Psychotropic drugs for the management of cancer-related fatigue: a systematic review and meta-analysis

Qu, Daofeng; Zhang, Zhao; Yu, Xiaoming; Zhao, Jie; Qiu, Fuming; Huang, Jianrong

doi:10.1111/ecc.12397

Cited by 52 publications

(32 citation statements)

References 48 publications

(61 reference statements)

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“…Pharmacologic interventions include psychostimulants, with some studies evaluating particularly methylphenidate, a psychostimulant dopamine agonist, which is better known for the management of cancer-related fatigue [124,125]. No evidence of improvement in cognitive impairment was showed with this drug in two randomized controlled trials with cancer patients treated with chemotherapy compared with placebo [118,119].…”

Section: Pharmacologic Interventionsmentioning

confidence: 99%

Long-Term Fatigue and Cognitive Disorders in Breast Cancer Survivors

Joly

Lange

Santos

et al. 2019

Cancers

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Survivors of early-stage breast cancer may report treatment-related side effects that persist for several years after the end of primary treatment. Among these, fatigue and cognitive disorders are frequent complaints and can negatively impact quality of life. Cancer-related fatigue is a very prevalent and distressing long-term side effect among breast cancer survivors that typically improves after completion of treatment, although many patients report severe fatigue several years post-treatment. Cognitive disorders are also common among survivors of breast cancer, especially if treated with chemotherapy. These symptoms are usually mild-to-moderate and often transient. Cognitive recovery is frequently observed within months or a few years after completion of chemotherapy or endocrine therapy. However, some breast cancer survivors may have persistent cognitive difficulties. Several types of interventions have proved to be beneficial in reducing cancer-related fatigue and cognitive difficulties. Most of these interventions for cancer-related fatigue are thought to be effective by reducing inflammation or disrupting pro-inflammatory circuits. Further studies are needed on cognitive management that has showed promising results. This narrative review summarizes the state of the art regarding long-term fatigue and cognitive disorders in patients with early breast cancer, describing prevalence, impact, pathophysiology, and risk factors, and focusing on available interventions.

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Section: Pharmacologic Interventionsmentioning

confidence: 99%

Long-Term Fatigue and Cognitive Disorders in Breast Cancer Survivors

Joly

Lange

Santos

et al. 2019

Cancers

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“…Cancer‐related fatigue (CRF) is a particularly common and distressing symptom that negatively affects quality of life in all phases of treatment or stages for those with cancer. The prevalence of CRF varies, depending on treatment or cancer type and stage, and it is estimated as ranging from 25% and 95% (Berger et al, 2019; Qu et al, 2016; Van Lancker et al, 2014). CRF has a negative effect on the physiological and physical state of patients and includes problems such as anxiety, sleep disturbance, depression, and pain (Oh & Seo, 2011; Weber & O'Brien, 2017).…”

Section: Introductionmentioning

confidence: 99%

Healthcare professionals knowledge on cancer‐related fatigue: A cross‐sectional survey in Oman

Maqbali

Gracey

Dunwoody

et al. 2020

Nursing & Health Sciences

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Cancer‐related fatigue is a common and distressing cancer symptom that negatively affects quality of life. The main objective of this study was to determine health professionals' knowledge relating to cancer patients' fatigue in Oman and identify current management practices of cancer‐related fatigue. A cross‐sectional survey design using Qualtrics® software was performed. The survey had five sections and comprised 32 items. A total of 138 healthcare professionals working in Oman participated in the study (response rate 63.9%). Nearly three quarters of the participants were nurses (74.6%, n = 103). The mean level of knowledge of cancer‐related fatigue was 16.6/23, with 50% of participants having the expected level of knowledge above 12. The result indicated that professional discipline and work experience each were significantly associated with overall level of knowledge. Participants identified the need for guidelines, assessment tools, and training for the oncology staff to help improve the quality of life of patients with cancer‐related fatigue.

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“…During active treatment, the most current National Comprehensive Cancer Network (NCCN) clinical practice guidelines recommended the use of methylphenidate (psychostimulants) for the pharmacological intervention for cancer related fatigue [14]. However, a systematic review and meta-analysis reported the inconsistent effectiveness of methylphenidate on CRF [15]. One possible explanation of this inconsistency and ineffectiveness of treatment for CRF may be due to lack of complete understanding of CRF etiology and mechanisms underlying its development.…”

Section: Introductionmentioning

confidence: 99%

Altered Cd8+ T lymphocyte Response Triggered by Arginase 1: Implication for Fatigue Intensification during Localized Radiation Therapy in Prostate Cancer Patients

et al. 2018

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Fatigue, the most common side effect of cancer treatments, is observed to intensify during external-beam radiation therapy (EBRT). The underlying molecular mechanisms remain unclear. This study investigated the differentially expressed genes/proteins and their association with fatigue intensification during EBRT. Fatigue scores measured by FACT-F and peripheral blood were collected prior to treatment (baseline D0), at midpoint (days 19–21, D21) and endpoint (days 38–42, D42) from men (n=30) with non-metastatic prostate cancer undergoing EBRT. RNA extracted from peripheral blood was used for gene expression analysis. Plasma arginase I and arginine were examined using ELISA and liquid chromatography–tandem mass spectrometry. Differences in fatigue scores, gene and protein expression between times points following EBRT were analyzed by one way ANOVA followed by Post Hoc t-test. Fatigue scores decreased significantly from baseline (44.6 ± 8.1) to midpoint (37.3 ± 10.6, p=0.000, low scores indicating high fatigue) and to endpoint (37.4 ± 10.1, p=0.001) during EBRT. ARG1 (encoding arginase type 1) was significantly up regulated from baseline to midpoint of EBRT (fold change =2.41, p<0.05) whereas genes associated with the adaptive immune functional pathway (CD28, CD27, CCR7, CD3D, CD8A and HLA-DOB) were significantly downregulated >2-fold between the study time points. The changes in gene expression were associated with patient reported fatigue intensity. Moreover, the upregulation of ARG1 was negatively correlated with the absolute lymphocyte count (R2=0.561, p=0.01) only in the high level of fatigue group (n=17) during EBRT. Increased ARG1 expression is known to result in arginine deficiency, which leads to immunosuppression by impairing lymphocyte proliferation and activation. EBRT-induced ARG1 upregulation may play an essential role in fatigue intensification via the arginine deficiency and suppression of T-cell proliferation pathways. These findings may provide novel insights into the molecular-genetic mechanisms underlying the development and intensification of cancer treatment-related fatigue.

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Psychotropic drugs for the management of cancer-related fatigue: a systematic review and meta-analysis

Cited by 52 publications

References 48 publications

Long-Term Fatigue and Cognitive Disorders in Breast Cancer Survivors

Long-Term Fatigue and Cognitive Disorders in Breast Cancer Survivors

Healthcare professionals knowledge on cancer‐related fatigue: A cross‐sectional survey in Oman

Altered Cd8+ T lymphocyte Response Triggered by Arginase 1: Implication for Fatigue Intensification during Localized Radiation Therapy in Prostate Cancer Patients

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