Multidimensional assessment of fatigue in patients with brain metastases before and after Gamma Knife radiosurgery

Eline Verhaak, Wietske C. M. Schimmel, Margriet M. Sitskoorn, Marjan Bakker, Patrick E. J. Hanssens, Karin Gehring*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Purpose 

Fatigue is a common and distressing symptom in cancer patients which negatively affects patients' daily functioning and health-related quality of life. The aim of this study was to assess multidimensional fatigue in patients with brain metastases (BM) before, and after Gamma Knife radiosurgery (GKRS). 

Methods 

Patients with BM, an expected survival > 3 months, and a Karnofsky Performance Status >= 70 and 104 Dutch non-cancer controls were recruited. The Multidimensional Fatigue Inventory (MFI), measuring general fatigue, physical fatigue, mental fatigue, reduced activity and reduced motivation, was used. Baseline levels of fatigue between patients and controls were compared using independent-samples t-tests. The course of fatigue over time, and clinical and psychological predictors thereof, were analyzed using linear mixed models (within-group analyses). 

Results 

Ninety-two, 67 and 53 patients completed the MFI at baseline, and 3 and 6 months after GKRS. Before GKRS, patients with BM experienced significantly higher levels of fatigue on all subscales compared to controls (medium to large effect sizes). Over 6 months, general and physical fatigue increased significantly (p = .009 and p <.001), and levels of mental fatigue decreased significantly (p = .027). No significant predictors of the course of fatigue over time could be identified. 

Conclusions 

Fatigue is a major problem for patients with BM. Different patterns over time were observed for the various aspects of fatigue in patients with BM. Information on the various aspects of fatigue is important because fatigue may negatively affect patients' functional independence, health-related quality of life, and adherence to therapy.

Original languageEnglish
Pages (from-to)377-384
JournalJournal of Neuro-Oncology
Volume144
Issue number2
DOIs
Publication statusPublished - 2019

Keywords

  • Brain metastases
  • Cancer
  • Fatigue
  • Multidimensional fatigue inventory
  • Patient reported outcomes
  • Radiosurgery
  • CANCER-RELATED FATIGUE
  • FUNCTIONAL ASSESSMENT
  • DEPRESSION
  • RADIOTHERAPY
  • MANAGEMENT
  • MECHANISMS
  • GLIOMAS

Cite this

@article{e345d55fe10948998894cfcbd502d998,
title = "Multidimensional assessment of fatigue in patients with brain metastases before and after Gamma Knife radiosurgery",
abstract = "Purpose Fatigue is a common and distressing symptom in cancer patients which negatively affects patients' daily functioning and health-related quality of life. The aim of this study was to assess multidimensional fatigue in patients with brain metastases (BM) before, and after Gamma Knife radiosurgery (GKRS). Methods Patients with BM, an expected survival > 3 months, and a Karnofsky Performance Status >= 70 and 104 Dutch non-cancer controls were recruited. The Multidimensional Fatigue Inventory (MFI), measuring general fatigue, physical fatigue, mental fatigue, reduced activity and reduced motivation, was used. Baseline levels of fatigue between patients and controls were compared using independent-samples t-tests. The course of fatigue over time, and clinical and psychological predictors thereof, were analyzed using linear mixed models (within-group analyses). Results Ninety-two, 67 and 53 patients completed the MFI at baseline, and 3 and 6 months after GKRS. Before GKRS, patients with BM experienced significantly higher levels of fatigue on all subscales compared to controls (medium to large effect sizes). Over 6 months, general and physical fatigue increased significantly (p = .009 and p <.001), and levels of mental fatigue decreased significantly (p = .027). No significant predictors of the course of fatigue over time could be identified. Conclusions Fatigue is a major problem for patients with BM. Different patterns over time were observed for the various aspects of fatigue in patients with BM. Information on the various aspects of fatigue is important because fatigue may negatively affect patients' functional independence, health-related quality of life, and adherence to therapy.",
keywords = "Brain metastases, Cancer, Fatigue, Multidimensional fatigue inventory, Patient reported outcomes, Radiosurgery, CANCER-RELATED FATIGUE, FUNCTIONAL ASSESSMENT, DEPRESSION, RADIOTHERAPY, MANAGEMENT, MECHANISMS, GLIOMAS",
author = "Eline Verhaak and Schimmel, {Wietske C. M.} and Sitskoorn, {Margriet M.} and Marjan Bakker and Hanssens, {Patrick E. J.} and Karin Gehring",
year = "2019",
doi = "10.1007/s11060-019-03240-w",
language = "English",
volume = "144",
pages = "377--384",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Kluwer Academic Publishers",
number = "2",

}

Multidimensional assessment of fatigue in patients with brain metastases before and after Gamma Knife radiosurgery. / Verhaak, Eline; Schimmel, Wietske C. M.; Sitskoorn, Margriet M.; Bakker, Marjan; Hanssens, Patrick E. J.; Gehring, Karin.

In: Journal of Neuro-Oncology, Vol. 144, No. 2, 2019, p. 377-384.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Multidimensional assessment of fatigue in patients with brain metastases before and after Gamma Knife radiosurgery

AU - Verhaak, Eline

AU - Schimmel, Wietske C. M.

AU - Sitskoorn, Margriet M.

AU - Bakker, Marjan

AU - Hanssens, Patrick E. J.

AU - Gehring, Karin

PY - 2019

Y1 - 2019

N2 - Purpose Fatigue is a common and distressing symptom in cancer patients which negatively affects patients' daily functioning and health-related quality of life. The aim of this study was to assess multidimensional fatigue in patients with brain metastases (BM) before, and after Gamma Knife radiosurgery (GKRS). Methods Patients with BM, an expected survival > 3 months, and a Karnofsky Performance Status >= 70 and 104 Dutch non-cancer controls were recruited. The Multidimensional Fatigue Inventory (MFI), measuring general fatigue, physical fatigue, mental fatigue, reduced activity and reduced motivation, was used. Baseline levels of fatigue between patients and controls were compared using independent-samples t-tests. The course of fatigue over time, and clinical and psychological predictors thereof, were analyzed using linear mixed models (within-group analyses). Results Ninety-two, 67 and 53 patients completed the MFI at baseline, and 3 and 6 months after GKRS. Before GKRS, patients with BM experienced significantly higher levels of fatigue on all subscales compared to controls (medium to large effect sizes). Over 6 months, general and physical fatigue increased significantly (p = .009 and p <.001), and levels of mental fatigue decreased significantly (p = .027). No significant predictors of the course of fatigue over time could be identified. Conclusions Fatigue is a major problem for patients with BM. Different patterns over time were observed for the various aspects of fatigue in patients with BM. Information on the various aspects of fatigue is important because fatigue may negatively affect patients' functional independence, health-related quality of life, and adherence to therapy.

AB - Purpose Fatigue is a common and distressing symptom in cancer patients which negatively affects patients' daily functioning and health-related quality of life. The aim of this study was to assess multidimensional fatigue in patients with brain metastases (BM) before, and after Gamma Knife radiosurgery (GKRS). Methods Patients with BM, an expected survival > 3 months, and a Karnofsky Performance Status >= 70 and 104 Dutch non-cancer controls were recruited. The Multidimensional Fatigue Inventory (MFI), measuring general fatigue, physical fatigue, mental fatigue, reduced activity and reduced motivation, was used. Baseline levels of fatigue between patients and controls were compared using independent-samples t-tests. The course of fatigue over time, and clinical and psychological predictors thereof, were analyzed using linear mixed models (within-group analyses). Results Ninety-two, 67 and 53 patients completed the MFI at baseline, and 3 and 6 months after GKRS. Before GKRS, patients with BM experienced significantly higher levels of fatigue on all subscales compared to controls (medium to large effect sizes). Over 6 months, general and physical fatigue increased significantly (p = .009 and p <.001), and levels of mental fatigue decreased significantly (p = .027). No significant predictors of the course of fatigue over time could be identified. Conclusions Fatigue is a major problem for patients with BM. Different patterns over time were observed for the various aspects of fatigue in patients with BM. Information on the various aspects of fatigue is important because fatigue may negatively affect patients' functional independence, health-related quality of life, and adherence to therapy.

KW - Brain metastases

KW - Cancer

KW - Fatigue

KW - Multidimensional fatigue inventory

KW - Patient reported outcomes

KW - Radiosurgery

KW - CANCER-RELATED FATIGUE

KW - FUNCTIONAL ASSESSMENT

KW - DEPRESSION

KW - RADIOTHERAPY

KW - MANAGEMENT

KW - MECHANISMS

KW - GLIOMAS

U2 - 10.1007/s11060-019-03240-w

DO - 10.1007/s11060-019-03240-w

M3 - Article

VL - 144

SP - 377

EP - 384

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

SN - 0167-594X

IS - 2

ER -