Abstract
Introduction
The purpose of this study was to examine changes in fatigue scores for patients receiving radiation therapy for bone metastases and its impact on quality of life (QOL).
Methods
Fatigue and QOL scores were prospectively collected in patients for up to 3 months following radiation therapy for bone metastases using three questionnaires: group 1, Edmonton Symptom Assessment System (ESAS) (0–10); group 2, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30); and Core 15 Palliative (EORTC QLQ-C15-PAL) (1–4).
Results
Average fatigue score in group 1 (399 patients) was 4.72 at baseline, 5.08 at month 1, 5.01 at month 2, and 4.95 at month 3, and was 2.40, 2.39, 2.56, and 2.70 in group 2 (482 patients), respectively. Thirty-five percent of patients in group 1 had fatigue score increase ≥2 points at month 1, 36 % at month 2, and 36 % at month 3. Twenty-one percent of patients in group 2 had fatigue score increase ≥1 at month 1, 27 % at month 2, and 40 % at month 3. There was a statistically significant increase in fatigue score from baseline to all 3 months in group 1 only. In both groups, there was a highly significant negative correlation between fatigue and overall QOL scores at baseline and any follow-up month.
Conclusions
There was a statistically significant worsening in fatigue in group 1 only. Up to one third had increased fatigue of clinical significance. Patients with less fatigue symptoms reported better overall QOL.
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References
Falkmer U, Jarhult J, Wersall P, Cavallin-Stahl E (2003) A systematic overview of radiation therapy effects in skeletal metastases. Acta Oncol 42(5–6):620–633
Richardson A (1998) Measuring fatigue in patients with cancer. Support Care Cancer 6(2):94–100
Porock D, Kristjanson LJ, Tinnelly K, Duke T, Blight J (2000) An exercise intervention for advanced cancer patients experiencing fatigue: a pilot study. J Palliat Care 16(3):30–36
Jereczek-Fossa BA, Marsiglia HR, Orecchia R (2002) Radiotherapy-related fatigue. Crit Rev Oncol Hematol 41(3):317–325
Ramirez-Zamora A, Pilitsis JG, Parmar VK, Campbell JC (2014) Fatigue and sleep difficulties. In: Smith HS, Pilitsis JG (eds) The art and science of palliative medicine, 1st edn. AME Publishing Company, Sheung Wan
Lawrence DP, Kupelnick B, Miller K, Devine D, Lau J (2004) Evidence report on the occurrence, assessment, and treatment of fatigue in cancer patients. J Natl Cancer Inst 32:40–50
Chow E, Fan G, Hadi S, Wong J, Kirou-Mauro A, Filipczak L (2008) Symptom clusters in cancer patients with brain metastases. Clin Oncol (R Coll Radiol) 20(1):76–82
Cramarossa G, Chow E, Zhang L, Bedard G, Zeng L, Sahgal A et al (2013) Predictive factors for overall quality of life in patients with advanced cancer. Support Care Cancer 21(6):1709–1716
Caissie A, Nguyen J, Chen E, Zhang L, Sahgal A, Clemons M et al (2012) Quality of life in patients with brain metastases using the EORTC QLQ-BN20 + 2 and QLQ-C15-PAL. Int J Radiat Oncol Biol Phys 83(4):1238–1245
Schag CC, Heinrich RL, Ganz PA (1984) Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol 2(3):187–193
Rao AV, Cohen HJ (2008) Fatigue in older cancer patients: etiology, assessment and treatment. Semin Oncol 35(6):633–642
Owen D, Laack NN, Mayo CS, Garces YI, Park SS, Bauer HJ et al (2014) Outcomes and toxicities of stereotactic body radiation therapy for non-spine bone oligometastases. Pract Radiat Oncol 4(2):e143–e149
Barrett-Lee P, Casbard A, Abraham J, Hood K, Coleman R, Simmonds P et al (2014) Oral ibandronic acid versus intravenous zoledronic acid in treatment of bone metastases from breast cancer: a randomised, open label, non-inferiority phase 3 trial. Lancet Oncol 15(1):114–122
Miura N, Numata K, Kusuhara Y, Shirato A, Hashine K, Sumiyoshi Y (2010) Docetaxel-prednisolone combination therapy for Japanese patients with hormone-refractory prostate cancer: a single institution experience. Jpn J Clin Oncol 40(11):1092–1098
Mathew P, Thall PF, Bucana CD, Oh WK, Morris MJ, Jones DM et al (2007) Platelet-derived growth factor receptor inhibition and chemotherapy for castration-resistant prostate cancer with bone metastases. Clin Cancer Res 13(19):5816–5824
Pulenzas N, Khan L, Tsao M, Zhang L, Lechner B, Thavarajah N et al (2014) Fatigue scores in patients with brain metastases receiving whole brain radiotherapy. Support Care Cancer 22(7):1757–1763
Zeng L, Koo K, Zhang L, Jon F, Dennis K, Holden L et al (2012) Fatigue in advanced cancer patients attending an outpatient palliative radiotherapy clinic as screened by the Edmonton symptom assessment system. Support Care Cancer 20(5):1037–1042
Blesch KS, Paice JA, Wickham R, Harte N, Schnoor DK, Purl S et al (1991) Correlates of fatigue in people with breast or lung cancer. Oncol Nurs Forum 18(1):81–87
Acknowledgments
We thank the generous support of Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Pulenzas Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund, and Ofelia Cancer Research Fund.
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Cheon, P.M., Pulenzas, N., Zhang, L. et al. Fatigue scores in patients receiving palliative radiotherapy for painful bone metastases. Support Care Cancer 23, 2097–2103 (2015). https://doi.org/10.1007/s00520-014-2561-0
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DOI: https://doi.org/10.1007/s00520-014-2561-0