Acute and chronic radiotherapy-related fatigue occurs in up to 80% and 30%,
respectively, of patients undergoing irradiation for cancer. Frequently, t
he symptom is not expected by the patients and is underestimated by medical
and nursing staff. Fatigue can affect global quality of life more than pai
n, sexual dysfunction and other cancer- or treatment-related symptoms. Its
etiology and correlates are not clear, Published reports are mainly descrip
tive, and in many of them numerous methodological biases are present. One o
f the limitations is lack of a standard method of assessment that could sim
plify the comparison between different series. In the last decade, modern i
nstruments have been designed to measure fatigue. They include uni- and mul
tidimensional tools. Use of these specific instruments is highly recommende
d for research on radiation-related fatigue. In daily practice when time is
limited, simple assessment is necessary. For example, systemic use of plai
n and easily understandable questions about fatigue, its level and impact o
n daily life could be sufficient and reliable. Therapeutic strategies for r
adiotherapy-induced fatigue have not yet been clearly defined, but a few ra
ndomized studies have been recently published. Physical exercise, group psy
chotherapy and relaxation therapy have been demonstrated to be effective. M
oreover, pharmacological treatment of concomitant disturbances (anemia, pai
n, insomnia, depression, dehydration, infection, malnutrition) and other ra
diotherapy side effects (diarrhea, hormonal insufficiency etc.) should be c
onsidered. Further methodologically correct studies are warranted to better
define the causes, optimal prevention, assessment and management of this s
ymptom.