Fatigue Symptom Inventory Used In Evaluating Cancer-related Fatigue Of Non-small Cell Lung Cancer Patients Receiving Chemotherapy

Background: With the development of medcine, the symptom of fatigue had received more and more attention from cancer patients and medical staff. There were much researches on dignosing, evaluating and treatment of fatigue abroad, but little in our coumtry.Objective:Using the fatigue symptom inventory (FSI) to investigate cancer-related fatigue and influence factors of fatigue in non-small cell lung cancer patients who were receiving chemotherapy. Finding the relationship between FSI and the fatigue criteria of CTCAE3.0 to evaluate the clinical application value of this scale.Methods: A survey was undertaken on those in-patients of non-small cell lung cancer in the department of oncology, the first afflilated hospital of Anhui Medical University from September, 2006 to August,2008.All these patients of our research should complete two cycles of chemotherapy and they would be asked to complete the 13-items fatigue symptom inventory before they started chemotherapy and a week after they started chemotherapy.Researchers should evaluate the fatigue level using CTCAE3.0. We compared FSI scores according to age, sex, staging of disease, pathlogy, operation history, KPS scores before chemotherapy, chemo-schemas and responses to chemotherapy. Linear correlation was applied to analyze the relationship between the score of FSI and the level of CTCAE3.0.Results: A total of 82 cases were enrolled and completed two cycles chemotherapy with platiunm. We had 20 patients receiving adjuvant chemotherapy and 62 patients of local-advanced or with tumor recurrence or metastasis receiving palliative chemotherapy. Age, sex, staging of disease, pathlogy, operation history, chemo-schemas and remission rate were not significantly associated with cancer-ralated fatigue in non-small cell lung cancer patients(P>0.05). Patients receiving palliative chemotherapy got higher FSI scores than adjuvant chemotherapy patients during the baseline(P=0.00)patients with KPS 60-70 got higher FSI scores than those with KPS80 or KPS90-100. FSI scores of 82 patients got higher after chemotherapy. We divided them into three groups of chemotherapy effective, chemotherapy ineffective and adjuvant chemotherapy and found that FSI scores of chemotherapy effective group did not changed after chemotherapy(P=0.08), while FSI scores of chemotherapy ineffective and adjuvant chemotherapy groups got significantly higher(P=0.00).FSI scores of the week after the second chemo-cycle show that chemotherapy effective group was lower(P=0.00),and no difference between chemotherapy ineffective group and adjuvant chemotherapy group(P=0.07). The incidence of fatigue during the first chemotherapy cycle was 57.32% and 62.19% during the second cycle.There was a good correlation between FSI and fatigue criteria of CTCAE3.0 (r=0.91).Conclusion: Non-small cell lung cancer patients got a high incidence and servere symptom of fatigue. Age, sex, staging of disease, pathlogy, operation history, were not significantly associated with cancer-ralated fatigue in non-small cell lung cancer patients. Those with lower Kanorfsky Performance Score(KPS) got higher fatigue level. Patients of local-advanced or with tumor recurrence or metastasis got higher fatigue level. Patients got effective after chemotherapy did not got a higher fatigue level, while in those didn't get effective or adjuvant chemotherapy patients, chemotherapy can significantly aggreveate fatigue , and fatigue level would get lower until the next course of chemotherapy. Chemo-schemas did not affect fatigue symptom. Fatigue Symptom Inventory can be used to evaluating fatigue in non-small cell lung cancer of chinese.