title: Prevalence and predictors of fatigue in glioblastoma: a prospective study.
abstract: BACKGROUND
  The main goal of this study was to assess frequency, clinical correlates, and independent predictors of fatigue in a homogeneous cohort of well-defined glioblastoma patients at baseline prior to combined radio-chemotherapy.
  
  
  METHODS
  We prospectively included 65 glioblastoma patients at postsurgical baseline and assessed fatigue, sleepiness, mean bedtimes, mood disturbances, and clinical characteristics such as clinical performance status, presenting symptomatology, details on neurosurgical procedure, and tumor location and diameter as well as pharmacological treatment including antiepileptic drugs, antidepressants, and use of corticosteroids. Data on fatigue and sleepiness were measured with the Fatigue Severity Scale and the Epworth Sleepiness Scale, respectively, and compared with 130 age- and sex-matched healthy controls.
  
  
  RESULTS
  We observed a significant correlation between fatigue and sleepiness scores in both patients (r = 0.26; P = .04) and controls (r = 0.36; P < .001). Only fatigue appeared to be more common in glioblastoma patients than in healthy controls (48% vs 11%; P < .001) but not the frequency of sleepiness (22% vs 19%; P = .43). Female sex was associated with increased fatigue frequency among glioblastoma patients but not among control participants. Multiple linear regression analyses identified depression, left-sided tumor location, and female sex as strongest associates of baseline fatigue severity.
  
  
  CONCLUSIONS
  Our findings indicate that glioblastoma patients are frequently affected by fatigue at baseline, suggesting that factors other than those related to radio- or chemotherapy have significant impact, particularly depression and tumor localization.
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland (P.O.V., S.H.); Department of Oncology, University Hospital Zurich, Zurich, Switzerland (A.S., S.H.); Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland (C.L., K.Z.); Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (K.Z.); Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland (U.H.).
authors.forename: Philipp O
authors.initials: PO
authors.lastname: Valko
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland (P.O.V., S.H.); Department of Oncology, University Hospital Zurich, Zurich, Switzerland (A.S., S.H.); Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland (C.L., K.Z.); Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (K.Z.); Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland (U.H.).
authors.forename: Asim
authors.initials: A
authors.lastname: Siddique
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland (P.O.V., S.H.); Department of Oncology, University Hospital Zurich, Zurich, Switzerland (A.S., S.H.); Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland (C.L., K.Z.); Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (K.Z.); Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland (U.H.).
authors.forename: Claudia
authors.initials: C
authors.lastname: Linsenmeier
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland (P.O.V., S.H.); Department of Oncology, University Hospital Zurich, Zurich, Switzerland (A.S., S.H.); Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland (C.L., K.Z.); Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (K.Z.); Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland (U.H.).
authors.forename: Kathrin
authors.initials: K
authors.lastname: Zaugg
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland (P.O.V., S.H.); Department of Oncology, University Hospital Zurich, Zurich, Switzerland (A.S., S.H.); Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland (C.L., K.Z.); Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (K.Z.); Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland (U.H.).
authors.forename: Ulrike
authors.initials: U
authors.lastname: Held
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland (P.O.V., S.H.); Department of Oncology, University Hospital Zurich, Zurich, Switzerland (A.S., S.H.); Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland (C.L., K.Z.); Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (K.Z.); Horten Center for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland (U.H.).
authors.forename: Silvia
authors.initials: S
authors.lastname: Hofer
mesh_terms: D001932:Brain Neoplasms / Q000150:complications* / Q000601:surgery; D005221:Fatigue / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005909:Glioblastoma / Q000150:complications* / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D012894:Sleep Stages
keywords: depression; fatigue; glioblastoma; sleepiness