Actigraphy findings and cancer-related fatigue (CRF) in advanced cancer patients treated with methylphenidate (MP) and nursing telephone intervention (NTI).

Abstract

e20528 Background: There are limited studies about actigraphic sleep, wakefulness, activity and fatigue and treatment in advanced cancer patients. The objective of this study was to evaluate the changes in the nocturnal sleep/rest, and daytime wake/activity and subjective measures of fatigue before and after treatment with MP+/- NTI. Methods: A subset of patients from a previous reported placebo and control telephone intervention (CTI) controlled RCT of MP and/or NTI for CRF were reviewed. Subjective and objective assessments were analyzed at Day-8 and Day-15 as a result of treatment with MP and/or NTI or their control arms. Actigraphic sleep measures assessed were total sleep time (TST), sleep efficiency, and wake after sleep onset (WASO). Additionally, activity (mean day-time activity), and fatigue (FACIT-F, ESAS-Fatigue item) were included in the multivariate analysis. Results: A total of 60 (MP=30, Placebo=30; NTI=35; CTI=25) patients were evaluated. The median age was 56, 62% were female; most common cancer type was breast 13/60(22%). The baseline mean FACIT-F subscale, ESAS Fatigue item, TST, WASO, sleep efficiency and day-time activity were 22.4 (9.33), 6.5(1.74), 437(162.4), 139(121.4), 71(16.4), 202(438). Multivariate outcomes at Day-8 showed significant change from baseline (η2=0.38, p<0.001) and interaction effect between MP and NTI (η2=0.26, p=0.015). WASO had an interaction effect (β=-101.4, p=0.009), an MP effect (β=80.4, p=0.002) and reduction in time (β=-52.1, p=0.003). FACIT-F and ESAS-Fatigue item showed improvement in time (β=6.9, p=0.010; β=-2.4, p<0.001). Conclusions: WASO was significantly lower in patients receiving methylphenidate and nursing telephone intervention. Further larger studies are needed to validate these findings.