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Background <p>Cancer-related fatigue (CRF) is a debilitating symptom in patients with lung cancer and is often more severe than in other cancer populations. This study investigated the impact of different cancer treatments on CRF trajectories and the role of physical activity (PA) during treatment.</p> Methods <p>Patients with non-small cell lung cancer (NSCLC) were included. CRF was assessed at diagnosis, during treatment, and 12&#xa0;weeks after treatment initiation using the Multidimensional Fatigue Inventory (MFI-20). ΔMFI-20 (<i>T</i><sub>followup</sub> − <i>T</i><sub>diagnosis</sub>) was compared across treatments (surgery, surgery and (neo-)adjuvant treatment, and non-surgical treatment). PA was measured with an Actigraph GT3X (for 1&#xa0;week during hospitalization after surgery and/or halfway through (neo-)adjuvant treatment), capturing daily step count and minutes of moderate to vigorous PA (MVPA). ΔMFI-20 between the three groups and the association with PA during treatment were examined using multivariable general linear models.</p> Results <p>Sixty-two patients (66 ± 8&#xa0;years, 66% male) were included. CRF increased significantly more in patients receiving surgery and (neo-)adjuvant treatment (<i>n</i> = 12) compared to surgery alone (<i>n</i> = 29) (ΔMFI-20, 16 ± 17 vs. 0.3 ± 13; <i>p</i> &lt; 0.05). The increase in CRF in non-surgically treated patients (<i>n</i> = 21) (ΔMFI-20, 6 ± 19) was not statistically different (<i>p</i> = 0.41) from those receiving surgery. Patients performed 3695 ± 2288 steps/day and 11 ± 14&#xa0;min of MVPA/day during treatment. Patients engaging in higher levels of PA during treatment (&gt; 5000 steps/day or &gt; 10&#xa0;min of MVPA/day) tended to have lower CRF increases compared to most inactive patients (&lt; 3000 steps/day) (ΔMFI-20, 6.4 ± 4.9; <i>p</i> = 0.06).</p> Conclusions <p>Patients with lung cancer experience significant increases in CRF throughout treatment, particularly those receiving (neo-)adjuvant treatment and surgery. PA levels during treatment were very low and tended to be related to lower fatigue increases. These findings highlight the importance of measuring CRF and the potential for exploring PA interventions to manage CRF.</p>

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The trajectory of cancer-related fatigue throughout lung cancer treatment and its association with physical activity

  • 期刊论文

  • 发表日期：

    2025年10月10日

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  • Francesca Van Hulle,
  • Eva Arents,
  • Kirsten Quadflieg,
  • Sarah Haesevoets,
  • Fien Hermans,
  • Maarten Criel,
  • David Ruttens,
  • Eric Derom,
  • Marc Daenen,
  • Martijn A. Spruit,
  • Veerle Surmont,
  • Dieter Stevens,
  • Chris Burtin,
  • Heleen Demeyer

摘要

Background

Cancer-related fatigue (CRF) is a debilitating symptom in patients with lung cancer and is often more severe than in other cancer populations. This study investigated the impact of different cancer treatments on CRF trajectories and the role of physical activity (PA) during treatment.

Methods

Patients with non-small cell lung cancer (NSCLC) were included. CRF was assessed at diagnosis, during treatment, and 12 weeks after treatment initiation using the Multidimensional Fatigue Inventory (MFI-20). ΔMFI-20 (Tfollowup − Tdiagnosis) was compared across treatments (surgery, surgery and (neo-)adjuvant treatment, and non-surgical treatment). PA was measured with an Actigraph GT3X (for 1 week during hospitalization after surgery and/or halfway through (neo-)adjuvant treatment), capturing daily step count and minutes of moderate to vigorous PA (MVPA). ΔMFI-20 between the three groups and the association with PA during treatment were examined using multivariable general linear models.

Results

Sixty-two patients (66 ± 8 years, 66% male) were included. CRF increased significantly more in patients receiving surgery and (neo-)adjuvant treatment (n = 12) compared to surgery alone (n = 29) (ΔMFI-20, 16 ± 17 vs. 0.3 ± 13; p < 0.05). The increase in CRF in non-surgically treated patients (n = 21) (ΔMFI-20, 6 ± 19) was not statistically different (p = 0.41) from those receiving surgery. Patients performed 3695 ± 2288 steps/day and 11 ± 14 min of MVPA/day during treatment. Patients engaging in higher levels of PA during treatment (> 5000 steps/day or > 10 min of MVPA/day) tended to have lower CRF increases compared to most inactive patients (< 3000 steps/day) (ΔMFI-20, 6.4 ± 4.9; p = 0.06).

Conclusions

Patients with lung cancer experience significant increases in CRF throughout treatment, particularly those receiving (neo-)adjuvant treatment and surgery. PA levels during treatment were very low and tended to be related to lower fatigue increases. These findings highlight the importance of measuring CRF and the potential for exploring PA interventions to manage CRF.