Smets E M, Visser M R, Willems-Groot A F, Garssen B, Oldenburger F, van Tienhoven G, de Haes J C
Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, The Netherlands.
Br J Cancer. 1998 Oct;78(7):899-906. doi: 10.1038/bjc.1998.599.
Cancer patients undergoing radiotherapy frequently report fatigue. However, knowledge of the importance of fatigue for these patients and of the factors associated with their fatigue is limited. The aim of the current investigation was to gain more insight into fatigue as related to radiotherapy by answering the following questions. First, how is the experience of fatigue best described? Secondly, to what extent is fatigue related to sociodemographic, medical (including treatment), physical and psychological factors? Finally, is it possible to predict which patients will suffer from fatigue after completion of radiotherapy? Patients with different types of cancer receiving radiotherapy with curative intent (n = 250) were interviewed before and within 2 weeks of completion of radiotherapy. During treatment, patients rated their fatigue at 2-weekly intervals. Results indicate a gradual increase in fatigue over the period of radiotherapy and a decrease after completion of treatment. Fatigue scores obtained after radiotherapy were only slightly, although significantly, higher than pretreatment scores. After treatment, 46% of the patients reported fatigue among the three symptoms that caused them most distress. Significant associations were found between post-treatment fatigue and diagnosis, physical distress, functional disability, quality of sleep, psychological distress and depression. No association was found between fatigue and treatment or personality characteristics. Multivariate regression analysis demonstrated that the intensity of pretreatment fatigue was the best predictor of fatigue after treatment. In view of this finding, a regression analysis was performed to gain more insight into the variables predicting pretreatment fatigue. The degree of functional disability and impaired quality of sleep were found to explain 38% of the variance in fatigue before starting radiotherapy. Fatigue in disease-free patients 9 months after treatment is described in paper (B) in this issue.
接受放射治疗的癌症患者经常报告感到疲劳。然而，对于疲劳对这些患者的重要性以及与他们疲劳相关的因素的了解是有限的。当前调查的目的是通过回答以下问题，更深入地了解与放射治疗相关的疲劳。首先，如何最好地描述疲劳的体验？其次，疲劳在多大程度上与社会人口统计学、医学（包括治疗）、身体和心理因素相关？最后，是否有可能预测哪些患者在放射治疗完成后会出现疲劳？对250名接受根治性放射治疗的不同类型癌症患者在放疗前和放疗完成后2周内进行了访谈。在治疗期间，患者每隔2周对自己的疲劳程度进行评分。结果表明，在放疗期间疲劳程度逐渐增加，治疗完成后有所下降。放疗后获得的疲劳评分仅略高于治疗前评分，尽管具有统计学意义。治疗后，46%的患者报告疲劳是最困扰他们的三种症状之一。发现治疗后疲劳与诊断、身体不适、功能残疾、睡眠质量、心理困扰和抑郁之间存在显著关联。未发现疲劳与治疗或人格特征之间存在关联。多变量回归分析表明，治疗前疲劳的强度是治疗后疲劳的最佳预测指标。鉴于这一发现，进行了回归分析以更深入了解预测治疗前疲劳的变量。发现功能残疾程度和睡眠质量受损可解释放疗开始前疲劳差异的38%。本期刊物的论文（B）描述了治疗后9个月无病患者的疲劳情况。
