State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
Support Care Cancer. 2021 Sep;29(9):5009-5019. doi: 10.1007/s00520-021-06054-7. Epub 2021 Feb 15.
To explore the incidence, severity, and risk factors of multidimensional fatigue in patients with nasopharyngeal carcinoma (NPC) receiving concurrent chemoradiotherapy (CCRT).
This prospective study included 79 patients with NPC in Guangzhou (China) from June 2015 to July 2018. Data were collected before and after CCRT, including demographic and clinical characteristics, nutritional parameters, and fatigue scores, based on completion of the Multiple Dimensional Inventory-20 Questionnaire, with five subscales: General Fatigue, Mental Fatigue, Physical Fatigue, Reduced Activity, and Reduced Motivation.
Increased general fatigue was found to be associated with lower lymphocyte count and body mass index <23 kg/m. Increased physical fatigue was related to age > 42 years. Higher scores for reduced activity were associated with age > 42 years, female sex, and lower serum sodium. Increased mental fatigue was related with lower lymphocyte count and unemployment; and increased total fatigue was associated with lower lymphocyte count, age > 42 years, and 3-6 courses of treatment. Furthermore, 3-6 courses of treatment was an independent predictor of severe general fatigue, while age >42 years was an independent predictor of severe physical fatigue. Importantly, cancer stage IVB and 3-6 courses of treatment could predict severe total fatigue.
Our data demonstrate that fatigue is increased in all dimensions in NPC patients following CCRT, and that the predictors differ for each fatigue dimension. These results could guide the development of targeted interventions that may reduce the impact of cancer-related fatigue in patients with NPC.
探讨接受同期放化疗（CCRT）的鼻咽癌（NPC）患者多维疲劳的发生率、严重程度和危险因素。
本前瞻性研究纳入了 2015 年 6 月至 2018 年 7 月在中国广州的 79 例 NPC 患者。在 CCRT 前后收集数据，包括人口统计学和临床特征、营养参数和疲劳评分，基于多维疲劳量表-20 问卷（Multiple Dimensional Inventory-20 Questionnaire）完成，包括 5 个亚量表：一般疲劳、精神疲劳、身体疲劳、活动减少和动力降低。
发现一般疲劳增加与淋巴细胞计数较低和体重指数<23 kg/m 有关。体力疲劳增加与年龄>42 岁有关。活动减少评分较高与年龄>42 岁、女性和血清钠较低有关。精神疲劳增加与淋巴细胞计数较低和失业有关；总疲劳增加与淋巴细胞计数较低、年龄>42 岁和 3-6 个疗程有关。此外，3-6 个疗程是一般疲劳严重的独立预测因素，而年龄>42 岁是体力疲劳严重的独立预测因素。重要的是，IVB 期癌症和 3-6 个疗程可以预测总疲劳严重程度。
我们的数据表明，CCRT 后 NPC 患者所有维度的疲劳均增加，且各疲劳维度的预测因素不同。这些结果可以指导制定有针对性的干预措施，可能会减轻 NPC 患者癌症相关疲劳的影响。
