FATIGUE AND RADIOTHERAPY - (A) EXPERIENCE IN PATIENTS UNDERGOING TREATMENT

Cancer patients undergoing radiotherapy frequently report fatigue. How ever, knowledge of the importance of fatigue for these patients and of the factors associated with their fatigue is limited. The aim of the current investigation was to gain more insight into fatigue as related to radiotherapy by answering the following questions. First, how is t he experience of fatigue best described? Secondly, to what extent is f atigue related to sociodemographic, medical (including treatment), phy sical and psychological factors? Finally, is it possible to predict wh ich patients will suffer from fatigue after completion of radiotherapy ? Patients with different types of cancer receiving radiotherapy with curative intent (n=250) were interviewed before and within 2 weeks of completion of radiotherapy. During treatment, patients rated their fat igue at 2-weekly intervals. Results indicate a gradual increase in fat igue over the period of radiotherapy and a decrease after completion o f treatment. Fatigue scores obtained after radiotherapy were only slig htly, although significantly, higher than pretreatment scores. After t reatment, 46% of the patients reported fatigue among the three symptom s that caused them most distress. Significant associations were found between post-treatment fatigue and diagnosis, physical distress, funct ional disability, quality of sleep, psychological distress and depress ion. No association was found between fatigue and treatment or persona lity characteristics. Multivariate regression analysis demonstrated th at the intensity of pretreatment fatigue was the best predictor of fat igue after treatment. In view of this finding, a regression analysis w as performed to gain more insight into the variables predicting pretre atment fatigue, The degree of functional disability and impaired quali ty of sleep were found to explain 38% of the variance in fatigue befor e starting radiotherapy. Fatigue in disease-free patients 9 months aft er treatment is described in paper (B) in this issue.