(Cristensen, 1989).To date there are few studies which systematically register how many cancer patients experience fatigue, in which stage of the disease process and to what extent. To give an indication, a literature-search using MEDLINE with CD-ROM over the period 1980 to 1991 yielded nine references in which 'fatigue' was included in the title and 'cancer' was included in title, keyword or abstract. Eight of these references pertained to nursing research.An appraisal of the research literature concerning fatigue in cancer is presented in this paper to give an overview of what is currently known. Literature, other than obtained using the MEDLINE-procedure, was gathered either by searching for studies in which fatigue was assessed as part of patient functioning or through references of the papers obtained. This procedure does evidently not lead to an exhaustive list of all the studies which included fatigue as an outcome-variable. However, we think to have obtained a representative sample. Topics that will be discussed are: the conceptualisation of fatigue and its measurement, prevalence rates of fatigue during and after treatment and somatic and psychological correlates of fatigue. Finally, considerations with regard to research and interventions will be discussed.

Summary Little is known regarding the prevalence and course of fatigue in cancer patients after treatment has ended and no recurrence found. The present study examines fatigue in disease-free cancer patients after being treated with radiotherapy (n = 154). The (Breij and Visser. 1990). 61%7 of the subjects reported fatigue that w-as described as 'moderate to quite bad'. Treatment had ended more than 2 vears before the sunrey in 60%e of the sample. Lastly.

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Primary non‐Hodgkin's lymphoma (NHL) of the central nervous system is a rare disease. The number of cases reported in the literature does not exceed 200. The current series comprises 15 cases of primary NHL of the CNS. In 12 cases material for pathology was obtained at surgery. In the other three cases the diagnosis was established by cytologic examination of the cerebrospinal fluid (CSF). The type of lymphoma was predominantly the diffuse lymphocytic type. All the patients received irradiation on the whole brain by means of two opposite lateral fields. The administered total doses were 40 Gy in four weeks in ten cases, 50 to 60 Gy in 5 to 6 weeks in four cases and 30 Gy in three weeks in one case. All but three patients are dead although initially a good tumor response was obtained as confirmed in most of the cases by CT scan. The mean survival of the dead patients was 14.5 months. No relationship was found between the administered dose and the relapse‐free time. In six cases (40%) evidence of seeding was observed. Because of the poor results obtained with irradiation either of only the tumor bearing area or whole brain and because of the high risk of seeding through the CSF, the irradiation of the entire CNS is recommended in patients with primary NHL of the brain.

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