Morri Mattia, Boccomino Riccardo, Brruku Eugenio, Bellina Terra Ausilia, Boschi Rita, Raucci Giovanni, Sabbi Daniela, Ibrahim Toni, Coluccino Paola
IRCCS Istituto Ortopedico Rizzoli, Servizio di Assistenza Infermieristico, Tecnico e della Riabilitazione (SAITeR), Bologna, Italy.
IRCCS Istituto Ortopedico Rizzoli, Servizio di Assistenza Infermieristico, Tecnico e della Riabilitazione (SAITeR), Bologna, Italy.
Semin Oncol Nurs. 2025 Feb;41(1):151761. doi: 10.1016/j.soncn.2024.151761. Epub 2024 Dec 10.
The aim of the present study is to describe the course of fatigue syndrome in patients with musculoskeletal tumors starting from chemotherapy and to compare it with that of other cancer populations. The second objective is to identify the risk factors for a higher level of fatigue.
A prospective prognostic observational cohort study was carried out. All patients diagnosed with musculoskeletal tumors who started chemotherapy treatment over 12 years of age were identified and enrolled consecutively from July 2019 to April 2021 in the osteo-oncology department. Patients' fatigue was measured using the Brief Fatigue Inventory at four different time points: at the beginning of treatment and then subsequently at 6, 12 and 24 months from the time of enrollment.
The mean fatigue value was 3.3 (SD = 2.4) at the start of antiblastic treatment, which progressively decreased over time until it reached a mean score of 2.1 (SD = 1.5). At 24 months; 17% of patients had moderate/severe fatigue. Presence of metastases at the onset of the disease, location of the tumor in the upper limb, a shorter oncological treatment-free gap and surgical treatment were independent predictive factors of BFI score.
In patients with musculoskeletal tumors, fatigue is a complication of the disease itself and does not occur only after chemotherapy treatment. In the first two years of treatment, there is a decreasing trend in fatigue syndrome, which remains a significant complication to be monitored over time and to be considered in patient management. Prevention pathways should be implemented.
During chemotherapy treatment of patients with bone and soft tissue sarcomas, a fatigue prevention plan should be implemented. Patients with tumor localisation in the upper limb, metastasis at onset and surgical treatment have a higher risk of developing a higher fatigue score.
本研究旨在描述肌肉骨骼肿瘤患者从化疗开始的疲劳综合征病程，并将其与其他癌症人群的病程进行比较。第二个目的是确定疲劳程度较高的风险因素。
进行了一项前瞻性预后观察队列研究。从2019年7月至2021年4月，在骨肿瘤科连续识别并纳入所有12岁以上开始化疗治疗的肌肉骨骼肿瘤患者。在四个不同时间点使用简明疲劳量表测量患者的疲劳程度：治疗开始时，以及入组后6、12和24个月。
抗瘤治疗开始时的平均疲劳值为3.3（标准差=2.4），随时间逐渐降低，直至平均得分达到2.1（标准差=1.5）。在24个月时，17%的患者有中度/重度疲劳。疾病发作时存在转移、肿瘤位于上肢、较短的无肿瘤治疗间隔和手术治疗是简明疲劳量表得分的独立预测因素。
在肌肉骨骼肿瘤患者中，疲劳是疾病本身的一种并发症，并非仅在化疗治疗后出现。在治疗的前两年，疲劳综合征呈下降趋势，但仍是一个需要长期监测并在患者管理中加以考虑的重要并发症。应实施预防措施。
在骨肉瘤和软组织肉瘤患者的化疗治疗期间，应实施疲劳预防计划。肿瘤位于上肢、发病时出现转移和接受手术治疗的患者发生较高疲劳评分的风险更高。
