Abstract
BackgroundCancer-related fatigue (CRF) is one of the most common and distressing complaints reported by cancer patients during chemotherapy considerably impacting all aspects of a patient’s life (physical, psychosocial, professional, and socioeconomic). The aim of this study was to assess the severity of cancer-related fatigue in a group of breast cancer patients undergoing chemotherapy and explore the association between fatigue scores and sociodemographic, clinical, biological, psychiatric, and genetic factors.MethodsA cross-sectional pilot study carried out at the oncology outpatient unit of Hôtel-Dieu de France University Hospital recruited 67 breast cancer patients undergoing chemotherapy between November 2017 and June 2019 to evaluate fatigue using the EORTC QLQ-C30 scale (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire). Genotyping for seven gene polymorphisms (COMT, DRD2, OPRM1, CLOCK, PER2, CRY2, ABCB1) was performed using the Lightcycler® (Roche).ResultsThe prevalence of fatigue was 46.3%. Multivariable analysis taking the fatigue score as the dependent variable showed that a higher number of cycles and a lower hemoglobin level were significantly associated with higher odds of exhibiting fatigue. Moreover, having at least one C allele for DRD2 SNP (vs. TT) was significantly associated with a 4.09 higher odds of expressing fatigue compared to TT patients. Finally, patients with at least one C allele for CLOCK SNP tended to display higher fatigue levels than TT patients.ConclusionsOur study showed that anemic breast cancer patients with a high number of chemotherapy cycles and those carrying at least one C allele for DRD2 and CLOCK SNPs are at greater risk of exhibiting fatigue. Since no previous research has reported such genetic results, future studies are necessary to confirm our findings.
Highlights
Cancer-related fatigue (CRF) is one of the most common and distressing complaints reported by cancer patients during chemotherapy considerably impacting all aspects of a patient’s life
Owing to the fact fatigue is biologically regulated by a sleep/wake homeostatic process [31, 32], our study evaluated three of the circadian rhythm regulation genes: the Circadian Locomotor Output Cycles Kaput Circadian Locomotor Output Cycles Kaput gene (CLOCK) gene
Patients receiving palliative chemotherapy and those treated with a capecitabine-based regimen had higher fatigue scores (Table 2)
Summary
Cancer-related fatigue (CRF) is one of the most common and distressing complaints reported by cancer patients during chemotherapy considerably impacting all aspects of a patient’s life (physical, psychosocial, professional, and socioeconomic). According to the 2020 global cancer burden, female breast cancer ranked among the most commonly diagnosed cancer [1]. In this context, chemotherapy and radiotherapy remain the mainstay of cancer treatment. Cancer-related fatigue (CRF) is one of the most common and distressing complaints reported. Studies have shown that fatigue experienced by cancer patients undergoing chemotherapy is persistent and may remain beyond the chemotherapy session, considerably impacting all aspects of a patient’s life: physical, psychosocial, professional, and socioeconomic [8]
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