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Multidimensional fatigue in patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: incidence, severity, and risk factors

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Abstract

Purpose

To explore the incidence, severity, and risk factors of multidimensional fatigue in patients with nasopharyngeal carcinoma (NPC) receiving concurrent chemoradiotherapy (CCRT).

Methods

This prospective study included 79 patients with NPC in Guangzhou (China) from June 2015 to July 2018. Data were collected before and after CCRT, including demographic and clinical characteristics, nutritional parameters, and fatigue scores, based on completion of the Multiple Dimensional Inventory-20 Questionnaire, with five subscales: General Fatigue, Mental Fatigue, Physical Fatigue, Reduced Activity, and Reduced Motivation.

Results

Increased general fatigue was found to be associated with lower lymphocyte count and body mass index <23 kg/m2. Increased physical fatigue was related to age > 42 years. Higher scores for reduced activity were associated with age > 42 years, female sex, and lower serum sodium. Increased mental fatigue was related with lower lymphocyte count and unemployment; and increased total fatigue was associated with lower lymphocyte count, age > 42 years, and 3–6 courses of treatment. Furthermore, 3–6 courses of treatment was an independent predictor of severe general fatigue, while age >42 years was an independent predictor of severe physical fatigue. Importantly, cancer stage IVB and 3–6 courses of treatment could predict severe total fatigue.

Conclusions

Our data demonstrate that fatigue is increased in all dimensions in NPC patients following CCRT, and that the predictors differ for each fatigue dimension. These results could guide the development of targeted interventions that may reduce the impact of cancer-related fatigue in patients with NPC.

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Funding

This research was partly supported by grants from the Youth Program of the National Natural Science Foundation of China (No.: 81602371).

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Author notes

  1. Lin-Min Chen and Qiu-Lan Yang contributed equally to this work.

Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China

    Lin-Min Chen, Qiu-Lan Yang, Yu-Yu Duan, Xue-Zhen Huan, Yan He, Cong Wang, Yu-Ying Fan, Yu-Cong Cai, Jian-Mei Li, Li-Ping Chen & Hui-Ying Qin

  2. Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People’s Republic of China

    Lin-Min Chen, Qiu-Lan Yang, Yu-Yu Duan, Xue-Zhen Huan, Yan He, Cong Wang, Yu-Ying Fan, Yu-Cong Cai, Jian-Mei Li & Li-Ping Chen

  3. Department of Nursing, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People’s Republic of China

    Hui-Ying Qin

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  1. Lin-Min Chen
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by X. Huan, Y. He, C. Wang, Y. Fan, Y. Cai, and J. Li. The first draft of the manuscript was written by L. Chen, Q. Yang, and Y. Duan, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Li-Ping Chen or Hui-Ying Qin.

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This study was approved by the Research Ethics Committee of SYSUCC, Guangzhou, China (No. B201502401).

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All patients were required to provide written informed consent before entering the study.

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The authors declare no competing interests.

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Chen, LM., Yang, QL., Duan, YY. et al. Multidimensional fatigue in patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: incidence, severity, and risk factors. Support Care Cancer 29, 5009–5019 (2021). https://doi.org/10.1007/s00520-021-06054-7

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