Agarwal Shilpi, Garg Rakesh, Minhas Varnika, Bhatnagar Sushma, Mishra Seema, Kumar Vinod, Bharati Sachidanand Jee, Gupta Nishkarsh, Khan Maroof Ahmad
Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, AIIMS, New Delhi, India.
Indian J Palliat Care. 2020 Oct-Dec;26(4):523-527. doi: 10.4103/IJPC.IJPC_223_19. Epub 2020 Nov 19.
Cancer-related fatigue (CRF) is one of the adverse outcomes of cancer and its treatment. Despite its high prevalence; the data are scarce from the Indian population on the prevalence of CRF and its predictors in advanced cancer patients. Hence, we aim to find the prevalence of the fatigue, its impact of fatigue on quality of life (QOL), and possible predictors.
This study was conducted after approval of the ethical committee in adult patients of advanced cancer receiving palliative care. The data collected included demographic details, nutritional status, any comorbidities involving cardiorespiratory, renal, pulmonary, and neurological system, type and stage of cancer, site of metastasis, any previous or ongoing chemotherapy or radiotherapy, history of drug intake, hemoglobin, and albumin. The study parameters included assessment of fatigue, QOL, and symptom assessment as per the validated tools. The primary objective of the study was to find the prevalence of fatigue in advanced cancer patients receiving palliative care. The secondary objectives were to find predictive factors of fatigue, its impact on QOL of patients, and the relation between the fatigue and QOL receiving palliative care. The correlation between fatigue score and QOL was analyzed using Pearson's correlation coefficient. Multiple linear regression analysis was performed for identifying the predictors of CRF.
The fatigue was observed in all 110 patients in this study. Of these, severe fatigue was seen in 97 patients (Functional Assessment of Chronic Illness Therapy [FACIT]-F < 30). The median (interquartile range [IQR]) FACIT-F score was 14 (8-23). The median (IQR) of the overall QOL was 16.66 (16.6-50). The correlation between the fatigue (FACIT-F) and QOL was + 0.64 ( < 0.001). The predictors of fatigue included pain, physical functioning, Eastern Cooperative Oncology Group, tiredness, and the level of albumin.
We conclude that the prevalence of fatigue in Indian patients with advanced cancer receiving palliative care was high and it has a negative impact on QOL. Pain, physical functioning, performance status, and albumin were found to be independent predictors of CRF.
癌症相关疲劳(CRF)是癌症及其治疗的不良后果之一。尽管其患病率很高,但关于印度晚期癌症患者中CRF患病率及其预测因素的数据却很稀少。因此,我们旨在找出疲劳的患病率、疲劳对生活质量(QOL)的影响以及可能的预测因素。
本研究在伦理委员会批准后,对接受姑息治疗的晚期癌症成年患者进行。收集的数据包括人口统计学细节、营养状况、涉及心肺、肾脏、肺部和神经系统的任何合并症、癌症类型和分期、转移部位、任何既往或正在进行的化疗或放疗、药物摄入史、血红蛋白和白蛋白。研究参数包括根据经过验证的工具对疲劳、生活质量和症状进行评估。本研究的主要目的是找出接受姑息治疗的晚期癌症患者中疲劳的患病率。次要目的是找出疲劳的预测因素、其对患者生活质量的影响以及接受姑息治疗的患者中疲劳与生活质量之间的关系。使用Pearson相关系数分析疲劳评分与生活质量之间的相关性。进行多元线性回归分析以确定CRF的预测因素。
本研究中的110名患者均出现疲劳。其中,97名患者出现严重疲劳(慢性病治疗功能评估[FACIT]-F<30)。FACIT-F评分的中位数(四分位间距[IQR])为14(8-23)。总体生活质量的中位数(IQR)为16.66(16.6-50)。疲劳(FACIT-F)与生活质量之间的相关性为+0.64(<0.001)。疲劳的预测因素包括疼痛、身体功能、东部肿瘤协作组状态、疲倦和白蛋白水平。
我们得出结论,接受姑息治疗的印度晚期癌症患者中疲劳的患病率很高,并且对生活质量有负面影响。疼痛、身体功能、表现状态和白蛋白被发现是CRF的独立预测因素。