Cancer-related fatigue (CRF) is a common side-effect of cancer and its treatments. For head and neck cancer (HNC), CRF may exacerbate the symptom burden and poor quality-of-life. Using data from the Head and Neck 5000 prospective clinical cohort, we investigated clinically important CRF over a year post-diagnosis, assessing temporal trends, CRF by HNC site and treatment received, and subgroups at higher risk of CRF. Recruitment was undertaken in 2011–2014. Socio-demographic and clinical data, and patient-reported CRF (EORTC QLQ-C30 fatigue subscale score ≥39 of a possible 100) were collected at baseline (pre-treatment) and 4- and 12- months post-baseline. Mixed-effects logistic multivariable regression was used to investigate time trends, compare cancer sites and treatment groups, and identify associations between clinical, socio-demographic and lifestyle variables and CRF. At baseline, 27.8% of 2847 patients scored in the range for clinically important CRF. This was 44.7% at 4 months and 29.6% at 12 months. In the multivariable model, after adjusting for time-point, the odds of having CRF over 12 months were significantly increased in females and current smokers; those with stage 3/4 disease, comorbidities and multimodal treatment; and those who had depression at baseline. The high prevalence of clinically important CRF indicates the need for additional interventions and supports for affected HNC patients. These findings also identified patient subgroups towards whom such interventions could be targeted.
癌症相关性疲劳是癌症及其治疗过程中常见的副作用。对于头颈癌患者而言，该症状可能加剧其整体症状负担并导致生活质量下降。基于头颈癌5000前瞻性临床队列数据，本研究系统分析了诊断后一年内具有临床意义的疲劳症状，评估其时间变化趋势、不同原发部位及治疗方式下的疲劳特征，并识别疲劳高风险亚组。研究于2011-2014年完成受试者招募，分别在基线期（治疗前）及基线后4个月、12个月收集社会人口学特征、临床数据及患者自评疲劳量表（采用EORTC QLQ-C30疲劳子量表，临界值设定为总分100分中的39分）。通过混合效应逻辑多元回归模型分析时间趋势、比较不同原发部位和治疗组，并探讨临床特征、社会人口学因素及生活方式与疲劳症状的关联。在2847例基线患者中，27.8%达到临床显著疲劳标准，该比例在4个月时升至44.7%，12个月时回落至29.6%。经时间点校正的多变量模型显示，女性、现时吸烟者、III/IV期疾病患者、合并症患者、接受多模式治疗者以及基线期存在抑郁症状的患者，在12个月内发生疲劳的风险显著增高。临床显著疲劳的高发生率提示需要对头颈癌患者提供额外的干预措施与支持，本研究结果同时为针对性干预的目标人群识别提供了依据。
肿瘤(癌症)患者之家