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The long-term course and relationship with survival of multidimensional fatigue in patients with brain metastases after Gamma Knife radiosurgery
Verhaak,Eline Schimmel,Wietske C M Sitskoorn,Margriet M Hanssens,Patrick E J Butterbrod,Elke Gehring,Karin
Verhaak,Eline
Schimmel,Wietske C M
Sitskoorn,Margriet M
Hanssens,Patrick E J
Butterbrod,Elke
Gehring,Karin
Abstract
Purpose The aims of this study were to evaluate long-term multidimensional fatigue in patients with brain metastases (BM) up to 21 months after Gamma Knife radiosurgery (GKRS) and (change in) fatigue as predictor of survival. Methods Patients with 1 to 10 BM, expected survival > 3 months, and Karnofsky Performance Status >= 70, and Dutch non-cancer controls were included. Fatigue was measured with the Multidimensional Fatigue Inventory. Levels of fatigue between patients and controls were compared using independent-samples t-tests. Linear mixed models were used to evaluate fatigue within the patient group up to 21 months after GKRS. Pre-GKRS fatigue and minimal clinically important (MCI) changes in fatigue in the first three months (defined as a 2-point difference) after GKRS were evaluated as predictors of survival time. Results Prior to GKRS, patients with BM (n = 92) experienced significantly higher fatigue on all subscales than controls (n = 104). Over 21 months, physical fatigue increased, and mental fatigue decreased significantly. More specifically, general, and physical fatigue increased significantly between pre-GKRS and 3 months, followed by stable scores between 3 (n = 67) and 6 (n = 53), 6 and 12 (n = 34) and 12 and 21 (n = 21) months. An MCI increase in general or physical fatigue over the first 3 months after GKRS was a significant predictor of shorter survival time. Conclusion Except for mental fatigue, all aspects of fatigue remained elevated or further increased up to 21 months after treatment. Furthermore, an increase in general or physical fatigue within three months after GKRS may be a prognostic indicator for poorer survival.ClinicalTrials.gov identifierNCT02953756, November 3, 2016.
Description
This study was funded by ZonMw, the Netherlands Organisation for Health Research and Development (project number 842003008).
Date
2023
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Publisher
Research Projects
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Keywords
Brain Neoplasms/secondary, Follow-Up Studies, Humans, Karnofsky Performance Status, Prognosis, Radiosurgery/adverse effects, Retrospective Studies, Treatment Outcome, SDG 3 - Good Health and Well-being
Citation
Verhaak, E, Schimmel, W C M, Sitskoorn, M M, Hanssens, P E J, Butterbrod, E & Gehring, K 2023, 'The long-term course and relationship with survival of multidimensional fatigue in patients with brain metastases after Gamma Knife radiosurgery', Journal of Cancer Research and Clinical Oncology, vol. 149, no. 12, pp. 9891-9901. https://doi.org/10.1007/s00432-023-04857-1