Long-term fatigue based on the EORTC QLQ-C30 up to five years after radiotherapy and its trajectories in men diagnosed with non-metastatic prostate cancer in the international REQUITE study

Abstract Background Fatigue is a common symptom in cancer patients associated with impaired quality of life (QoL). Little is known about long-term fatigue trajectories in prostate cancer (PCa) patients. Methods Using the European Organisation for Research and Treatment of Cancer Quality of Life Group Core Questionnaire (EORTC QLQ-C30), 1758 men treated with radiotherapy (2014–2016) for non-metastatic PCa prospectively reported fatigue up to five years later. Associations between pre-radiotherapy characteristics and clinically important fatigue (Score: ≥39/100) two years post-radiotherapy were investigated using logistic regression. Fatigue trajectories were explored using latent class growth analysis and multinomial regression. Results About 35% (608/1758) of patients experienced clinically important fatigue at least once from the start of radiotherapy up to five years later. Two years post-radiotherapy, 14% of patients reported fatigue, which was associated with pre-radiotherapy fatigue level (OR: 8.67), self-reported diabetes (OR: 1.94), BMI (OR: 1.07), and age (OR: 1.03). Long-term fatigue was strongly linked to pain, insomnia, pelvic symptoms, functional impairments, and reduced QoL. Four fatigue trajectories were identified, characterised by low (45%), moderate (42%), elevated and decreasing (8%), and (6%) increasing mean fatigue levels. Diabetes was associated with a 6 percentage point increase in the probability of experiencing an increasing fatigue trajectory. Conclusions The findings emphasise the need for early identification of PCa patients susceptible to long-term fatigue. PCa patients with elevated pre-radiotherapy fatigue levels and diabetes may require closer monitoring in risk-stratified aftercare programmes.

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Publication Details

Journal
British Journal of Cancer
Published
2026-11-04
DOI
https://doi.org/10.1038/s41416-026-03644-2
Primary Topic
Cancer survivorship and care
Type
article
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article

Long-term fatigue based on the EORTC QLQ-C30 up to five years after radiotherapy and its trajectories in men diagnosed with non-metastatic prostate cancer in the international REQUITE study

Bibiana Piqué-Leiva, Burkhard Neu, R. Valdagni, Maria Carmen De Santis et al.
British Journal of Cancer
Cancer survivorship and care
article

Long-term fatigue based on the EORTC QLQ-C30 up to five years after radiotherapy and its trajectories in men diagnosed with non-metastatic prostate cancer in the international REQUITE study

Bibiana Piqué-Leiva, Burkhard Neu, R. Valdagni, Maria Carmen De Santis, Elisabetta Garibaldi, Martijn Swimberghe, Katrien Vandecasteele, M. Van Eijkeren, Christian Weißenberger, Marzia Franceschini, Ester Aguado-Flor, Mónica Ramos, Chris J. Talbot, Wilfried De Neve, Tim H. Ward, Stéphanie Peeters, Annick Van Greveling, Tom Vercauteren, Pieter R.A.J. Deseyne, Erik Briers, Elena Delmastro, B. Avuzzi, Yolande N. Lievens, Susanne Singer, Adam J. Webb, Gabriele Pietro, Giselle Post, A. Cicchetti, Manuel Altabas, Ana Isabel Vega, Liv Veldeman, Carsten Herskind, Christian Weiß, Rudolf Kaaks, Barry S. Rosenstein, B. Noris Chiorda, Benjamin Gauter-Fleckenstein, Thomas Schnabel, Ananya Choudhury, Ulrich Giesche, Marie‐Luise Sautter‐Bihl, Tommaso Giandini, T. Rancati, S. Morlino, Noelia Docampo, Philipp Heumann, Morgan Michalet, T. Rattay, Soumia Arredouani, Elhaseen Elhamin, Valérie Fonteyne, Michael Ehmann, Anusha Müller, Sara Gutiérrez‐Enríquez, Gilles Defraene, Antonio Gómez‐Caamaño, Claudia Sangalli, Maarten L.F. Lambrecht, Françoise Bons, Miguel Elías Aguado-Barrera, Meritxell Mollà, Leen Paelinck, Caroline G Weltens, Martina E. Schmidt, Muriel Brengues, C. Bourgier, Christel Monten, Irmgard Helmbold, Catharine West, Marie‐Pierre Farcy‐Jacquet, Elena Sperk, Piet Ost, Hilary Stobart, Marlon Romano Veldwijk, Susana Magriña, Petra Stegmaier, Renée Bultijnck, Victoria M. Reyes, Fréderic Duprez, Laura Lozza, Rita Aerts, Johannes Claßen, Jenny Chang‐Claude, Erik Van Limbergen, Dirk De Ruysscher, Marcus Mareel, Roxana Draghici, Ben Vanneste, David Azria, Frank Giordano, Giraldo Alexandra, FRANCESCO PISANI, Alba Delgado, Axel Benner, Jörg Schäfer, Thomas Blaschke, REQUITE/REQUITEplus/RADprecise consortia, Alejandro Seoane, Juan C. Rosas, Xavier Maldonado
article en

Abstract

Abstract Background Fatigue is a common symptom in cancer patients associated with impaired quality of life (QoL). Little is known about long-term fatigue trajectories in prostate cancer (PCa) patients. Methods Using the European Organisation for Research and Treatment of Cancer Quality of Life Group Core Questionnaire (EORTC QLQ-C30), 1758 men treated with radiotherapy (2014–2016) for non-metastatic PCa prospectively reported fatigue up to five years later. Associations between pre-radiotherapy characteristics and clinically important fatigue (Score: ≥39/100) two years post-radiotherapy were investigated using logistic regression. Fatigue trajectories were explored using latent class growth analysis and multinomial regression. Results About 35% (608/1758) of patients experienced clinically important fatigue at least once from the start of radiotherapy up to five years later. Two years post-radiotherapy, 14% of patients reported fatigue, which was associated with pre-radiotherapy fatigue level (OR: 8.67), self-reported diabetes (OR: 1.94), BMI (OR: 1.07), and age (OR: 1.03). Long-term fatigue was strongly linked to pain, insomnia, pelvic symptoms, functional impairments, and reduced QoL. Four fatigue trajectories were identified, characterised by low (45%), moderate (42%), elevated and decreasing (8%), and (6%) increasing mean fatigue levels. Diabetes was associated with a 6 percentage point increase in the probability of experiencing an increasing fatigue trajectory. Conclusions The findings emphasise the need for early identification of PCa patients susceptible to long-term fatigue. PCa patients with elevated pre-radiotherapy fatigue levels and diabetes may require closer monitoring in risk-stratified aftercare programmes.

British Journal of Cancer
Openalex Percentile: Top 17%
Cancer survivorship and care
DOIOpen Access PDFOpenAlex
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