BACKGROUND:Fatigue has a significant impact on the quality of life (QOL) of cancer patients. Recent research has suggested that physical activity can reduce fatigue in patients receiving active cancer treatment. In this project, we examined the impact that participation in a randomized controlled trial of a multidisciplinary intervention designed to impact overall QOL had on fatigue for advanced cancer patients actively receiving treatment. METHODS:Patients with newly diagnosed cancer were randomly assigned to an 8-session structured multidisciplinary intervention or a standard-care arm at the beginning of their course of radiotherapy (RT) designed to impact QOL. Ninety-minute sessions were led by either a psychiatrist or psychologist, collaborating with a nurse, physical therapist, chaplain, or social worker, depending on the session's theme. The fatigue assessments used in this trial included the Linear Analogue Self Assessment (LASA), the Profile of Mood States (POMS), Spielberger's State-Trait Anxiety Inventory (STAI), and the Symptom Distress Scale (SDS). RESULTS: There were 115 participants enrolled and the 2 randomization arms were well balanced in terms of baseline characteristics and treatment received except for increased commuting distance for the patients in the intervention arm (P = 0.042). Most of scores indicated less fatigue (higher score) in the standard treatment group, but there were no statistically significant differences found at baseline and weeks 4, 8, and 27 except for SDS at week 8 (P = 0.018) with less patients reporting significant fatigue in the standard treatment arm. For the entire participant population, fatigue levels initially worsened with radiotherapy, stabilized at week 8, and returned to baseline by week 27. Disease site, chemotherapy use, and radiotherapy dose did not have a significant impact on fatigue levels. CONCLUSIONS:Radiotherapy initially caused a worsening of fatigue but with time fatigue levels returned to baseline. Clinically, this structured multidisciplinary intervention had no impact on fatigue, and there was the suggestion the multiple sessions may have contributed to worse fatigue during active cancer treatment.
RCT Entities:
BACKGROUND:Fatigue has a significant impact on the quality of life (QOL) of cancerpatients. Recent research has suggested that physical activity can reduce fatigue in patients receiving active cancer treatment. In this project, we examined the impact that participation in a randomized controlled trial of a multidisciplinary intervention designed to impact overall QOL had on fatigue for advanced cancerpatients actively receiving treatment. METHODS:Patients with newly diagnosed cancer were randomly assigned to an 8-session structured multidisciplinary intervention or a standard-care arm at the beginning of their course of radiotherapy (RT) designed to impact QOL. Ninety-minute sessions were led by either a psychiatrist or psychologist, collaborating with a nurse, physical therapist, chaplain, or social worker, depending on the session's theme. The fatigue assessments used in this trial included the Linear Analogue Self Assessment (LASA), the Profile of Mood States (POMS), Spielberger's State-Trait Anxiety Inventory (STAI), and the Symptom Distress Scale (SDS). RESULTS: There were 115 participants enrolled and the 2 randomization arms were well balanced in terms of baseline characteristics and treatment received except for increased commuting distance for the patients in the intervention arm (P = 0.042). Most of scores indicated less fatigue (higher score) in the standard treatment group, but there were no statistically significant differences found at baseline and weeks 4, 8, and 27 except for SDS at week 8 (P = 0.018) with less patients reporting significant fatigue in the standard treatment arm. For the entire participant population, fatigue levels initially worsened with radiotherapy, stabilized at week 8, and returned to baseline by week 27. Disease site, chemotherapy use, and radiotherapy dose did not have a significant impact on fatigue levels. CONCLUSIONS: Radiotherapy initially caused a worsening of fatigue but with time fatigue levels returned to baseline. Clinically, this structured multidisciplinary intervention had no impact on fatigue, and there was the suggestion the multiple sessions may have contributed to worse fatigue during active cancer treatment.
Authors: Laura S Gilchrist; Mary Lou Galantino; Meredith Wampler; Victoria G Marchese; G Stephen Morris; Kirsten K Ness Journal: Phys Ther Date: 2009-01-15
Authors: Matthew M Clark; Pamela J Atherton; Maria I Lapid; Sarah M Rausch; Marlene H Frost; Andrea L Cheville; Jean M Hanson; Yolanda I Garces; Paul D Brown; Jeff A Sloan; Jarrett W Richardson; Katherine M Piderman; Teresa A Rummans Journal: Am J Hosp Palliat Care Date: 2013-02-21 Impact factor: 2.500
Authors: Matthew M Clark; Teresa A Rummans; Pamela J Atherton; Andrea L Cheville; Mary E Johnson; Marlene H Frost; Janis J Miller; Jeff A Sloan; Karen M Graszer; Jean G Haas; Jean M Hanson; Yolanda I Garces; Katherine M Piderman; Maria I Lapid; Pamela J Netzel; Jarrett W Richardson; Paul D Brown Journal: Cancer Date: 2012-08-28 Impact factor: 6.860
Authors: Shiraz I Mishra; Roberta W Scherer; Claire Snyder; Paula M Geigle; Debra R Berlanstein; Ozlem Topaloglu Journal: Cochrane Database Syst Rev Date: 2012-08-15
Authors: Annalisa Giacalone; Jerry Polesel; Angela De Paoli; Anna Maria Colussi; Ivana Sartor; Renato Talamini; Umberto Tirelli Journal: Support Care Cancer Date: 2009-09-26 Impact factor: 3.603
Authors: Dona E C Locke; Paul A Decker; Jeff A Sloan; Paul D Brown; James F Malec; Matthew M Clark; Teresa A Rummans; Karla V Ballman; Paul L Schaefer; Jan C Buckner Journal: J Pain Symptom Manage Date: 2007-08-20 Impact factor: 3.612