title: One-year longitudinal study of fatigue, cognitive functions, and quality of life after adjuvant radiotherapy for breast cancer.
abstract: OBJECTIVE
  Most patients with localized breast cancer (LBC) who take adjuvant chemotherapy (CT) complain of fatigue and a decrease in quality of life during or after radiotherapy (RT). The aim of this longitudinal study was to compare the impact of RT alone with that occurring after previous CT on quality of life.
  
  
  METHODS
  Fatigue (the main endpoint) and cognitive impairment were assessed in 161 CT-RT and 141 RT patients during RT and 1 year later. Fatigue was assessed with Functional Assessment of Cancer Therapy-General questionnaires, including breast and fatigue modules.
  
  
  RESULTS
  At baseline, 60% of the CT-RT patients expressed fatigue vs. 33% of the RT patients (p <0.001). Corresponding values at the end of RT were statistically similar (61% and 53%), and fatigue was still reported at 1 year by more than 40% of patients in both groups. Risk factors for long-term fatigue included depression (odds ratio [OR] = 6), which was less frequent in the RT group at baseline (16% vs. 28 %, respectively, p = 0.01) but reached a similar value at the end of RT (25% in both groups). Initial mild cognitive impairments were reported by RT (34 %) patients and CT-RT (24 %) patients and were persistent at 1 year for half of them. No biological disorders were associated with fatigue or cognitive impairment.
  
  
  CONCLUSIONS
  Fatigue was the main symptom in LBC patients treated with RT, whether they received CT previously or not. The correlation of persistent fatigue with initial depressive status favors administering medical and psychological programs for LBC patients treated with CT and/or RT, to identify and manage this main quality-of-life-related symptom.
authors.affiliation: Medical Oncology Department, Centre François Baclesse, Caen, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Noal
authors.forename: Christelle
authors.initials: C
authors.lastname: Levy
authors.forename: Agnès
authors.initials: A
authors.lastname: Hardouin
authors.forename: Chantal
authors.initials: C
authors.lastname: Rieux
authors.forename: Natacha
authors.initials: N
authors.lastname: Heutte
authors.forename: Carine
authors.initials: C
authors.lastname: Ségura
authors.forename: Fabienne
authors.initials: F
authors.lastname: Collet
authors.forename: Djelila
authors.initials: D
authors.lastname: Allouache
authors.forename: Odile
authors.initials: O
authors.lastname: Switsers
authors.forename: Corinne
authors.initials: C
authors.lastname: Delcambre
authors.forename: Thierry
authors.initials: T
authors.lastname: Delozier
authors.forename: Michel
authors.initials: M
authors.lastname: Henry-Amar
authors.forename: Florence
authors.initials: F
authors.lastname: Joly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002985:Clinical Protocols; D003071:Cognition / Q000187:drug effects / Q000528:radiation effects; D003072:Cognition Disorders / Q000209:etiology*; D003863:Depression / Q000150:complications; D005221:Fatigue / Q000209:etiology*; D005260:Female; D005602:France; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors