Romero-Elías María, Álvarez-Bustos Alejandro, Méndez Marta, Sánchez Antonio, Gutiérrez Lourdes, Cebolla-Boado Héctor, Ruiz-Casado Ana
Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain.
Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain.
Support Care Cancer. 2025 Apr 1;33(4):338. doi: 10.1007/s00520-025-09386-w.
To explore the potential correlates of cancer-related fatigue (CRF) at the time of diagnosis, with a specific consideration toward aspects related to physical activity and physical condition.
Candidates were patients ≥ 18, diagnosed with colon or rectum cancer (stages I-IV), able to walk a mile or to complete the 6-min walking test. Fatigue was measured through PERFORM which is a multidimensional questionnaire (PQ). Quality of life (EORTC-QLQC30 and EORTC-QLQC29), diet (PREDIMED), and sociodemographic data were also assessed by questionnaires. Physical activity was measured by self-reported questionnaire (IPAQ) and accelerometers, and physical condition through objective tests such as Rockport 1-mile walk, estimated VO peak, 6-min walk, sit-to-stand, handgrip and, anthropometric data.
A total of 238 CRC patients (64.8 ± 11.0 mean age, 66.4% men) were recruited. Mean fatigue PQ score was 50.5. Values under 50.2 were associated with reduced QOL. CRF was associated with female sex (p < 0.001), poorer self-reported perceived health (p = 0.008), being retired woman (p = 0.025), poorer QOL (p = < 0.001), and a previous diagnosis of hypercholesterolemia (p = 0.032). CRF was associated with a number of symptoms such as pain, anxiety, and gastrointestinal symptoms, in addition to dyspnoea, body image, and financial difficulties. CRF was associated to low self-reported PA levels (in women) and more sedentary levels (in men). CRF was not associated with metastatic stage, physical condition, or objectively assessed physical activity.
One out of four patients presents CRF at the time of CRC diagnosis. Women reported to have significantly higher levels of fatigue than men. Its association with other symptoms such as pain, anxiety, gastrointestinal symptoms, and its tremendous impact on the QOL make it necessary to ask the patients about fatigue in the first consultation. Oncologists should be aware of the importance of documenting this symptom in the clinical record to guarantee the follow-up and management.
探讨癌症诊断时与癌症相关疲劳（CRF）潜在相关的因素，特别考虑与身体活动和身体状况相关的方面。
研究对象为年龄≥18岁、诊断为结肠癌或直肠癌（I-IV期）、能够行走一英里或完成6分钟步行试验的患者。通过PERFORM（一种多维问卷，PQ）测量疲劳程度。生活质量（EORTC-QLQC30和EORTC-QLQC29）、饮食（PREDIMED）以及社会人口学数据也通过问卷进行评估。身体活动通过自我报告问卷（IPAQ）和加速度计测量，身体状况通过客观测试评估，如罗克波特1英里步行、估计的VO峰值、6分钟步行、坐立试验、握力测试以及人体测量数据。
共招募了238例结直肠癌患者（平均年龄64.8±11.0岁，66.4%为男性）。疲劳PQ平均得分为50.5。得分低于50.2与生活质量下降相关。CRF与女性性别（p<0.001）、自我报告的健康状况较差（p=0.008）、退休女性（p=0.025）、生活质量较差（p<0.001）以及既往高胆固醇血症诊断（p=0.032）相关。CRF与多种症状相关，如疼痛、焦虑和胃肠道症状，此外还有呼吸困难、身体形象和经济困难。CRF与自我报告的低身体活动水平（女性）和更多久坐时间（男性）相关。CRF与转移阶段、身体状况或客观评估的身体活动无关。
四分之一的患者在结直肠癌诊断时出现CRF。女性报告的疲劳水平明显高于男性。其与疼痛、焦虑、胃肠道症状等其他症状的关联以及对生活质量的巨大影响使得在首次会诊时询问患者疲劳情况很有必要。肿瘤学家应意识到在临床记录中记录该症状对于保证随访和管理的重要性。
