title: Time course and predictors for cancer-related fatigue in a series of oropharyngeal cancer patients treated with chemoradiation therapy.
abstract: BACKGROUND
  Cancer-related fatigue (CRF) is a highly prevalent and underestimated symptom in cancer patients. This study aims to analyze CRF solely in a cohort of oropharyngeal cancer patients who underwent treatment with radiotherapy (RT).
  
  
  METHODS
  In January 2008 to June 2010, 87 consecutive oropharyngeal carcinoma patients underwent definitive RT. Concurrent chemotherapy was used for 94% of patients. The median prescription dose to the planning target volume of the gross or clinical tumor volume was 70 Gy for definitive cases (n = 84) and 66 Gy for postoperative cases (n = 3), both delivered over 6.5 weeks. A normalized 12-point numeric rating scale assessed CRF from patient visits before, during, and after RT.
  
  
  RESULTS
  The median follow-up of living patients was 14 months. Fatigue peaked 1-2 weeks post-RT and remained higher than baseline for up to 2 years post-RT in 50% of patients. The average fatigue score at the time of completion of therapy or maximum thereafter up to 1 year post-RT was significantly worse than baseline. Patients who experienced pain had a trend toward significance with association for a higher maximum difference in fatigue from baseline. Karnofsky performance status score, weight change, and mood disorders did not correlate with CRF.
  
  
  CONCLUSIONS
  Fatigue was a common treatment-related symptom in this uniform cohort of patients with oropharyngeal cancer. RT was highly correlated with worsening of CRF. Pain control has the potential to help mitigate CRF in patients experiencing pain, and will need to be confirmed using larger datasets.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 22, New York, New York 10021, USA. sprattd@mskcc.org
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Spratt
authors.forename: Mayuko
authors.initials: M
authors.lastname: Sakae
authors.forename: Nadeem
authors.initials: N
authors.lastname: Riaz
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Lok
authors.forename: Samuel
authors.initials: S
authors.lastname: Essandoh
authors.forename: Meier
authors.initials: M
authors.lastname: Hsu
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhang
authors.forename: Karen
authors.initials: K
authors.lastname: Schupak
authors.forename: Jeremy
authors.initials: J
authors.lastname: Setton
authors.forename: Nancy Y
authors.initials: NY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D015331:Cohort Studies; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D059408:Pain Management; D011879:Radiotherapy Dosage; D016896:Treatment Outcome