{A figure is presented}Fatigue During Head-And-Neck Radiotherapy: Prospective Study on 117 Consecutive Patients

Barbara Alicja Jereczek-Fossa, Luigi Santoro, Daniela Alterio, Benedetta Franchi, Maria Rosaria Fiore, Piero Fossati, Anna Kowalczyk, Paola Canino, Mohssen Ansarin, Roberto Orecchia

Research output: Contribution to journalArticlepeer-review

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 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.

Original languageEnglish
Pages (from-to)403-415
Number of pages13
JournalInternational Journal of Radiation Oncology Biology Physics
Volume68
Issue number2
DOIs
Publication statusPublished - Jun 1 2007

Keywords

  • Asthenia
  • Fatigue
  • Head and neck cancer
  • MFI-20
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

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