P-190 Treating fatigue in patients with colorectal cancer (CC)

Abstract

Introduction: Moderate to severe fatigue affects up to 40% of cc patients even years after completion of adjuvant therapy. Multiple factors contribute to this persistent symptom calling for a broad-based intervention. The aim of this study was to evaluate the impact of a 12 week group -based program that includes cognitive therapy and didactic sessions to help participants manage severe stress, improve diet and exercise patterns and make appropriate behavioral changes. Methods: A study design was used to evaluate the impact of the program on participant fatigue scores. Criteria were completion of chemotherapy at least 6 months previously and baseline SF-36 Health Survey vitality subscale score of <50. 70 participants were enrolled, 62 completed the program. All 70 were retained in the analysis. Change in fatigue score was the primary outcome and was measured by three instruments: The Piper Fatigue Scale (PFS), the SF-36 vitality subscale and a visual analogue scale. Outcomes were measured at the end of the program and 3 and 6 months following program completion. Longitudinal analysis of data was done using generalized estimating equations. Results: The mean age of participants was 58.2 years. The median years of education was 16. Adjuvant therapy included chemotherapy for 78% of the patients and radiotherapy for 39%. The PFS improved from 6.0 at baseline to 4.2 (p < 0.0001) at the end of the program and continued to improve to 3.6 at the six month follow up (p < 0.0001). The vitality subscale similarly improved from 35.0 at baseline to 47.8 (p < 0.0001) at end of program and 52.9 (p < 0.0001) at the 6 month follow up. Similar patterns were noted with fatigue and mood visual scales. Overall self-rated health improved from baseline to the 6 month follow up program (p = 0.0001). After adjusting for age, sleep, physical activity, diet and smoking status, longitudinal analysis showed a significant reduction in fatigue symptoms as measured by PFS (p < 0.0001), SF-36 vitality (p < 0.0001) and fatigue visual scale (p < 0.0001) across time. Conclusion: These results suggest an overall 42% improvement in fatigue symptoms among survivors suffering from severe fatigue that persisted for 6 months following completion of the program.