRS）前后的多维疲劳。
招募了预期生存时间> 3 个月、卡氏功能状态评分≥70 分且无癌症的 104 名荷兰对照患者和 BM 患者。使用多维疲劳量表（MFI）评估一般疲劳、身体疲劳、心理疲劳、活动减少和动力降低。采用独立样本 t 检验比较患者和对照组的基线疲劳水平。采用线性混合模型（组内分析）分析疲劳随时间的变化及其临床和心理预测因素。
92、67 和 53 例患者分别在 GKRS 前、后 3 个月和 6 个月完成了 MFI。在 GKRS 之前，与对照组相比，BM 患者在所有子量表上的疲劳水平均显著升高（中到大效应量）。在 6 个月内，一般疲劳和身体疲劳显著增加（p=0.009 和 p<0.001），心理疲劳水平显著降低（p=0.027）。未发现与疲劳随时间变化相关的显著预测因素。
疲劳是 BM 患者的主要问题。在 BM 患者中，不同方面的疲劳随时间呈现出不同的模式。了解疲劳的各个方面很重要，因为疲劳可能会对患者的功能独立性、健康相关生活质量和治疗依从性产生负面影响。
