Factors Associated with Fatigue in Patients Undergoing Radiotherapy: A Literature Review
Abstract
Fatigue is one of the most common and disturbing symptoms among cancer patients, affecting almost all individuals undergoing radiotherapy, which lasts for a long time and interferes with the quality of life in performing daily activities. There has been a lot of research on the causative factors of fatigue in cancer patients undergoing radiotherapy. However, there is still a lack of literature review that looks at what are the factors that cause fatigue in cancer patients in general who undergo radiotherapy. This study aims to review existing literature to screen for factors contributing to fatigue in breast cancer patients undergoing radiotherapy. This study is a systematic review using The Joanna Briggs Institute Guideline and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Of the 220 articles found in PubMed, ScienceDirect, and JSTOR databases (years 2017-2022), 77 articles met the full-text access criteria. After rigorous selection, 7 articles were selected for analysis. These articles were reviewed using a quantitative analysis approach to identify demographic, clinical, treatment, and psychosocial factors associated with fatigue in cancer patients undergoing radiotherapy. The results showed that there are several factors that cause fatigue in cancer patients undergoing radiotherapy including demographic factors (age, occupation, education level), clinical factors (hemoglobin level, comorbidities, cancer stage), treatment factors (number of fractions, fraction dose), and psychosocial factors (insomnia, anxiety, and depression). Management of fatigue in cancer patients undergoing radiotherapy requires a comprehensive approach that considers demographic, clinical, treatment, and psychosocial factors that influence the patient's condition. Thus, effective interventions should include all these factors to improve patients' quality of life.
References
Aapro, M., Scotte, F., Bouillet, T., Currow, D., & Vigano, A. (2017). A Practical Approach to Fatigue Management in Colorectal Cancer. Clinical Colorectal Cancer, 16(4), 275–285. https://doi.org/10.1016/j.clcc.2016.04.010
Ardhiansyah, A. O. (2021). Dasar-dasar Onkologi dan Hallmark of Cancer (Edisi 2). Airlangga University Press.
Barros, E. M., McIntosh, S. A., & Savage, K. I. (2022). The DNA damage induced immune response: Implications for cancer therapy. DNA Repair, 120, 103409. https://doi.org/10.1016/j.dnarep.2022.103409
Berger, A. M., Mooney, K., & Alvarez-Perez, A. (2015). Cancer-Related Fatigue, Version 2.2015: Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network, 13(8). https://doi.org/10.6004/jnccn.2015.0122
Bower, J. E., & Bak, K. (2020). Fatigue and Cancer Treatment: Mechanisms, Diagnosis, and Management. Annual Review of Medicine, 71. https://doi.org/10.1146/annurev-med-051418-014542
Chaydhury, M. M. S., & Jain, A. A. P. B. J. (2019). Stress, anxiety, depression, and resilience in cancer patients on radiotherapy. Industrial Psychiatry Journal, 195–201. https://doi.org/10.4103/ipj.ipj
Chen, C.-Y., Bing-Shen, Huang., Ji-Hong, H., Joseph, Tung-Chieh, C., Min-Chi, Chen., S., Ching, S., & Mei-Ling, C. (2024). Persistent Fatigue in Patients With Hepatocellular Carcinoma Receiving Radiotherapy.. Journal of Nursing Research.
Forster, T., Jakel, C., Akbaba, S., & Krug, D. (2020). Fatigue following radiotherapy of low-risk early breast cancer - A randomized controlled trial of intraoperative electron radiotherapy versus standard hypofractionated whole-breast radiotherapy: The COSMOPOLITAN trial (NCT03838419). Radiation Oncology, 15(1), 1–10. https://doi.org/10.1186/s13014-020-01581-9
Goldhirsch, A., Leonardi, Maria Cristina, Gentilini, O. D., & Verinesi, P. (Eds.). (2017). Breast Cancer Innovations in Research and Management. Springer International Publishing.
Grusdat, N. P., Stäuber, A., Tolkmitt, M., Schnabel, J., Schubotz, B., Wright, P. R., & Schulz, H. (2022). Routine cancer treatments and their impact on physical function, symptoms of cancer-related fatigue, anxiety, and depression. Supportive Care in Cancer, 30(5), 3733–3744. https://doi.org/10.1007/s00520-021-06787-5
Heredia-Ciuro, A., Castillo-Pérez, I., Lazo-Prados, A., Granados-Santiago, M., López-López, L., Ortiz-Rubio, A., & Valenza, M. C. (2022). Radiotherapy-Related Fatigue Associated Impairments in Lung Cancer Survivors during COVID-19 Voluntary Isolation. Healthcare (Switzerland), 10(3), 4–11. https://doi.org/10.3390/healthcare10030448
Hidayati, A. O., & Arifah, S. (2020). Factors of Anemia in Cancer Patients Getting Radiotherapy and / or Chemotherapy. 11, 29–36.
Hsiao, C., Daly, B., & Saligan, L. (2016). The Etiology and management of radiotherapy-induced fatigue. Expert Review of Quality of Life in Cancer Care, 1(4), 323–328. https://doi.org/10.1080/23809000.2016.1191948
Hwang, S. Y., & Kwon, S. H. (2024). Factors Affecting Fatigue in Breast Cancer Patients Undergoing Radiotherapy. Journal of the Korean Academy of Fundamentals of Nursing, 31(1), 29–37. https://doi.org/10.7739/jkafn.2024.31.1.29
Jamora, K., Cruz-Lim, E. M., Cereno, R. E., Castillo, M. R., & Baldivia, K. (2022). Hypofractionated radiotherapy in postmastectomy locally advanced breast cancer: an interim report on acute toxicities and dosimetry. Reports of Practical Oncology and Radiotherapy, 27(6), 943–953. https://doi.org/10.5603/RPOR.A2022.0102
Kumar, V., Frcpath, M., Abbas, A., & Aster, J. (2019). Buku ajar patologi Dasar (M. F. Ham & M. Saraswati (Eds.); 10th ed.). Elsevier Health Sciences.
Lariviere, M. J., Chao, H. H., Doucette, A., Kegelman, T. P., Taunk, N. K., Freedman, G. M., & Vapiwala, N. (2020). Factors Associated With Fatigue in Patients with Breast Cancer Undergoing External Beam Radiation Therapy. Practical Radiation Oncology, 10(6), 409–422. https://doi.org/10.1016/j.prro.2020.05.011
Manir, K. S., Bhadra, K., Kumar, G., Manna, A., Patra, N. B., & Sarkar, S. K. (2017). Fatigue in Breast Cancer Patients on Adjuvant Treatment : Course and Prevalence. Indian Journal of Palliative Care, 2, 109–116. https://doi.org/10.4103/0973-1075.100826
Mayo Foundation for Medical Education and, R. (2023). Cancer fatigue: Why it occurs and how to cope.
Moghaddam tabrizi, F., & Alizadeh, S. (2017). Maedica-a Journal of Clinical Medicine Cancer Related Fatigue in Breast Cancer Survivors: in Correlation to Demographic Factors cancer related fatique in breast cancer survivor: In Correlation To Demographic Factors. Maedica A Journal of Clinical Medicine, 12(2), 106–111.
Mukherjee, S. (2020). Kanker-Biografi suatu penyakit. Kepustakaan populer gramedia.
Mustian, K. M., Alfano, C. M., & Heckler, C. (2017). Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue: A Meta-analysis. JAMA Oncology, 3(7). https://doi.org/10.1001/jamaoncol.2016.6914
Nikoloudi, M., Lymvaios, I., Zygogianni, A., Parpa, E., Strikou, D. A., Tsilika, E., Kouloulias, V., & Mystakidou, K. (2020). Quality of life, anxiety, and depression in the head-and-neck cancer patients, undergoing intensity-modulated radiotherapy treatment. Indian Journal of Palliative Care, 26(1), 54–59. https://doi.org/10.4103/IJPC.IJPC_168_19
Park, H., & Kim, K. (2020). Impact of psycho-social factors on fatigue among breast cancer patients who are currently undergoing radiotherapy. International Journal of Environmental Research and Public Health, 17(17), 1–13. https://doi.org/10.3390/ijerph17176092
Poirier, P. (2006). The relationship of sick leave benefits, employment patterns, and individual characteristics to radiation therapy-related fatigue. Oncology Nursing Forum, 33(3), 593–601. https://doi.org/10.1188/06.ONF.593-601
Prastiwi, D., Lestari, W., Utami, R. T., & Rinarto, N. D. (2023). Pengantar Biomedik: Panduan Komprehensif. PT. Sonpedia Publishing Indoensia. https://doi.org/UII
Rizkiyah, N., Iffah, M., & Faraningrum, R. L. (2023). Metode hipofraksinasi pada radioterapi dengan kasus kanker payudara. 1(10), 1153–1166.
Rossi, F., Di Paola, A., Pota, E., Argenziano, M., Di Pinto, D., Marrapodi, M. M., Di Leva, C., Di Martino, M., & Tortora, C. (2021). Biological aspects of inflamm-aging in childhood cancer survivors. Cancers, 13(19), 1–19. https://doi.org/10.3390/cancers13194933
Siegel, R., DeSantis, C., Virgo, K., Stein, K., Mariotto, A., Smith, T., Cooper, D., Gansler, T., Lerro, C., Fedewa, S., Lin, C., Leach, C., Cannady, R. S., Cho, H., Scoppa, S., Hachey, M., Kirch, R., Jemal, A., & Ward, E. (2012). Cancer treatment and survivorship statistics, 2012. CA: A Cancer Journal for Clinicians, 62(4), 220–241. https://doi.org/10.3322/caac.21149
Tarrasch, R., Carmel-Neiderman, N. N., Ben-Ami, S., Kaufman, B., Pfeffer, R., Ben-David, M., & Gamus, D. (2018). The Effect of Reflexology on the Pain-Insomnia-Fatigue Disturbance Cluster of Breast Cancer Patients during Adjuvant Radiation Therapy. Journal of Alternative and Complementary Medicine, 24(1), 62–68. https://doi.org/10.1089/acm.2017.0023
Todt, K., Engström, M., Ekström, M., & Efverman, A. (2022a). Fatigue During Cancer-Related Radiotherapy and Associations with Activities, Work Ability and Quality of Life: Paying Attention to Subgroups more Likely to Experience Fatigue. Integrative Cance. Integrative Cancer Therapies, 21. https://doi.org/10.1177/15347354221138576
Todt, K., Engström, M., Ekström, M., & Efverman, A. (2022b). Fatigue During Cancer-Related Radiotherapy and Associations with Activities, Work Ability and Quality of Life: Paying Attention to Subgroups more Likely to Experience Fatigue. Integrative Cancer Therapies, 21. https://doi.org/10.1177/15347354221138576
Tödt, K., Engström, M., Ekström, M., & Efverman, A. (2022). Fatigue During Cancer-Related Radiotherapy and Associations with Activities, Work Ability and Quality of Life: Paying Attention to Subgroups more Likely to Experience Fatigue. Integrative Cancer Therapies, 21, 15347354221138576. https://doi.org/10.1177/15347354221138576
Wang, S. H., He, G. P., Jiang, P. L., Tang, L. L., Feng, X. M., Zeng, C., & Wang, G. F. (2013). Relationship between cancer-related fatigue and personality in patients with breast cancer after chemotherapy. Psycho-Oncology, 22(10), 2386–2390. https://doi.org/10.1002/pon.3303
Copyright (c) 2024 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
