• Int. J. Radiat. Oncol. Biol. Phys. · Nov 2011

    One-year longitudinal study of fatigue, cognitive functions, and quality of life after adjuvant radiotherapy for breast cancer.

    • Sabine Noal, Christelle Levy, Agnès Hardouin, Chantal Rieux, Natacha Heutte, Carine Ségura, Fabienne Collet, Djelila Allouache, Odile Switsers, Corinne Delcambre, Thierry Delozier, Michel Henry-Amar, and Florence Joly.
    • Medical Oncology Department, Centre François Baclesse, Caen, France.
    • Int. J. Radiat. Oncol. Biol. Phys. 2011 Nov 1; 81 (3): 795-803.

    PurposeMost patients with localized breast cancer (LBC) who take adjuvant chemotherapy (CT) complain of fatigue and a decrease in quality of life during or after radiotherapy (RT). The aim of this longitudinal study was to compare the impact of RT alone with that occurring after previous CT on quality of life.Methods And MaterialsFatigue (the main endpoint) and cognitive impairment were assessed in 161 CT-RT and 141 RT patients during RT and 1 year later. Fatigue was assessed with Functional Assessment of Cancer Therapy-General questionnaires, including breast and fatigue modules.ResultsAt baseline, 60% of the CT-RT patients expressed fatigue vs. 33% of the RT patients (p <0.001). Corresponding values at the end of RT were statistically similar (61% and 53%), and fatigue was still reported at 1 year by more than 40% of patients in both groups. Risk factors for long-term fatigue included depression (odds ratio [OR] = 6), which was less frequent in the RT group at baseline (16% vs. 28 %, respectively, p = 0.01) but reached a similar value at the end of RT (25% in both groups). Initial mild cognitive impairments were reported by RT (34 %) patients and CT-RT (24 %) patients and were persistent at 1 year for half of them. No biological disorders were associated with fatigue or cognitive impairment.ConclusionsFatigue was the main symptom in LBC patients treated with RT, whether they received CT previously or not. The correlation of persistent fatigue with initial depressive status favors administering medical and psychological programs for LBC patients treated with CT and/or RT, to identify and manage this main quality-of-life-related symptom.Copyright © 2011 Elsevier Inc. All rights reserved.

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