Abstract
Objective
To evaluate the pattern of manifestation of fatigue, insomnia and hot flashes within
the prospective, observational, multi-center EMBRACE study.
Methods
Morbidity was prospectively assessed according to CTCAE v.3 and patient-reported outcome
with EORTC QLQ-C30/CX24 at baseline and regular follow-up. Analyses of crude incidence,
prevalence rates and actuarial estimates were performed.
Results
A total of 1176 patients were analyzed with a median follow-up of 27 months. At baseline,
CTCAE G1/G2 prevalence rates for fatigue were 29%/6.2%, for insomnia 18%/3.1% and
for hot flashes 7.9%/1.6% with respective 3-year prevalence rates of 29%/6.8%, 17%/4.4%
and 19%/5.9%. Similar patterns of manifestation were seen in patient-reported EORTC
outcomes. The 3-year actuarial estimates for G ≥ 3 CTCAE fatigue, insomnia and hot
flashes were 5.5%, 4.7% and 1.9%. Younger age was associated with significantly higher
risk for fatigue, insomnia and hot flashes.
Conclusion
Fatigue, insomnia and hot flashes occurred mainly in the mild to moderate range. Fatigue
and insomnia were already present before treatment and showed minor fluctuations or
recovery during follow-up, whereas hot flashes showed a considerable increase after
treatment. More research is needed to evaluate contributing risk factors in order
to define intervention strategies.
Keywords
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Article info
Publication history
Published online: April 04, 2018
Accepted:
March 13,
2018
Received in revised form:
March 11,
2018
Received:
December 9,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
