title: A cross-sectional investigation of fatigue in advanced renal cell carcinoma treatment: results from the FAMOUS study.
abstract: OBJECTIVE
  With an increasing choice of new treatment options, the management of side effects to maintain a chosen treatment if likely to be effective on the tumor remains important. The perception of side effects however varies between the physician and the patient, leading to possible wrong assumptions on tolerability that result in dose modifications, which may ultimately affect effectiveness. The aim was to assess fatigue in patients with advanced or metastatic renal cell carcinoma (RCC) by comparing the evaluation of the physician to the one provided by their respective patient. In addition, we aimed to assess possible influences of fatigue on parameters of quality of life.
  
  
  METHODS
  Patients receiving systemic treatment for advanced RCC and their physicians were questioned independently regarding incidence and severity of fatigue and its effect on quality of life.
  
  
  RESULTS
  Both physicians and patients completed 98 matching questionnaires. Patients were treated with sunitinib, sorafenib, bevacizumab combined with interferon alpha, temsirolimus, everolimus, or interferon alpha alone. Incidence and severity of fatigue was differently assessed by patients and physicians, with fatigue being more severe when reported by the patient. The severity of fatigue increased with progressing treatment lines. Quality of life was significantly lower in patients experiencing fatigue compared with patients without fatigue. Emotional, functional, and physical well-being were all affected by fatigue, the latter being the most affected subscale. Social well-being was least affected.
  
  
  CONCLUSIONS
  Fatigue is a complex and cumulative condition of patients treated for advanced RCC, and it considerably affects patient's quality of life. As many of its underlying causes may be treated, the divergent perception of occurrence and severity of fatigue should be integrated in treatment concepts. The active role of the patient in helping to manage ailments through assessment should be implemented when optimizing treatment of RCC.
authors: Department of Urology, Friedrich-Alexander University, Erlangen, Germany. Electronic address: peter.goebell@waldkrankenhaus.de.
authors: Goebell
authors: G
authors: P J
authors: Centre for Urology, Freiburg, Germany.
authors: Münch
authors: M
authors: A
authors: Oncology Outpatient-Centre, Leer, Germany.
authors: Müller
authors: M
authors: L
authors: Joint practice for Oncology, Halle (Saale), Germany.
authors: Hurtz
authors: H
authors: H J
authors: iOMEDICO AG, Freiburg, Germany.
authors: Koska
authors: K
authors: M
authors: Outpatient-Centre for Interdisciplinary Oncology and Haematology, Freiburg, Germany.
authors: Busies
authors: B
authors: S
authors: Outpatient-Centre for Interdisciplinary Oncology and Haematology, Freiburg, Germany.
authors: Marschner
authors: M
authors: N
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000068258:Bevacizumab; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D000068338:Everolimus; D005221:Fatigue / Q000139:chemically induced* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000008:administration & dosage / Q000009:adverse effects; D010820:Physicians; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects; D011788:Quality of Life; D057566:Self Report; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077157:Sorafenib; D000077210:Sunitinib; D011795:Surveys and Questionnaires
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D007211:Indoles; D016898:Interferon-alpha; D010671:Phenylurea Compounds; D011758:Pyrroles; D009536:Niacinamide; D000068258:Bevacizumab; C401859:temsirolimus; D000068338:Everolimus; D000077157:Sorafenib; D000077210:Sunitinib; D020123:Sirolimus
keywords: Carcinoma; Fatigue; Quality of life; Questionnaires; Registries; Renal cell; Self-report; Topic category: Genitourinary cancer