Long-term cancer-related fatigue outcomes in patients with locally advanced prostate cancer after intensity-modulated radiotherapy combined with hormonal therapy

Abstract

The aim of our study was to investigate the relationship between cancer-related fatigue and clinical parameters, and the effect factors of fatigue for the prostate cancer patients. Long-term follow-up is performed using the Fatigue Symptom Inventory before treatment (A), at the end of intensity-modulated radiotherapy (B), and 3 months (C), 12 months (D), 24 months (E), 36 months (F), and 48 months (G) after the end of intensity-modulated radiotherapy. Three dimensions of fatigue are assessed during follow-up: severity, perceived interference with quality of life, and duration in the past week. In all, 97 patients with locally advanced prostate cancer were enrolled in the study. Median follow-up time was 43.9 months. The fatigue index was significantly higher in the prostate-specific antigen >20 ng/mL, Gleason score >8, the Eastern Cooperative Oncology Group scores, and the higher education. The most severe fatigue occurred at time points B and C. The score for duration of fatigue fluctuated across the time points, with significantly increased scores at time points D, E, and F.In conclusion, we show that cancer-related fatigue is the important symptom which affects the quality of life for the prostate cancer patients. For patients with locally advanced prostate cancer with a high Eastern Cooperative Oncology Group score, a Gleason score of >8 points, prostate-specific antigen levels of >20 ng/mL, and high education, attention should be paid to the interference of fatigue with quality of life, especially general level of activity, ability to concentrate, and mood, after radiotherapy combined with hormonal therapy.

Cross-sectional study of patient-reported fatigue, physical activity and cardiovascular status in men after robotic-assisted radical prostatectomy

“…Cancer-related fatigue has previously been reported as a side effect of PCa treatment in up to 80% of men [27–30]. Few studies have investigated levels of fatigue in men who have exclusively undergone RARP for PCa; however, much work has been conducted in men receiving ADT and radiotherapy.…”

The influence of education level on sleep-related outcomes and sleep management strategies in prostate cancer patients

“…Other studies showed that lower education level has been associated with obesity in the general population [25,26], more comorbidities in cancer patients in general [12], and higher fatigue level in PCa [27,28] as well as [29] breast cancer populations. We also recognize that previous research [30][31][32] has reported the opposite results on the relationship between education and fatigue levels in cancer patients, i.e., those with higher education having higher fatigue level. This discrepancy may be due F I G .…”

Exploring Genetic Attributions Underlying Radiotherapy-Induced Fatigue in Prostate Cancer Patients

“…If radiosensitivity is indeed implicated in development of RIF, an unusually sensitive or resistant prostate cancer response to radiotherapy may warn the treating oncologist of an increased risk of RIF by the patient. Because PCPs receiving intensity-modulated radiotherapy seem to experience the highest fatigue levels at end of radiotherapy and the ensuing three months, 111 an oncologist suspicious of RIF PCP may consider enrolling their patient in prophylactic RIF treatment before the end of radiotherapy series (i.e., the peak of expected fatigue). However, although these clinical implications are interesting and have utility, the definitive role of radiosensitivity in the development of RIF must be further investigated, as the herein provided evidence is suggestive at best.…”