Long-Term Longitudinal Patterns of Patient-Reported Fatigue After Breast Cancer: A Group-Based Trajectory Analysis. Issue 19 (1st July 2022)

• Record Type: Journal Article
• Authors: Vaz-Luis, Ines; Di Meglio, Antonio; Havas, Julie; El-Mouhebb, Mayssam; Lapidari, Pietro; Presti, Daniele; Soldato, Davide; Pistilli, Barbara; Dumas, Agnes; Menvielle, Gwenn; Charles, Cecile; Everhard, Sibille; Martin, Anne-Laure; Cottu, Paul H.; Lerebours, Florence; Coutant, Charles; Dauchy, Sarah; Delaloge, Suzette; Lin, Nancy U.; Ganz, Patricia A.; Partridge, Ann H.; André, Fabrice; Michiels, Stefan
• Is Part Of: Journal of clinical oncology. Volume 40:Issue 19(2022)
• Page Start: 2148
• Page End: 2162
• Publication Date: 2022-07-01
• Subjects: Oncology -- Periodicals; Cancer -- Periodicals; Oncology; Medical Oncology; Cancérologie -- Périodiques; Cancer -- Périodiques; Cancérologie; Cancer; Oncology; Oncologia; Càncer; Periodicals; 616.994
• DOI: 10.1200/JCO.21.01958
• Languages: English
• ISSNs: 0732-183X

Abstract

Abstract : PURPOSE: Fatigue is recognized as one of the most burdensome and long-lasting adverse effects of cancer and cancer treatment. We aimed to characterize long-term fatigue trajectories among breast cancer survivors. METHODS: We performed a detailed longitudinal analysis of fatigue using a large ongoing national prospective clinical study (CANcer TOxicity, ClinicalTrials.gov identifier: NCT01993498 ) of patients with stage I-III breast cancer treated from 2012 to 2015. Fatigue was assessed at diagnosis and year 1, 2, and 4 postdiagnosis. Baseline clinical, sociodemographic, behavioral, tumor-related, and treatment-related characteristics were available. Trajectories of fatigue and risk factors of trajectory-group membership were identified by iterative estimates of group-based trajectory models. RESULTS: Three trajectory groups were identified for severe global fatigue (n = 4, 173). Twenty-one percent of patients were in the high -risk group, having risk estimates of severe global fatigue of 94.8% (95% CI, 86.6 to 100.0) at diagnosis and 64.6% (95% CI, 59.2 to 70.1) at year 4; 19% of patients clustered in the deteriorating group with risk estimates of severe global fatigue of 13.8% (95% CI, 6.7 to 20.9) at diagnosis and 64.5% (95% CI, 57.3 to 71.8) at year 4; 60% were in the low -risk group with risk estimates of 3.6% (95% CI, 2.5 to 4.7) at diagnosis and 9.6% (95% CI, 7.5 to 11.7) at year 4. The distinct dimensions of fatigue clustered in different trajectory groups than those identified by severe global fatigue, being differentially affected by sociodemographic, clinical, and treatment-related factors. CONCLUSION: Our findings highlight the multidimensional nature of cancer-related fatigue and the complexity of its risk factors. This study helps to identify patients with increased risk of severe fatigue and to inform personalized interventions to ameliorate this problem.