Supportive Care in Cancer

, Volume 27, Issue 3, pp 1041–1047 | Cite as

Prevalence, characteristics, and treatment of fatigue in oncological cancer patients in Italy: a cross-sectional study of the Italian Network for Supportive Care in Cancer (NICSO)

  • Fausto RoilaEmail author
  • Guglielmo Fumi
  • Benedetta Ruggeri
  • Andrea Antonuzzo
  • Carla Ripamonti
  • Sonia Fatigoni
  • Luigi Cavanna
  • Stefania Gori
  • Alessandra Fabi
  • Nicola Marzano
  • Claudio Graiff
  • Vitaliana De Sanctis
  • Aurora Mirabile
  • Samantha Serpentini
  • Chiara Bocci
  • Maria Simona Pino
  • Giuseppina Cilenti
  • Claudio Verusio
  • Enzo Ballatori
  • on behalf of NICSO (Network Italiano per le Cure di Supporto in Oncologia)
Original Article



Fatigue is one of the most distressing symptoms of cancer patients. Its characteristics and impact on quality of life have not been fully explored and treatment of cancer-related fatigue in Italian oncological centers has not been codified.


A cross-sectional study was carried out on all patients attending for any reason the 24 participating centers in two non-consecutive days. Patients with fatigue filled out the Brief Fatigue Inventory (BFI) questionnaire and reported any pharmacological or non-pharmacological treatment for fatigue.


From October 2014 to May 2015, 1394 cancer patients agreed to participate in the study. Fatigue was referred by 866 (62.1%) of patients; its duration was > 4 months in 441 patients (50.9%). In the investigators’ opinion, the most important (probable or almost sure) determinants of fatigue were reduced physical activity (271 patients), anxiety (149), pain (131), insomnia (125), anemia (123), and depression (123). Fatigue of moderate/severe intensity was reported by 43%/29.2% of patients, while usual fatigue in the last 24 h by 45%/33.1%, and the worst fatigue in the last 24 h by 33%/54.8%, respectively. Concerning the impact on quality of life, fatigue interfered moderately/severely with general activity in 30.8%/38.6% of patients, with mood in 26.1%/32.8%, with the ability to work in 27.9%/35.6%, with normal work in 26.7%/38.9%, with relationships with others in 21%/23.4% and with the ability to amuse themselves in 22.2%/33.1%. Only 117/866 patients (13.5%) received a pharmacological treatment represented by a corticosteroid in 101 patients (86.3%) while 188 patients (21.7%) received a non-pharmacological treatment such as physical exercise (120 patients, 63.8%) and various alimentary supplements (52 patients, 27.6%).


Cancer-related fatigue is frequently reported by oncological patients; its intensity and impact on quality of life is relevant.


Cancer-related fatigue Characteristics of fatigue Pharmacological treatment Non-pharmacological treatment 



Other investigators are the following: Andrea Sbrana, Gianna Musettini, Azzurra Farnesi, Francesco Spina, Paola Matteucci, Paolo Bossi, Elisa Minenza, Camilla Di Nunzio, Elena Orlandi, Claudia Biasini, Alessandro Inno, Monica Turazza, Fabiana Marchetti, Domenica Pellegrini, Simona Gasparro, Daniele Alesini, Rossana De Feudis, Teresa Gasparre, Michele Altieri, Elisabetta Cretella, Alessandro Marabese, Maurizio Valeriani, Claudia Scaringi, Salvatore Artale, Lucia Barbarini, Eleonora Capovilla, Silvia Tessarin, Giovanni Battista Ivaldi, Ilaria Meaglia, Evaristo Maiello, Chiara Parati, Saverio Cinieri, Luigi Coltelli, Angela S. Ribecco, Emanuela Romagnoli, Antonio Ardizzoia, Paolo Tralongo, Amalia Falzetta, Elena Bandieri, Marco Danova.

Compliance with ethical standards

Conflict of interest

Fausto Roila declares no conflict of interest. Fausto Roila declares to have full control of all primary data and he agrees to allow the journal to review the data if requested.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Fausto Roila
    • 1
    Email author
  • Guglielmo Fumi
    • 1
  • Benedetta Ruggeri
    • 2
  • Andrea Antonuzzo
    • 3
  • Carla Ripamonti
    • 4
  • Sonia Fatigoni
    • 1
  • Luigi Cavanna
    • 5
  • Stefania Gori
    • 6
  • Alessandra Fabi
    • 7
  • Nicola Marzano
    • 8
  • Claudio Graiff
    • 9
  • Vitaliana De Sanctis
    • 10
  • Aurora Mirabile
    • 11
  • Samantha Serpentini
    • 12
  • Chiara Bocci
    • 13
  • Maria Simona Pino
    • 14
  • Giuseppina Cilenti
    • 15
  • Claudio Verusio
    • 16
  • Enzo Ballatori
    • 17
  • on behalf of NICSO (Network Italiano per le Cure di Supporto in Oncologia)
  1. 1.Azienda Ospedaliera S. Maria S.C. OncologiaTerniItaly
  2. 2.Clinical GovernanceASUR MarcheAscoli PicenoItaly
  3. 3.University Hospital of PisaPisaItaly
  4. 4.Oncology Unit 2Istituto Nazionale dei TumoriMilanItaly
  5. 5.Oncologia-Ematologia-AUSL PIACENZAPiacenzaItaly
  6. 6.Oncology UnitOspedale Sacro Cuore Don CalabriaNegrarItaly
  7. 7.Division of Medical Oncology“Regina Elena” National Cancer InstituteRomeItaly
  8. 8.UOSD Oncologia Medica Ospedale S. PaoloBariItaly
  9. 9.Ospedale Centrale di BolzanoBolzanoItaly
  10. 10.Radiotherapy, St. Andrea HospitalSapienza UniversityRomeItaly
  11. 11.Azienda Ospedaliera S.AntonioGallarateItaly
  12. 12.Istituto Oncologico Veneto IOV-IRCCSPaduaItaly
  13. 13.Fondazione Salvatore MaugeriI.R.C.C.S.PaviaItaly
  14. 14.SOC Oncologia Medica Ospedale S. Maria AnnunziataFlorenceItaly
  15. 15.Ospedale Casa Sollievo della SofferenzaSan Giovanni RotondoFoggiaItaly
  16. 16.ASST della Valle OlonaHospital of SaronnoSaronnoItaly
  17. 17.Spinetoli, Ascoli PicenoItaly

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