Fatigue in Long‐Term Head and Neck Cancer Survivors From Diagnosis Until Five Years After Treatment

Abstract

ObjectivesFatigue due to cancer is a challenging symptom that might be long‐lasting after cancer treatment. The aim of this study was to follow the development of fatigue among head and neck cancer (HNC) patients prospectively and longitudinally and to analyze predictors for acute and chronic fatigue.MethodsHNC patients treated with curative intent were included at diagnosis and completed the following questionnaires multiple times, up to 5 years after treatment: the EORTC QLQ‐FA12 for fatigue, EORTC QLQ‐C30, and HNC‐specific EORTC QLQ‐H&N35 together with an anxiety and depression questionnaire. Predictors of fatigue were evaluated at 3 months and 5 years after treatment.ResultsOf the 311 study participants, 74% responded at the 5‐year follow‐up. Physical fatigue was significantly worse 3 months after treatment, while emotional and cognitive fatigue were the worst at diagnosis and at 3 months. All fatigue domains were significantly better after 1 year, and the fatigue scores remained stable from 1 until 5 years after treatment. Three months after chemoradiotherapy, physical fatigue was more significant, but no long‐term differences due to treatment modalities were found. Depression and anxiety were predictors for chronic emotional fatigue, and local HN pain and swallowing problems were predictors for chronic physical fatigue. Better global quality of life at diagnosis was associated with less physical and emotional fatigue.ConclusionFatigue was worst in the short term for HNC patients and improved after 1 year, and long‐term fatigue remained stable up to 5 years after treatment. A few predictors for chronic fatigue were found.Level of Evidence3 Laryngoscope, 133:2211–2221, 2023