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(Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer

Juan C. Rosas, Miguel E. Aguado‐Barrera, David Azria, Erik Briers, Rebecca Elliott, Marie‐Pierre Farcy‐Jacquet, Alexandra Giraldo, Sara Gutiérrez‐Enríquez, Tiziana Rancati, Tim Rattay, et al.
(2023) INTERNATIONAL JOURNAL OF CANCER. 153(9). p.1579-1591
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Abstract
Fatigue is common in breast-cancer survivors. Our study assessed fatigue longitudinally in breast cancer patients receiving adjuvant radiotherapy (RT) and aimed to identify risk factors associated with long-term fatigue and underlying fatigue trajectories. Fatigue was measured in a prospective multicenter cohort (REQUITE) using the Multidimensional Fatigue Inventory (MFI-20) and analyzed using mixed models. Multivariable logistic models identified factors associated with fatigue dimensions at 2 years post-RT and latent class growth analysis identified individual fatigue trajectories. A total of 1443, 1302, 1203 and 1098 patients completed the MFI-20 at baseline, end of RT, after 1 and 2 years. Overall, levels of fatigue significantly increased from baseline to end of RT for all fatigue dimensions (P < .05) and returned to baseline levels after 2 years. A quarter of patients were assigned to latent trajectory high (23.7%) and moderate (24.8%) fatigue classes, while 46.3% and 5.2% to the low and decreasing fatigue classes, respectively. Factors associated with multiple fatigue dimensions at 2 years include age, BMI, global health status, insomnia, pain, dyspnea and depression. Fatigue present at baseline was consistently associated with all five MFI-20 fatigue dimensions (ORGeneralFatigue = 3.81, P < .001). From latent trajectory analysis, patients with a combination of factors such as pain, insomnia, depression, younger age and endocrine therapy had a particularly high risk of developing early and persistent high fatigue years after treatment. Our results confirmed the multidimensional nature of fatigue and will help clinicians identify breast cancer patients at higher risk of having persistent/late fatigue so that tailored interventions can be delivered.
Keywords
Cancer Research, Oncology, radiotherapy, longitudinal trajectories, fatigue, determinants, breast cancer

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MLA
Rosas, Juan C., et al. “(Pre)Treatment Risk Factors for Late Fatigue and Fatigue Trajectories Following Radiotherapy for Breast Cancer.” INTERNATIONAL JOURNAL OF CANCER, vol. 153, no. 9, Wiley, 2023, pp. 1579–91, doi:10.1002/ijc.34640.
APA
Rosas, J. C., Aguado‐Barrera, M. E., Azria, D., Briers, E., Elliott, R., Farcy‐Jacquet, M., … the REQUITE Consortium, [missing]. (2023). (Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer. INTERNATIONAL JOURNAL OF CANCER, 153(9), 1579–1591. https://doi.org/10.1002/ijc.34640
Chicago author-date
Rosas, Juan C., Miguel E. Aguado‐Barrera, David Azria, Erik Briers, Rebecca Elliott, Marie‐Pierre Farcy‐Jacquet, Alexandra Giraldo, et al. 2023. “(Pre)Treatment Risk Factors for Late Fatigue and Fatigue Trajectories Following Radiotherapy for Breast Cancer.” INTERNATIONAL JOURNAL OF CANCER 153 (9): 1579–91. https://doi.org/10.1002/ijc.34640.
Chicago author-date (all authors)
Rosas, Juan C., Miguel E. Aguado‐Barrera, David Azria, Erik Briers, Rebecca Elliott, Marie‐Pierre Farcy‐Jacquet, Alexandra Giraldo, Sara Gutiérrez‐Enríquez, Tiziana Rancati, Tim Rattay, Victoria Reyes, Barry Rosenstein, Dirk De Ruysscher, Elena Sperk, Hilary Stobart, Christopher Talbot, Ana Vega, Begoña Taboada‐Valladares, Liv Veldeman, Tim Ward, Adam Webb, Catharine West, Jenny Chang‐Claude, Petra Seibold, and [missing] the REQUITE Consortium. 2023. “(Pre)Treatment Risk Factors for Late Fatigue and Fatigue Trajectories Following Radiotherapy for Breast Cancer.” INTERNATIONAL JOURNAL OF CANCER 153 (9): 1579–1591. doi:10.1002/ijc.34640.
Vancouver
1.
Rosas JC, Aguado‐Barrera ME, Azria D, Briers E, Elliott R, Farcy‐Jacquet M, et al. (Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer. INTERNATIONAL JOURNAL OF CANCER. 2023;153(9):1579–91.
IEEE
[1]
J. C. Rosas et al., “(Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer,” INTERNATIONAL JOURNAL OF CANCER, vol. 153, no. 9, pp. 1579–1591, 2023.
@article{01H93F704QS24TPQBSZPCJ7HWC,
  abstract     = {{Fatigue is common in breast-cancer survivors. Our study assessed fatigue longitudinally in breast cancer patients receiving adjuvant radiotherapy (RT) and aimed to identify risk factors associated with long-term fatigue and underlying fatigue trajectories. Fatigue was measured in a prospective multicenter cohort (REQUITE) using the Multidimensional Fatigue Inventory (MFI-20) and analyzed using mixed models. Multivariable logistic models identified factors associated with fatigue dimensions at 2 years post-RT and latent class growth analysis identified individual fatigue trajectories. A total of 1443, 1302, 1203 and 1098 patients completed the MFI-20 at baseline, end of RT, after 1 and 2 years. Overall, levels of fatigue significantly increased from baseline to end of RT for all fatigue dimensions (P < .05) and returned to baseline levels after 2 years. A quarter of patients were assigned to latent trajectory high (23.7%) and moderate (24.8%) fatigue classes, while 46.3% and 5.2% to the low and decreasing fatigue classes, respectively. Factors associated with multiple fatigue dimensions at 2 years include age, BMI, global health status, insomnia, pain, dyspnea and depression. Fatigue present at baseline was consistently associated with all five MFI-20 fatigue dimensions (ORGeneralFatigue = 3.81, P < .001). From latent trajectory analysis, patients with a combination of factors such as pain, insomnia, depression, younger age and endocrine therapy had a particularly high risk of developing early and persistent high fatigue years after treatment. Our results confirmed the multidimensional nature of fatigue and will help clinicians identify breast cancer patients at higher risk of having persistent/late fatigue so that tailored interventions can be delivered.}},
  author       = {{Rosas, Juan C. and Aguado‐Barrera, Miguel E. and Azria, David and Briers, Erik and Elliott, Rebecca and Farcy‐Jacquet, Marie‐Pierre and Giraldo, Alexandra and Gutiérrez‐Enríquez, Sara and Rancati, Tiziana and Rattay, Tim and Reyes, Victoria and Rosenstein, Barry and De Ruysscher, Dirk and Sperk, Elena and Stobart, Hilary and Talbot, Christopher and Vega, Ana and Taboada‐Valladares, Begoña and Veldeman, Liv and Ward, Tim and Webb, Adam and West, Catharine and Chang‐Claude, Jenny and Seibold, Petra and the REQUITE Consortium, [missing]}},
  issn         = {{0020-7136}},
  journal      = {{INTERNATIONAL JOURNAL OF CANCER}},
  keywords     = {{Cancer Research,Oncology,radiotherapy,longitudinal trajectories,fatigue,determinants,breast cancer}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1579--1591}},
  publisher    = {{Wiley}},
  title        = {{(Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer}},
  url          = {{http://doi.org/10.1002/ijc.34640}},
  volume       = {{153}},
  year         = {{2023}},
}
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