Radiotherapy-Induced Fatigue in Breast Cancer Patients

Kowalczyk, L; Deutschmann, Christine; Crevenna, Richard; Konrad, Stefan; Singer, Christian F.; Farr, Alex

doi:10.1159/000509410

Cited by 11 publications

(4 citation statements)

References 71 publications

(98 reference statements)

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“…Residual confounding is also a possibility, although we were able to adjust for a range of psychosocial and clinical characteristics, including the receipt of chemotherapy, which are highly associated with fatigue (Bower, 2014). However, given the limited sample size and availability of data, we were not able to further assess the effects of specific types of chemotherapies, particularly cardiotoxic chemotherapies, or radiation dose, which have been recognized as potential contributors of fatigue (Abrahams et al, 2016; Kowalczyk et al, 2021). The original case-control study excluded women who developed cardiovascular outcomes prior to breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory, Oxidative Stress, and Cardiac Damage Biomarkers and Radiation-Induced Fatigue in Breast Cancer Survivors

Vasbinder

Thompson

Zaslavksy

et al. 2022

Biological Research For Nursing

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Purpose Studies examining biomarkers associated with fatigue in breast cancer survivors treated with radiation are limited. Therefore, we examined the longitudinal association between serum biomarkers and post-breast cancer fatigue in survivors treated with radiation: [oxidative stress] 8-hydroxyguanosine, myeloperoxidase; [inflammation] interleukin-6 (IL-6), c-reactive protein, growth differentiation factor-15 (GDF-15), placental growth factor, transforming growth factor-beta, [cardiac damage] cystatin-C, troponin-I. Methods In a secondary analysis, we included participants from the Women’s Health Initiative if they had: a previous breast cancer diagnosis (stages I-III), no prior cardiovascular diseases, pre-and post-breast cancer serum samples drawn approximately 3 years apart, and fatigue measured using the Short-Form 36 vitality subscale at both serum collections. Biomarkers were measured using ELISA or RT-qPCR and modeled as the log2 post-to pre-breast cancer ratio. Results Overall, 180 women with a mean (SD) age of 67.0 (5.5) years were included. The mean (SD) vitality scores were 66.2 (17.2) and 59.7 (19.7) pre- and post-breast cancer, respectively. Using multivariable weighted linear regression, higher biomarker ratios of cystatin-C, IL-6, and GDF-15 were associated with a lower vitality score (i.e., higher fatigue). For example, for each 2-fold difference in cystatin-C biomarker ratio, the vitality score was lower by 7.31 points (95% CI: −14.2, −0.45). Conclusion Inflammatory and cardiac damage biomarkers are associated with fatigue in breast cancer survivors treated with radiation; however, these findings should be replicated in a larger sample. Biomarkers could be measured in clinical practice or assessed in risk prediction models to help identify patients at high risk for fatigue.

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Section: Discussionmentioning

confidence: 99%

Inflammatory, Oxidative Stress, and Cardiac Damage Biomarkers and Radiation-Induced Fatigue in Breast Cancer Survivors

Vasbinder

Thompson

Zaslavksy

et al. 2022

Biological Research For Nursing

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“…1 During the active treatment phase, fatigue affects up to 25% to 99% of patients, including patients undergoing chemotherapy, radiation, hormonal, surgical and/or biological therapies. [2][3][4][5][6][7] CRF usually increases during cancer treatments and decreases in the year that follows their completion. However, for about 25% to 33% of cancer survivors, CRF persists for months, years, or even decades after successful treatment completion.…”

Section: Introductionmentioning

confidence: 99%

European Portuguese Version of the Multidimensional Fatigue Symptom Inventory-Short Form: Validation Study

et al. 2023

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Introduction: Appropriate management of fatigue relies upon comprehensive assessment instruments and timely delivery of targeted interventions. The aims of this study were to translate a commonly used English-language measure of fatigue in cancer patients (the Multidimensional Fatigue Symptom Inventory–Short-Form, or MFSI-SF) into European Portuguese and to evaluate the psychometric properties (internal consistency reliability, factorial structure, and discriminant, convergent and criterion concurrent validity) of the translated measure for use with Portuguese patients.Material and Methods: After translation and adaptation of the MFSI-SF to European Portuguese, 389 participants (68.38% women), with a mean age of 59.14 years, completed the study protocol. This sample included 148 patients in active cancer treatment from a cancer center and a community sample composed of 55 cancer survivors, 75 patients with other chronic diseases, and 111 healthy controls.Results: The European Portuguese version of the Multidimensional Fatigue Symptom Inventory-Short Form (IMSF-FR) showed strong internal consistency (Cronbach’s alpha = 0.97, McDonald’s omega = 0.95). An exploratory factor analysis indicated that the items loaded in a 5-factor model in subscales were similar to the original version. Strong correlations between the IMSF-FR and other measures of fatigue and vitality confirmed convergent validity. Discriminant validity was supported by weak-to-moderate correlations between the IMSF-FR and measures of sleepiness, propensity to sleep, and lapses of attention and memory. The IMSF-FR accurately distinguished cancer patients from healthy controls and was able to differentiate clinician rated levels of performance among cancer patients.Conclusion: The IMFS-FR is a reliable and valid tool to assess cancer-related fatigue. By providing integrated comprehensive characterization of fatigue, this instrument may assist clinicians implementing targeted interventions.

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“…Fatigue is one of the most common 1 and quality-of-life debilitating 2 symptoms in patients with cancer, though it still seems to be underreported, underdiagnosed, and undertreated during radiotherapy for cancer. 3,4 Thus, cancer care practitioners in integrative oncology should have access to knowledge needed to identify patients at risk of experiencing fatigue during radiotherapy and understand the relation between fatigue and health-related quality of life (HRQL) as well as functional performance. Cancer-related fatigue refers to “a pervasive, subjective sense of tiredness persisting over time, interferes with activities of daily living, and is not relieved by adequate rest or sleep.” 5 Around half of patients with cancer receive radiotherapy as part of their cancer therapy.…”

Section: Introductionmentioning

confidence: 99%

Fatigue During Cancer-Related Radiotherapy and Associations with Activities, Work Ability and Quality of Life: Paying Attention to Subgroups more Likely to Experience Fatigue

et al. 2022

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Background: Having knowledge of which patients are more likely to experience fatigue during radiotherapy and the relationship between fatigue and health-related quality of life (HRQL) is important to improve identification and care of patients experiencing burdensome fatigue. Objective: To identify subgroups of patients, varying in situational, physiological, and psychological factors, who are more likely to experience fatigue an ordinary week of radiotherapy, and to compare patients experiencing and not experiencing fatigue regarding perceived HRQL and functional performance, that is, daily and physical activity and work ability. Methods: Cross-sectional study of 457 patients (52% women) undergoing radiotherapy (38% breast, 32% prostate cancer), using self-reported questionnaire data on fatigue, HRQL and functional performance analyzed using multivariable regression models. Results: Of the 448 patients who answered the fatigue question, 321 (72%) experienced fatigue. Patients reporting any comorbidity or depressed mood were more likely to experience fatigue, relative risk (RR) 1.56 ([95% confidence interval (CI)] 1.13-2.16) and RR 2.57 (CI 1.73-3.83), respectively. Patients with fatigue reported worse HRQL and performed less physical activity, including daily ( P = .003), vigorous ( P = .003) and moderate ( P = .002) activity. Patients with and without fatigue reported 60% versus 40% sickness absence. Conclusion: Patients with depressed mood or comorbidity were more likely to experience fatigue an ordinary week of radiotherapy than other patients were. Patients experiencing fatigue perceived worse HRQL and performed less daily and physical activity compared to patients not experiencing fatigue. Cancer care practitioners may consider paying extra attention to these subgroups of patients.

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Radiotherapy-Induced Fatigue in Breast Cancer Patients

Cited by 11 publications

References 71 publications

Inflammatory, Oxidative Stress, and Cardiac Damage Biomarkers and Radiation-Induced Fatigue in Breast Cancer Survivors

Inflammatory, Oxidative Stress, and Cardiac Damage Biomarkers and Radiation-Induced Fatigue in Breast Cancer Survivors

European Portuguese Version of the Multidimensional Fatigue Symptom Inventory-Short Form: Validation Study

Fatigue During Cancer-Related Radiotherapy and Associations with Activities, Work Ability and Quality of Life: Paying Attention to Subgroups more Likely to Experience Fatigue

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