4月16日,，在線發(fā)表在JCO雜志上的一項研究表明,，癌癥治療后導(dǎo)致的長期疲勞可能比想象中要更不常見，至少對于早期乳腺癌患者是如此,。早期乳腺癌治療后，有三分之一的病人在治療結(jié)束時出現(xiàn)癌癥相關(guān)的疲勞,，但是只有6%在1年后還存在此問題,。以上結(jié)果表明,，早期乳腺癌治療后的疲勞會隨著時間而消退,。
持久的疲勞在癌癥治療后較普遍,，但是癌癥相關(guān)的疲勞的早期自然史還沒有得到系統(tǒng)性的研究，其與癌癥,、手術(shù)和輔助治療的關(guān)系還不清楚,。
該研究前瞻性的隨訪了218名接受輔助治療的早期乳腺癌婦女，這些婦女在手術(shù)后被納入隊列,，觀察時間點是在治療結(jié)束時,，1、3,、6,、9、12個月以及5年,。
手術(shù)后癌癥相關(guān)疲勞的發(fā)生率為24%（n=51）,，治療結(jié)束時為31%（n=69）,。6個月時持續(xù)疲勞的發(fā)生率為11%（n=24）,，12個月為6%（n=12）,。在每個時間點，近三分之一的病人存在情緒障礙,。癌癥相關(guān)的疲勞與明顯身體障礙和醫(yī)療服務(wù)利用具有相關(guān)性,。
這項研究表明,，癌癥相關(guān)的疲勞很常見，但是通常存在一個自限的過程,。之前報道中的癌癥相關(guān)疲勞的長持久性,，可能是與癌癥或治療無關(guān)的因素造成的,。
晚期癌癥相關(guān)的疲勞是更為復(fù)雜的問題——與一個活躍腫瘤的生物學(xué)特性和物理效應(yīng)有關(guān)，同時還與使用的藥物有關(guān),。
本研究的一個特色是使用調(diào)查問卷去區(qū)別生理和心理癥狀,，這是過去一些研究所沒有的。對6個月時仍存在疲勞的婦女進行評估以排除其他原因,，例如甲狀腺功能減退和抑郁癥,。
基于針對慢性疲勞的研究，運動聯(lián)合認知行為治療可能幫助一些病人,。
最近一項針對乳腺癌幸存者的研究發(fā)現(xiàn)，飲食中添加更多omega-3的女性疲勞的風險降低,，尤其當她們使用魚油丸時。但是這些發(fā)現(xiàn)不能證明omega-3直接影響疲勞的長期風險,。研究者也說服用魚油去抵抗疲勞還為時尚早。他們指出,，一個星期吃幾次魚不失為一個好主意。（生物谷Bioon.com）
doi:10.1200/JCO.2011.34.6148
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Cancer-Related Fatigue in Women With Breast Cancer: Outcomes of a 5-Year Prospective Cohort Study.
Webber K,McCourt J,Lloyd AR,et al.
Abstract： PURPOSEProlonged and disabling fatigue is prevalent after cancer treatment, but the early natural history of cancer-related fatigue (CRF) has not been systematically examined to document consistent presence of symptoms. Hence, relationships to cancer, surgery, and adjuvant therapy are unclear. PATIE... PURPOSEProlonged and disabling fatigue is prevalent after cancer treatment, but the early natural history of cancer-related fatigue (CRF) has not been systematically examined to document consistent presence of symptoms. Hence, relationships to cancer, surgery, and adjuvant therapy are unclear. PATIENTS AND METHODSA prospective cohort study of women receiving adjuvant treatment for early-stage breast cancer was conducted. Women (n = 218) were enrolled after surgery and observed at end treatment and at 1, 3, 6, 9, and 12 months as well as 5 years. Structured interviews and self-report questionnaires were used to record physical and psychologic health as well as disability and health care utilization. Patients with CRF persisting for 6 months were assessed to exclude alternative medical and psychiatric causes of fatigue. Predictors of persistent fatigue, mood disturbance, and health care utilization were sought by logistic regression.ResultsThe case rate for CRF was 24% (n = 51) postsurgery and 31% (n = 69) at end of treatment; it became persistent in 11% (n = 24) at 6 months and 6% (n = 12) at 12 months. At each time point, approximately one third of the patients had comorbid mood disturbance. Persistent CRF was predicted by tumor size but not demographic, psychologic, surgical, or hematologic parameters. CRF was associated with significant disability and health care utilization. CONCLUSIONCRF is common but generally runs a self-limiting course. Much of the previously reported high rates of persistent CRF may be attributable to factors unrelated to the cancer or its treatment.
