Oberoi Sapna, Huang Beili, Rabbani Rasheda, Askin Nicole, Okoli George, Jain Richa, Sung Lillian, Jeyaraman Maya M, Mahar Alyson, Woodgate Roberta, Zarychanski Ryan
Department of Pediatric Hematology/Oncology, Cancer Care Manitoba, Winnipeg, Manitoba, Canada.
Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
Cancer Med. 2024 Dec;13(23):e70502. doi: 10.1002/cam4.70502.
The literature on fatigue in children and adolescents undergoing cancer treatment is highly variable, creating uncertainties about its prevalence and identifying those at higher risk.
The primary purpose was to describe the prevalence of fatigue among patients (< 21 years) undergoing cancer treatment across cancer types. Secondary outcomes included the prevalence of severe fatigue and factors associated with fatigue.
Systematic searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO were conducted from inception to May 22, 2023. Two reviewers independently identified relevant citations and extracted data. Pooled prevalence estimates were derived using an inverse variance, random-effects model. We used Joanna Briggs's critical appraisal checklist to assess study quality. (PROSPERO: CRD42020179307).
We included 47 studies: 26 for prevalence and 29 for factors associated with fatigue. The pooled prevalence of fatigue was 73% (95% [Confidence Interval, CI: 66%-79%; I 96%; 26 studies; 2699 patients], and severe fatigue was 30% [95% CI 14%-46%, I 98%; 8 studies; 1027 patients]). Subgroup analyses based on cancer type, study design, fatigue scale, fatigue reporting personnel, sample frame, and response rate did not reveal significant differences in fatigue prevalence. Fatigue prevalence significantly differed by treatment setting (inpatient [83%] vs. outpatient [55%] vs. inpatient and outpatient [69%]; p: 0.02). Due to considerable heterogeneity among studies, data on fatigue-associated factors are presented descriptively.
The prevalence of fatigue among children and adolescents undergoing cancer treatment is variable but notably high. Systematic evaluation of factors associated with fatigue is essential to understanding which children are at high risk of developing fatigue.
PROSPERO: CRD42020179307.
关于接受癌症治疗的儿童和青少年疲劳情况的文献差异很大，这使得其患病率以及确定高危人群存在不确定性。
主要目的是描述不同癌症类型的癌症治疗患者（<21岁）中疲劳的患病率。次要结果包括严重疲劳的患病率以及与疲劳相关的因素。
从数据库建库至2023年5月22日，对MEDLINE、Embase、Cochrane对照试验中心注册库、CINAHL和PsycINFO进行系统检索。两名 reviewers 独立识别相关文献并提取数据。采用逆方差随机效应模型得出合并患病率估计值。我们使用乔安娜·布里格斯的批判性评价清单来评估研究质量。（国际前瞻性系统评价注册库：CRD42020179307）。
我们纳入了47项研究：26项关于患病率，29项关于与疲劳相关的因素。疲劳的合并患病率为73%（95%置信区间[CI]：66%-79%；I²=96%；26项研究；2699例患者），严重疲劳为30%（95%CI 14%-46%，I²=98%；8项研究；1027例患者）。基于癌症类型、研究设计、疲劳量表、疲劳报告人员、样本框架和应答率的亚组分析未发现疲劳患病率存在显著差异。疲劳患病率在治疗环境方面存在显著差异（住院患者[83%]与门诊患者[55%]与住院和门诊患者[69%]；p：0.02）。由于研究之间存在相当大的异质性，与疲劳相关因素的数据以描述性方式呈现。
接受癌症治疗的儿童和青少年中疲劳的患病率各不相同，但显著较高。对与疲劳相关因素进行系统评估对于了解哪些儿童有患疲劳的高风险至关重要。
国际前瞻性系统评价注册库：CRD42020179307。
