Abstract 1562P
Background
Cancer-related fatigue (CRF) is a distressing multidimensional syndrome affecting frequently cancer survivors. Evidenced-based interventions include physical exercise, psychosocial treatment, and mind-body-medicine. We aim to characterize fatigue responders (FR) and non-responders (FnR) to inpatient cancer rehabilitation (ICR).
Methods
Single ICR clinic cohort study from multimodal, fatigue-tailored rehabilitation program. At admission and discharge BFI (Brief Fatigue Inventory), SIF (Single Item Fatigue), HADS (Hospital Anxiety Depression Scale), ESAS (Edmonton Symptom Assessment Scale), FTSTS (5 Time Sit To Stand), HGS (Hand Grip Strenght) and 6mWT (6 minute Walking Test) were measured. BFI response was defined as ≥25% improved (reduced) BFI sum score, or (in 28 patients with missing BFI) improved SIF score. Baseline characteristics and admission-discharge differences (delta) are compared for FR and FnR by t-test (one-sided p).
Results
Of 149 patients (101 female; age 55.3y, 24/88 [min/max]; Lenght of Stay 54 days, 23/87; hematological: 28, breast: 64, GI: 18, Lung: 13, other tumors: 26; 47 with anticancer therapy) 99 were FR, 50 FnR. Admission scores: BFI 42/90; SIF: total 6.0/10, cogn 4.8, emot 3.1, phys 5.4, Sleep 4.6; ESAS: Fatigue 5.9, dizziness 2.5, Anx 3.7, Depr 3.5, Wellb 4.5; HADS-A 7.2/21, HADS-D 6.7, FTSTS 10.8 sec, HGS 25.4 kg, 6mWT 482 m. ICR therapies per week: 0.9 creative, 0.8 psychooncology, 1.5 mind-body, 0.6 nutrition, 0.5 fatigue group, 1.0 endurance). All outcomes improve (delta): FTSTS -3.9 sec, HGS 1.1 kg, 6mWT 73 m, BFI -17.2, SIF: total -2.5, cogn -1.8, emot -1.5, phys -2.7, sleep -1.5; ESAS: fatigue -2.6, dizziness -1.2, Anx -1.9, Depr -2.1, Wellb -2.1, HADS-A -2.3, HADS-D -2.8. FR differed (p <0.05) from FnR only for all SIF, ESAS, and HADS discharge variables, delta of all SIF variables, ESAS-fatigue, -dizziness, -Wellb, and HADS-A, and for creative-therapies per week (p=0.047).
Conclusions
Fatigue-tailored, multimodal ICR improves all physical function and subjective outcomes in severely affected survivors. BFI-response is not associated with not improved phsyical function but improved anxiety and creative therapies,.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.