1345P - Caregivers' burden and fatigue during patients' (pts) treatment with curative, concomitant chemoradiotherapy (CRT) for locally advanced head and ne...

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Head and Neck Cancers
Supportive and Palliative Care
Surgical Oncology
Biological Therapy
Radiation Oncology
Presenter Carla van Herpen
Citation Annals of Oncology (2014) 25 (suppl_4): iv471-iv477. 10.1093/annonc/mdu350
Authors C. van Herpen1, S.M.C.H. Langenberg2, C.C.M. van Opstal1, A.N.M. Wymenga3, W.T.A. van der Graaf4, J.B. Prins5
  • 1Medical Oncology, Radboud umc, 6500 HB - Nijmegen/NL
  • 2Medical Oncology, Radboud university medical center, 6525GA - Nijmegen/NL
  • 3Medical Oncology, Medisch Spectrum Twente (MST), NL-7500 KA - Enschede/NL
  • 4Medical Oncology /452, Radboud umc, NL-6500 HB - Nijmegen/NL
  • 5Medical Psychology, Radboud university medical center, 6500 HB - Nijmegen/NL



Caregivers are of vital importance supporting LAHNC pts' during CRT. Since symptoms of pts with LAHNC are very visible and treatment is burdensome, this may impact caregivers as well. We therefore aimed to explore the course of caregivers’ burden and fatigue in relation to pts’ fatigue during and after CRT.


Caregivers and pts completed a general questionnaire and the subscale "fatigue severity" of the Checklist Individual Strength (healthy controls M 17.3, SD 10.1). Additionally, caregivers completed the Self-Perceived Pressure from Informal Care questionnaire measuring burden (caregivers palliative phase M 6.0, SD 2.2). The severity of burden and fatigue was determined with validated cut-off scores. Measurements were conducted prior to CRT (T0), 1 week (T1) and 3 months after completing CRT (T2). The course of fatigue and burden was analyzed with general linear models.


60 couples were included. 93% completed T0, 82% T1 and 75% T2. Caregivers’ and pts’ mean age was 54 (SD 14) and 56 years (SD 10), 75% and 34% were female, respectively. 70% of the caregivers were pts’ partner. At T0, caregivers’ burden was moderate (M 4.1, SD 2.4), as was burden at T1 (M 4.6, SD 2.4). At T2, a significant decrease in burden was observed (M 3.2, SD 2.4; p = .001). For caregivers’ fatigue, normal levels were found at T0 (M 24.3, SD 13), rising to moderate levels at T1 (M 27.5, SD 12.4), with a significant decrease to normal at T2 (M 22.4, SD 11.8; p = .019). Caregivers’ fatigue and burden were correlated at all time points (r = 0.43-0.54, p = .001). Comparing caregivers’ fatigue to pts’ fatigue over time, a peak in fatigue at T1 was found for both groups (p = .001). Pts were more fatigued over time (p = .025), with a lower level at baseline but a faster increase in fatigue than their caregivers (p = .003). Additionally, pts’ fatigue showed higher levels at T2 compared to T0 (p = .026).


During and after LAHNC pts’ treatment, and regarding their severity of fatigue, caregivers seem resilient. When proactive support is considered for caregivers at risk for overstraining, intervention early during CRT is recommended.


C. van Herpen: Dr. C.M.L. van Herpen received research funding from Novartis and Merck, and serves on a Merck advisory board

W.T.A. van der Graaf: Prof. dr. W.T.A. van der Graaf received research funding from Novartis. All other authors have declared no conflicts of interest.