Interventions for the management of fatigue in adults with a primary brain tumour

Day, Julia; Yust‐Katz, Shlomit; Cachia, David; Rooney, Alasdair G; Katz, Lior H.; Wefel, Jeffrey S.; Tremont, Ivo; Armstrong, Terri S.

doi:10.1002/14651858.cd011376

Cited by 5 publications

(4 citation statements)

References 36 publications

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“…This may make it difficult to conduct systematic prospective investigations of their effect and may be one of the reasons why at least one of the studies identified in the present review had difficulty with accrual. Of note, the primary outcome of all the stimulant trials was fatigue, for which there was no support (see Day et al for a review of fatigue outcomes in adults with primary brain tumors). One of the studies suggested that patients with higher baseline levels of fatigue may gain the most benefit on HRQoL from armodafinil (stimulant of interest in this study) and recommend further investigation in larger studies.…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

et al. 2018

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Objectives The objectives of this systematic review were to (a) identify supportive‐care (psychosocial/behavioral, pharmacological, complementary, or alternative) interventions that have been evaluated via randomized controlled trials (RCTs) to improve patient‐reported health‐related quality of life (HRQoL) among adults with brain tumors, (b) evaluate the quality of the intervention studies, and (c) evaluate if developed interventions have been efficacious at improving HRQoL, as compared with control conditions in RCTs. Methods This systematic review was conducted using preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. Four databases were searched for RCTs of supportive‐care interventions for adults with brain tumors, primary or metastatic, that included a patient‐reported HRQoL outcome. Quality of the included studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results Ten RCTs involving 640 patients with either a primary or metastatic brain tumor investigating supportive‐care interventions with a HRQoL outcome were identified. In terms of quality, three of the studies received a “strong” rating, three received a “moderate” rating, and four of the studies received a “weak” rating. Only two of the interventions (ie, a home‐based psychosocial intervention and individualized acupuncture with standard rehabilitation) demonstrated improvements in HRQoL over control conditions. Conclusions HRQoL is of the utmost importance when treating patients with brain tumors. Yet there is a notable paucity of research to inform clinical decisions and evidence‐based practice. More high‐quality studies of interventions aimed at improving HRQoL are needed.

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Section: Discussionmentioning

confidence: 99%

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

et al. 2018

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“…16 There are yet no data on new oral anticoagulants in brain tumour patients and on their potential interactions with chemotherapy or seizure medication. 21 A 6-week crossover study of modafinil versus placebo in stable brain tumour patients with moderate fatigue showed reduction in fatigue severity in both arms, but no significant benefit from modafinil over placebo. 22 Several RCTs examined the effect of methylphenidate or armodafinil on fatigue in patients undergoing radiotherapy for brain metastases.…”

Section: Venous Thromboembolismmentioning

confidence: 99%

European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma

Pace¹,

Dirven

Koekkoek

et al. 2017

The Lancet Oncology

232

184

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Patients with glioma present with complex palliative care needs throughout their disease trajectory. The life-limiting nature of gliomas and the presence of specific symptoms related to neurological deterioration necessitate an appropriate and early palliative care approach. The multidisciplinary palliative care task force of the European Association of Neuro-Oncology did a systematic review of the available scientific literature to formulate the best possible evidence-based recommendations for the palliative care of adult patients with glioma, with the aim to reduce symptom burden and improve the quality of life of patients and their caregivers, particularly in the end-of-life phase. When recommendations could not be made because of the scarcity of evidence, the task force either used evidence from studies of patients with systemic cancer or formulated expert opinion. Areas of palliative care that currently lack evidence and thus deserve attention for further research are fatigue, disorders of behaviour and mood, interventions for the needs of caregivers, and timing of advance care planning.

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“… 13 A possible explanation is that radiotherapy can cause endocrine dysfunction when the irradiated area encroaches upon the hypothalamus or pituitary gland. 37 , 39 Moreover, radiotherapy can also cause neuro-inflammation leading to aberrant cytokine and neurotransmitter production and hormone dysregulation, resulting in fatigue. 6 , 17–19 Since there was no significant difference in fatigue prevalence between patients who had received different treatment modalities (no treatment 12% fatigued; resection 25% fatigued; radiotherapy 36% fatigued) and since the number of patients in both the radiotherapy and wait-and-scan group were small, further research in larger patient samples is warranted.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and severity of fatigue in meningioma patients and its association with patient-, tumor- and treatment-related factors

Quach,

Dirven,

Vingerhoed

et al. 2023

Neuro-Oncology Advances

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Background Fatigue is a commonly reported and severe symptom in primary brain tumor patients, but the exact occurrence in meningioma patients is unknown. This study aimed to determine the frequency and severity of fatigue in meningioma patients as well as associations between the level of fatigue and patient-, tumor-, and treatment-related factors. Methods In this multicenter cross-sectional study, meningioma patients completed questionnaires on fatigue (MFI-20), sleep (PSQI), anxiety and depression (HADS), tumor-related symptoms (MDASI-BT) and cognitive functioning (MOS-CFS). Multivariable regression models were used to evaluate the independent association between fatigue and each patient-, tumor-, and treatment-related factor separately, corrected for relevant confounders. Results Based on predetermined in- and exclusion criteria, 275 patients, on average 5.3 (SD=2.0) years since diagnosis, were recruited. Most patients had undergone resection (92%). Meningioma patients reported higher scores on all fatigue subscales compared to normative data and 26% were classified as fatigued. Having experienced a complication due to resection (OR 3.6, 95% CI: 1.8-7.0), having received radiotherapy (OR 2.4, 95% CI: 1.2-4.8), a higher number of comorbidities (OR 1.6, 95% CI: 1.3-1.9) and lower educational level (low level as reference; high level OR 0.3, 95% CI: 0.2-0.7) were independently associated with more fatigue. Conclusions Fatigue is a frequent problem in meningioma patients even many years after treatment. Both patient- and treatment-related factors were determinants of fatigue, with the treatment-related factors being the most likely target for intervention in this patient population.

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Interventions for the management of fatigue in adults with a primary brain tumour

Cited by 5 publications

References 36 publications

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

Patient‐reported health‐related quality of life outcomes in supportive‐care interventions for adults with brain tumors: A systematic review

European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma

The prevalence and severity of fatigue in meningioma patients and its association with patient-, tumor- and treatment-related factors

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