The trajectory of cancer-related fatigue throughout lung cancer treatment and its association with physical activity.

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Supportive Care in Cancer Pub Date : 2025-10-10 DOI:10.1007/s00520-025-09956-y

Francesca Van Hulle, Eva Arents, Kirsten Quadflieg, Sarah Haesevoets, Fien Hermans, Maarten Criel, David Ruttens, Eric Derom, Marc Daenen, Martijn A Spruit, Veerle Surmont, Dieter Stevens, Chris Burtin, Heleen Demeyer

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Abstract

Background: Cancer-related fatigue (CRF) is a debilitating symptom in patients with lung cancer and is often more severe than in other cancer populations. This study investigated the impact of different cancer treatments on CRF trajectories and the role of physical activity (PA) during treatment.

Methods: Patients with non-small cell lung cancer (NSCLC) were included. CRF was assessed at diagnosis, during treatment, and 12 weeks after treatment initiation using the Multidimensional Fatigue Inventory (MFI-20). ΔMFI-20 (T_followup - T_diagnosis) was compared across treatments (surgery, surgery and (neo-)adjuvant treatment, and non-surgical treatment). PA was measured with an Actigraph GT3X (for 1 week during hospitalization after surgery and/or halfway through (neo-)adjuvant treatment), capturing daily step count and minutes of moderate to vigorous PA (MVPA). ΔMFI-20 between the three groups and the association with PA during treatment were examined using multivariable general linear models.

Results: Sixty-two patients (66 ± 8 years, 66% male) were included. CRF increased significantly more in patients receiving surgery and (neo-)adjuvant treatment (n = 12) compared to surgery alone (n = 29) (ΔMFI-20, 16 ± 17 vs. 0.3 ± 13; p < 0.05). The increase in CRF in non-surgically treated patients (n = 21) (ΔMFI-20, 6 ± 19) was not statistically different (p = 0.41) from those receiving surgery. Patients performed 3695 ± 2288 steps/day and 11 ± 14 min of MVPA/day during treatment. Patients engaging in higher levels of PA during treatment (> 5000 steps/day or > 10 min of MVPA/day) tended to have lower CRF increases compared to most inactive patients (< 3000 steps/day) (ΔMFI-20, 6.4 ± 4.9; p = 0.06).

Conclusions: Patients with lung cancer experience significant increases in CRF throughout treatment, particularly those receiving (neo-)adjuvant treatment and surgery. PA levels during treatment were very low and tended to be related to lower fatigue increases. These findings highlight the importance of measuring CRF and the potential for exploring PA interventions to manage CRF.

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肺癌治疗过程中癌症相关疲劳的发展轨迹及其与身体活动的关系

背景：癌症相关性疲劳（CRF）是肺癌患者的一种衰弱症状，通常比其他癌症人群更严重。本研究探讨了不同癌症治疗对CRF轨迹的影响以及治疗期间体育活动（PA）的作用。方法：纳入非小细胞肺癌（NSCLC）患者。在诊断时、治疗期间和治疗开始后12周，使用多维疲劳量表（MFI-20）评估CRF。ΔMFI-20（随访-诊断）比较不同治疗（手术、手术+（新）辅助治疗和非手术治疗）。使用Actigraph GT3X测量PA（手术后住院1周和/或（新）辅助治疗中途），记录每日步数和中度至剧烈PA （MVPA）分钟数。使用多变量一般线性模型检验三组之间的ΔMFI-20以及治疗期间与PA的关联。结果：纳入62例患者（66±8岁），其中66%为男性。接受手术和（新）辅助治疗的患者（n = 12）比单纯接受手术（n = 29）（ΔMFI-20, 16±17 vs. 0.3±13；p 5000步/天或bbb10分钟MVPA/天）的CRF增加明显更低(结论：肺癌患者在整个治疗过程中CRF显著增加，特别是接受（新）辅助治疗和手术的患者。治疗期间的PA水平非常低，往往与较低的疲劳增加有关。这些发现强调了测量CRF的重要性以及探索PA干预措施来管理CRF的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.