title: Prevalence, Impact, and Correlates of Severe Fatigue in Patients With Gastrointestinal Stromal Tumors.
abstract: The introduction of the tyrosine kinase inhibitor (TKI) imatinib in the treatment of gastrointestinal stromal tumor (GIST) in 2000 was the start of a new era of targeted treatment. Since then, the median survival of patients with GIST has substantially increased. Prolonged survival and chronic TKI use are associated with treatment-induced symptoms, such as fatigue, which can compromise quality of life (QoL).
  
  
  
  This study determined the prevalence of severe fatigue in GIST patients compared to matched healthy controls, the impact of fatigue on daily life, and associations between fatigue and current TKI use.
  
  
  
  One hundred nineteen patients treated with surgery and/or a TKI for GIST were asked to participate. Participants completed questionnaires including the Checklist Individual Strength-Fatigue Severity scale (CIS-fatigue), Short-Form 36-Item Health Survey, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, Fatigue Catastrophizing Scale, Self-Efficacy Scale, and the Hospital Anxiety and Depression Scale.
  
  
  
  Eighty-nine GIST patients (75%) completed questionnaires, 61 patients (69%) were on a TKI. Prevalence of severe fatigue measured with CIS-fatigue was significantly higher in GIST patients (30%) than in 234 matched healthy controls (15%). The prevalence of severe fatigue did not differ significantly between patients receiving treatment with curative (29%) or palliative intent (36%). Severely fatigued patients reported lower QoL and more impairment on all functional domains. TKI use, more psychological distress, and lower physical functioning were associated with fatigue.
  
  
  
  Severe fatigue occurs in 30% of GIST patients and in 33% of GIST patients on a TKI. The fatigue is disabling and is not only associated with current TKI use but also with psychological distress and physical functioning. GIST patients should be informed about these associated factors of fatigue that deserve appropriate management.
authors.affiliation: Expert Center for Chronic Fatigue, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Hanneke.Poort@radboudumc.nl.
authors.forename: Hanneke
authors.initials: H
authors.lastname: Poort
authors.affiliation: Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors.forename: Winette T A
authors.initials: WT
authors.lastname: van der Graaf
authors.affiliation: Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Tielen
authors.affiliation: Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Myrella
authors.initials: M
authors.lastname: Vlenterie
authors.affiliation: Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: José A E
authors.initials: JA
authors.lastname: Custers
authors.affiliation: Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Judith B
authors.initials: JB
authors.lastname: Prins
authors.affiliation: Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Constans A H H V M
authors.initials: CA
authors.lastname: Verhagen
authors.affiliation: Expert Center for Chronic Fatigue, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Marieke F M
authors.initials: MF
authors.lastname: Gielissen
authors.affiliation: Expert Center for Chronic Fatigue, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Knoop
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D046152:Gastrointestinal Stromal Tumors / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D047428:Protein Kinase Inhibitors
keywords: Fatigue; gastrointestinal stromal tumors; molecular targeted therapy; quality of life