Sharp Linda, Watson Laura-Jayne, Lu Liya, Harding Sam, Hurley Katrina, Thomas Steve J, Patterson Joanne M
Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle NE1 7RU, UK.
Speech & Language Therapy, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, UK.
Cancers (Basel). 2023 Oct 5;15(19):4864. doi: 10.3390/cancers15194864.
Cancer-related fatigue (CRF) is a common side-effect of cancer and its treatments. For head and neck cancer (HNC), CRF may exacerbate the symptom burden and poor quality-of-life. Using data from the Head and Neck 5000 prospective clinical cohort, we investigated clinically important CRF over a year post-diagnosis, assessing temporal trends, CRF by HNC site and treatment received, and subgroups at higher risk of CRF. Recruitment was undertaken in 2011-2014. Socio-demographic and clinical data, and patient-reported CRF (EORTC QLQ-C30 fatigue subscale score ≥39 of a possible 100) were collected at baseline (pre-treatment) and 4- and 12- months post-baseline. Mixed-effects logistic multivariable regression was used to investigate time trends, compare cancer sites and treatment groups, and identify associations between clinical, socio-demographic and lifestyle variables and CRF. At baseline, 27.8% of 2847 patients scored in the range for clinically important CRF. This was 44.7% at 4 months and 29.6% at 12 months. In the multivariable model, after adjusting for time-point, the odds of having CRF over 12 months were significantly increased in females and current smokers; those with stage 3/4 disease, comorbidities and multimodal treatment; and those who had depression at baseline. The high prevalence of clinically important CRF indicates the need for additional interventions and supports for affected HNC patients. These findings also identified patient subgroups towards whom such interventions could be targeted.
癌症相关疲劳（CRF）是癌症及其治疗的常见副作用。对于头颈癌（HNC），CRF可能会加重症状负担并降低生活质量。利用头颈5000前瞻性临床队列的数据，我们调查了确诊后一年中具有临床重要意义的CRF，评估了时间趋势、按HNC部位和接受的治疗分类的CRF，以及CRF风险较高的亚组。招募工作于2011年至2014年进行。在基线（治疗前）以及基线后4个月和12个月收集社会人口统计学和临床数据，以及患者报告的CRF（欧洲癌症研究与治疗组织QLQ-C30疲劳子量表得分在可能的100分中≥39分）。采用混合效应逻辑多变量回归来研究时间趋势、比较癌症部位和治疗组，并确定临床、社会人口统计学和生活方式变量与CRF之间的关联。在基线时，2847名患者中有27.8%的人CRF得分在具有临床重要意义的范围内。4个月时为44.7%，12个月时为29.6%。在多变量模型中，在调整时间点后，女性、当前吸烟者、患有3/4期疾病、有合并症和接受多模式治疗的患者，以及基线时有抑郁症的患者在12个月内出现CRF的几率显著增加。具有临床重要意义的CRF的高患病率表明需要对受影响的HNC患者采取额外的干预措施和支持。这些发现还确定了可以针对这些干预措施的患者亚组。
