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Purpose <p>Radiotherapy (RT) for oropharyngeal cancer (OPC) can lead to late toxicity. Fatigue is a known debilitating issue for many cancer survivors, yet prevalence and severity of long-term fatigue in patients treated for OPC is unknown.</p> Method <p>As part of a mixed-methods study, fatigue in OPC patients ≥ 2&#xa0;years post RT + / − chemotherapy was evaluated. Fatigue scores (multidimensional fatigue inventory; MFI) were compared to general population controls. Predictive sociodemographic/clinical factors of fatigue were investigated by multivariable linear regression. Associations between fatigue, health related quality of life (EQ-5D-5L), work (work productivity and activity impairment — WPAI), mood disturbance (Profile of Mood Scale — POMS) and RT dose were explored.</p> Results <p>In 349 patients treated for OPC with median follow-up time post-RT (+ / − chemo) of 6&#xa0;years (<i>IQR</i> 4–8), &gt; 20% reported severe fatigue in all domains. Scores were significantly worse in patients for mental (mean difference 1.2, 95% <i>CI</i> 0.6–1.8, <i>p</i> = &lt; 0.001) and general fatigue (mean difference 0.8, 95% <i>CI</i> 0.1–1.3, <i>p</i> = 0.015) compared to controls. Age and co-morbidities were significant predictors of mental and general fatigue (<i>p</i> &lt; 0.05). Worse fatigue was associated with worse quality of life, greater work productivity impairment and worse mood (<i>r</i> = − 0.604, 0.582 and 0.679, respectively, all <i>p</i> &lt; 0.05). No correlation was found between fatigue and RT dose to the posterior fossa.</p> Conclusions <p>Mental and general fatigue remain significant issues in OPC patients several years after RT + / − chemotherapy.</p> Implications for Cancer Survivors <p>Better monitoring of fatigue throughout follow-up care, and timely interventions&#xa0;could help improve patient functioning.</p>

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Multidimensional fatigue and its impact on work productivity, mood and quality of life in long-term survivors following definitive intensity-modulated radiotherapy for oropharyngeal cancer: A cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月18日

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  • Zsuzsanna Iyizoba-Ebozue,
  • Emma Nicklin,
  • Stuart Currie,
  • James Price,
  • J. P. C. Baldwin,
  • Robin Prestwich,
  • Sarah Brown,
  • Emma Hall,
  • John Lilley,
  • Matthew Lowe,
  • David J. Thomson,
  • Finbar Slevin,
  • Marcus Tyyger,
  • Louise Murray,
  • Florien Boele

摘要

Purpose

Radiotherapy (RT) for oropharyngeal cancer (OPC) can lead to late toxicity. Fatigue is a known debilitating issue for many cancer survivors, yet prevalence and severity of long-term fatigue in patients treated for OPC is unknown.

Method

As part of a mixed-methods study, fatigue in OPC patients ≥ 2 years post RT + / − chemotherapy was evaluated. Fatigue scores (multidimensional fatigue inventory; MFI) were compared to general population controls. Predictive sociodemographic/clinical factors of fatigue were investigated by multivariable linear regression. Associations between fatigue, health related quality of life (EQ-5D-5L), work (work productivity and activity impairment — WPAI), mood disturbance (Profile of Mood Scale — POMS) and RT dose were explored.

Results

In 349 patients treated for OPC with median follow-up time post-RT (+ / − chemo) of 6 years (IQR 4–8), > 20% reported severe fatigue in all domains. Scores were significantly worse in patients for mental (mean difference 1.2, 95% CI 0.6–1.8, p = < 0.001) and general fatigue (mean difference 0.8, 95% CI 0.1–1.3, p = 0.015) compared to controls. Age and co-morbidities were significant predictors of mental and general fatigue (p < 0.05). Worse fatigue was associated with worse quality of life, greater work productivity impairment and worse mood (r = − 0.604, 0.582 and 0.679, respectively, all p < 0.05). No correlation was found between fatigue and RT dose to the posterior fossa.

Conclusions

Mental and general fatigue remain significant issues in OPC patients several years after RT + / − chemotherapy.

Implications for Cancer Survivors

Better monitoring of fatigue throughout follow-up care, and timely interventions could help improve patient functioning.