Bandara Vindya, Capp Anne, Ahmed Gias, Arm Jameen, Martin Jarad
Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
J Med Imaging Radiat Oncol. 2019 Oct;63(5):683-690. doi: 10.1111/1754-9485.12922. Epub 2019 Jul 10.
Fatigue is a commonly reported symptom in men receiving radiation therapy and androgen deprivation therapy (ADT) for prostate cancer. Despite this, the complex mechanisms remain unclear. This study aims to investigate factors which correlate with development of fatigue.
Twenty-seven men with high-risk prostate cancer undergoing radiation therapy and 18 months of ADT were assessed for fatigue, haemoglobin (Hb), testosterone, magnetic resonance imaging (MRI) fat fraction (FF) and apparent diffusion coefficient (ADC), at baseline and at intervals after radiotherapy. Changes from baseline were analysed using paired t-tests. Linear time trends were assessed using linear mixed effect models.
Overall, mean fatigue score increased from baseline to the 18-month time interval (difference 4.5, P = 0.0114). The mean value for Hb significantly decreased (P < 0.001) from baseline to 18 months. The mean value for testosterone significantly decreased (P < 0.001) from baseline to 12 months, and remained low. Mean for MRI FF showed a significant increase (P < 0.001) from baseline to 6 months. MRI ADC showed a non-significant decrease from baseline to 6 months (P = 0.4416).
Radiotherapy and ADT resulted in a significant increase in fatigue scores. Statistically significant changes were noted in Hb, testosterone and MRI FF and ADC, however, none were shown to have a strong association with worsening fatigue. Further investigation in a larger cohort is required to assess the interaction between fatigue and possible biological factors.
疲劳是接受前列腺癌放射治疗和雄激素剥夺疗法（ADT）的男性中常见的症状。尽管如此，其复杂机制仍不清楚。本研究旨在调查与疲劳发展相关的因素。
对27例接受放射治疗和18个月ADT的高危前列腺癌男性患者在基线时以及放疗后的不同时间间隔进行疲劳、血红蛋白（Hb）、睾酮、磁共振成像（MRI）脂肪分数（FF）和表观扩散系数（ADC）评估。使用配对t检验分析与基线的变化。使用线性混合效应模型评估线性时间趋势。
总体而言，平均疲劳评分从基线到18个月时间间隔有所增加（差值4.5，P = 0.0114）。Hb的平均值从基线到18个月显著下降（P < 0.001）。睾酮的平均值从基线到12个月显著下降（P < 0.001），并保持在低水平。MRI FF的平均值从基线到6个月显著增加（P < 0.001）。MRI ADC从基线到6个月呈非显著下降（P = 0.4416）。
放疗和ADT导致疲劳评分显著增加。在Hb、睾酮以及MRI FF和ADC方面观察到有统计学意义的变化，然而，没有一个被证明与疲劳加重有强烈关联。需要在更大的队列中进行进一步研究，以评估疲劳与可能的生物学因素之间的相互作用。
