Objective measures of physical fatigue in women undergoing adjuvant therapy for early-stage breast cancer.

Abstract

e19680 Background: Cancer-related fatigue (CRF) is prevalent with cancer diagnosis and treatment, and its subjective nature has made it difficult to characterize and treat. To help address this issue, we evaluated objective measures of these parameters and correlated the results with the self-reported measurement of fatigue. Methods: Women with stage I-III breast cancer receiving dose dense doxorubicin and cyclophosphamide (AC) were recruited. Participants were tested at baseline and week 2 after cycle 4 of AC. The assessment included a 6 Minute Walk (6MW), Jamar dynamometer (grip strength), and self-report Brief Fatigue Inventory (BFI). In addition, total daily energy expenditure (TEE) was measured using the Bodybugg (BB) armband for 1 week prior to chemotherapy and week 2 of cycle 4. Results: To date, 20 of the planned 25 participants have been enrolled in the clinical trial and 15 have completed pre and post chemotherapy assessments. The mean change in BFI score was +1.8 (increased fatigue). While all measures of physical function decreased (mean): TEE (-4.4%), dominant hand grip strength (-2.7%), 6MW (-3.7%), correlations with BFI were weak (|r|<0.1) for all measures other than TEE (r=-0.321) and 6MW (r=-0.312). Conclusions: The self-report of fatigue may be associated with objective tests of total daily energy expenditure and 6 minute walk, and continued accrual is warranted. Change in study measures in patient sample (post assessment – pre assessment). Pt BFI TEE (%) Hand grip strength (%) 6MWORK* (%) Dominant Nondominant 1 + 4.0 + 5.7 + 5.9 - 30.9 - 21.5 2 - 1.1 - 16.3 - 39.4 - 7.1 - 5.6 3 + 0.0 + 3.5 + 0.0 + 0.0 + 9.1 4 + 2.2 - 4.2 - 12.8 - 8.6 - 19.9 5 + 5.9 - 14.6 - 5.6 + 32.0 + 3.7 6 - 1.2 + 26.7 + 0.0 + 9.1 + 1.0 7 + 0.0 - 9.1 + 0.0 + 0.0 - 9.7 8 - 0.9 + 14.3 + 19.0 - 16.7 - 1.4 9 + 4.7 - 8.4 + 0.0 - 8.0 + 3.2 10 + 4.3 - 15.3 + 5.9 - 5.9 - 8.7 11 - 1.2 - 28.8 + 5.0 + 11.1 + 1.2 12 + 5.9 - 12.6 - 15.0 - 5.0 - 15.4 13 - 1.1 + 4.0 + 3.0 + 16.0 + 3.1 14 + 5.0 - 9.2 + 0.0 + 0.0 + 1.0 15 - 0.1 - 2.2 - 6.7 + 3.1 + 4.6 Mean + 1.8 - 4.4 - 2.7 - 0.7 - 3.7 * 6MWORK (kg-m) = patient’s weight (kg) × distance traveled (m).