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Title: Fatigue During Head-And-Neck Radiotherapy: Prospective Study on 117 Consecutive Patients

Abstract

Purpose: Fatigue is an underevaluated cancer-related and treatment-related symptom. We analyzed fatigue in head and neck cancer patients undergoing radiotherapy (RT). Methods and Materials: A total of 117 patients were enrolled (mean age, 58 years). Radiation therapy (median dose, 66 Gy) was given with either exclusive or postoperative intent in 52 and 65 patients, respectively. Chemotherapy (CT) was added before and/or during RT in 61 patients. The patients completed a 20-item questionnaire (Multidimensional Fatigue Inventory [MFI-20]) before, during (weekly), and after RT. The impact of patient-, tumor-, and treatment-related factors on fatigue was evaluated with unifactorial and multifactorial tests. Results: Fatigue level increased during RT reaching a maximum at Week 6 and then slowly decreased. In multivariate stepwise regression analysis age (inversely related, p < 0.05), psychologic disorders (p < 0.005), and previous head-and-neck surgery (inversely related, p < 0.005) were correlated with higher pre-RT fatigue level. Pre-RT fatigue score (p < 0.0001), induction and/or concomitant CT (p = 0.035), need of cortisone during RT (p = 0.005), and thyroid disorders (p = 0.032) were correlated with higher during-RT fatigue level. Pre-RT fatigue score (p < 0.0001), induction and/or concomitant CT (p < 0.001), and need of cortisone during RTmore » (p < 0.005) were correlated with higher post-RT fatigue level. No impact of gender, performance status, comorbidities other than psychologic and thyroid, tumor stage/site, RT intent, dose, volume, duration, or toxicity was observed. Conclusion: Fatigue affects all patients undergoing RT for head-and-neck cancer, reaches maximum score at the 6th week of RT, and slowly decreases thereafter. Age, thyroid dysfunction, psychologic disorders, pre-RT fatigue score, CT, and cortisone use are correlated with RT-related fatigue levels.« less

Authors:
 [1];  [2];  [3];  [3];  [3];  [3];  [4];  [3];  [5];  [3];  [6]
  1. Division of Radiotherapy, European Institute of Oncology, Milan (Italy) and University of Milan, Milan (Italy). E-mail: barbara.fossa@ieo.it
  2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan (Italy)
  3. Division of Radiotherapy, European Institute of Oncology, Milan (Italy)
  4. Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk (Poland)
  5. Division of Head and Neck Surgery, European Institute of Oncology, Milan (Italy)
  6. (Italy)
Publication Date:
OSTI Identifier:
20951659
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 68; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2007.01.024; PII: S0360-3016(07)00136-8; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; CORTISONE; FATIGUE; HEAD; MULTIVARIATE ANALYSIS; NECK; NEOPLASMS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SURGERY; SYMPTOMS; THYROID; TOXICITY

Citation Formats

Jereczek-Fossa, Barbara Alicja, Santoro, Luigi, Alterio, Daniela, Franchi, Benedetta, Fiore, Maria Rosaria, Fossati, Piero, Kowalczyk, Anna, Canino, Paola, Ansarin, Mohssen, Orecchia, Roberto, and University of Milan, Milan. Fatigue During Head-And-Neck Radiotherapy: Prospective Study on 117 Consecutive Patients. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2007.01.024.
Jereczek-Fossa, Barbara Alicja, Santoro, Luigi, Alterio, Daniela, Franchi, Benedetta, Fiore, Maria Rosaria, Fossati, Piero, Kowalczyk, Anna, Canino, Paola, Ansarin, Mohssen, Orecchia, Roberto, & University of Milan, Milan. Fatigue During Head-And-Neck Radiotherapy: Prospective Study on 117 Consecutive Patients. United States. doi:10.1016/j.ijrobp.2007.01.024.
Jereczek-Fossa, Barbara Alicja, Santoro, Luigi, Alterio, Daniela, Franchi, Benedetta, Fiore, Maria Rosaria, Fossati, Piero, Kowalczyk, Anna, Canino, Paola, Ansarin, Mohssen, Orecchia, Roberto, and University of Milan, Milan. Fri . "Fatigue During Head-And-Neck Radiotherapy: Prospective Study on 117 Consecutive Patients". United States. doi:10.1016/j.ijrobp.2007.01.024.
@article{osti_20951659,
title = {Fatigue During Head-And-Neck Radiotherapy: Prospective Study on 117 Consecutive Patients},
author = {Jereczek-Fossa, Barbara Alicja and Santoro, Luigi and Alterio, Daniela and Franchi, Benedetta and Fiore, Maria Rosaria and Fossati, Piero and Kowalczyk, Anna and Canino, Paola and Ansarin, Mohssen and Orecchia, Roberto and University of Milan, Milan},
abstractNote = {Purpose: Fatigue is an underevaluated cancer-related and treatment-related symptom. We analyzed fatigue in head and neck cancer patients undergoing radiotherapy (RT). Methods and Materials: A total of 117 patients were enrolled (mean age, 58 years). Radiation therapy (median dose, 66 Gy) was given with either exclusive or postoperative intent in 52 and 65 patients, respectively. Chemotherapy (CT) was added before and/or during RT in 61 patients. The patients completed a 20-item questionnaire (Multidimensional Fatigue Inventory [MFI-20]) before, during (weekly), and after RT. The impact of patient-, tumor-, and treatment-related factors on fatigue was evaluated with unifactorial and multifactorial tests. Results: Fatigue level increased during RT reaching a maximum at Week 6 and then slowly decreased. In multivariate stepwise regression analysis age (inversely related, p < 0.05), psychologic disorders (p < 0.005), and previous head-and-neck surgery (inversely related, p < 0.005) were correlated with higher pre-RT fatigue level. Pre-RT fatigue score (p < 0.0001), induction and/or concomitant CT (p = 0.035), need of cortisone during RT (p = 0.005), and thyroid disorders (p = 0.032) were correlated with higher during-RT fatigue level. Pre-RT fatigue score (p < 0.0001), induction and/or concomitant CT (p < 0.001), and need of cortisone during RT (p < 0.005) were correlated with higher post-RT fatigue level. No impact of gender, performance status, comorbidities other than psychologic and thyroid, tumor stage/site, RT intent, dose, volume, duration, or toxicity was observed. Conclusion: Fatigue affects all patients undergoing RT for head-and-neck cancer, reaches maximum score at the 6th week of RT, and slowly decreases thereafter. Age, thyroid dysfunction, psychologic disorders, pre-RT fatigue score, CT, and cortisone use are correlated with RT-related fatigue levels.},
doi = {10.1016/j.ijrobp.2007.01.024},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 68,
place = {United States},
year = {Fri Jun 01 00:00:00 EDT 2007},
month = {Fri Jun 01 00:00:00 EDT 2007}
}