title: Assessment of Cancer-Related Fatigue, Pain, and Quality of Life in Cancer Patients at Palliative Care Team Referral: A Multicenter Observational Study (JORTC PAL-09).
abstract: BACKGROUND
  Cancer-related fatigue greatly influences quality of life in cancer patients; however, no specific treatments have been established for cancer-related fatigue, and at present, no medication has been approved in Japan. Systematic research using patient-reported outcome to examine symptoms, particularly fatigue, has not been conducted in palliative care settings in Japan. The objective was to evaluate fatigue, pain, and quality of life in cancer patients at the point of intervention by palliative care teams.
  
  
  METHODS
  Patients who were referred to palliative care teams at three institutions and met the inclusion criteria were invited to complete the Brief Fatigue Inventory, Brief Pain Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative.
  
  
  RESULTS
  Of 183 patients recruited, the majority (85.8%) were diagnosed with recurrence or metastasis. The largest group (42.6%) comprised lung cancer patients, of whom 67.2% had an Eastern Cooperative Oncology Group Performance Status of 0-1. The mean value for global health status/quality of life was 41.4, and the highest mean European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative symptom item score was for pain (51.0). The mean global fatigue score was 4.1, and 9.8%, 30.6%, 38.7%, and 20.8% of patients' fatigue severity was classified as none (score 0), mild (1-3), moderate (4-6), and severe (7-10), respectively.
  
  
  CONCLUSIONS
  Cancer-related fatigue, considered to occur more frequently in cancer patients, was successfully assessed using patient-reported outcomes with the Brief Fatigue Inventory for the first time in Japan. Results suggested that fatigue is potentially as problematic as pain, which is the main reason for palliative care.
authors.affiliation: Department of Palliative Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwase
authors.affiliation: Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawaguchi
authors.affiliation: Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tokoro
authors.affiliation: Department of Breast Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Kimito
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kanai
authors.affiliation: Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Department of Palliative Medicine, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kashiwaya
authors.affiliation: Department of Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan; Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Kae
authors.initials: K
authors.lastname: Okuma
authors.affiliation: Department of Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan; Department of Psychosomatic Medicine, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Inada
authors.affiliation: Department of Palliative Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Japanese Organisation for Research and Treatment of Cancer (JORTC), NPO, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ariyoshi
authors.affiliation: Japanese Organisation for Research and Treatment of Cancer (JORTC), NPO, Tokyo, Japan; Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Tempei
authors.initials: T
authors.lastname: Miyaji
authors.affiliation: Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Azuma
authors.affiliation: Department of Palliative Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Japanese Organisation for Research and Treatment of Cancer (JORTC), NPO, Tokyo, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ishiki
authors.affiliation: Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
authors.forename: Sakae
authors.initials: S
authors.lastname: Unezaki
authors.affiliation: Japanese Organisation for Research and Treatment of Cancer (JORTC), NPO, Tokyo, Japan; Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D012017:Referral and Consultation; D011795:Surveys and Questionnaires