Long-term fatigue dimensions in the Multidimensional Fatigue Inventory (MFI) up to five years after radiotherapy and their trajectories in men diagnosed with non-metastatic prostate cancer in the international REQUITE study

Abstract Background Fatigue is a common, multidimensional symptom in cancer patients. Little is known about fatigue dimensions and their trajectories in prostate cancer (PCa). Methods Using the Multidimensional Fatigue Inventory (MFI), 1097 men treated with radiotherapy for non-metastatic PCa (2014–2016) prospectively reported fatigue up to five years later. Prevalent fatigue was defined as scores ≥75th percentile in men aged ≥60 years in a German general population sample. Pre-radiotherapy patient characteristics were examined for their associations with general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation two years later using logistic regression models. Fatigue trajectories up to two years post-radiotherapy were explored using latent class growth analysis and multinomial regression. Results About 72% (785/1097) of patients reported being fatigued for at least one dimension in the MFI from before the start of radiotherapy up to five years later, with 45% (367/816) being fatigued two years post-radiotherapy. Pre-radiotherapy fatigue level (OR: 4.7–9.0), depression (OR: 2.5), diabetes (OR: 1.8–2.2), hypertension (OR: 1.6–1.8), and BMI (OR: 1.8–2.2) were statistically significant predictors of long-term fatigue two years post-radiotherapy across dimensions. Depression, BMI, and pelvic radiotherapy were associated with experiencing a high fatigue trajectory. Conclusions Early fatigue assessments, in addition to self-reported comorbidities and BMI, showed additional benefits beyond symptom detection by providing prognostic value for poorer long-term fatigue outcomes. Multidimensional fatigue assessments could guide tailored symptom management strategies, targeting specific dimensions to address associated impairments in quality of life and functioning.

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Publication Details

Journal
British Journal of Cancer
Published
2026-11-09
DOI
https://doi.org/10.1038/s41416-026-03626-4
Primary Topic
Cancer survivorship and care
Type
article
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article

Long-term fatigue dimensions in the Multidimensional Fatigue Inventory (MFI) up to five years after radiotherapy and their 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 dimensions in the Multidimensional Fatigue Inventory (MFI) up to five years after radiotherapy and their 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, Mónica Ramos, Chris J. Talbot, Wilfried De Neve, 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, Ulrich Giesche, Marie‐Luise Sautter‐Bihl, Tommaso Giandini, T. Rancati, S. Morlino, Noelia Docampo, Philipp Heumann, Morgan Michalet, Tim 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, 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, Marcus Mareel, Roxana Draghici, Ben Vanneste, David Azria, Frank Giordano, Erik van Limberghen, Giraldo Alexandra, FRANCESCO PISANI, Alba Delgado, Axel Benner, Jörg Schäfer, Thomas Blaschke, REQUITE/REQUITEplus/RADprecise consortia, Alejandro Seoane, Juan C. Rosas, Xavier Maldonado, Ester Aguado Flor, Piet Ost, Ananya Choudhury, Tim Ward, Dirk De Ruysscher
article en

Abstract

Abstract Background Fatigue is a common, multidimensional symptom in cancer patients. Little is known about fatigue dimensions and their trajectories in prostate cancer (PCa). Methods Using the Multidimensional Fatigue Inventory (MFI), 1097 men treated with radiotherapy for non-metastatic PCa (2014–2016) prospectively reported fatigue up to five years later. Prevalent fatigue was defined as scores ≥75th percentile in men aged ≥60 years in a German general population sample. Pre-radiotherapy patient characteristics were examined for their associations with general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation two years later using logistic regression models. Fatigue trajectories up to two years post-radiotherapy were explored using latent class growth analysis and multinomial regression. Results About 72% (785/1097) of patients reported being fatigued for at least one dimension in the MFI from before the start of radiotherapy up to five years later, with 45% (367/816) being fatigued two years post-radiotherapy. Pre-radiotherapy fatigue level (OR: 4.7–9.0), depression (OR: 2.5), diabetes (OR: 1.8–2.2), hypertension (OR: 1.6–1.8), and BMI (OR: 1.8–2.2) were statistically significant predictors of long-term fatigue two years post-radiotherapy across dimensions. Depression, BMI, and pelvic radiotherapy were associated with experiencing a high fatigue trajectory. Conclusions Early fatigue assessments, in addition to self-reported comorbidities and BMI, showed additional benefits beyond symptom detection by providing prognostic value for poorer long-term fatigue outcomes. Multidimensional fatigue assessments could guide tailored symptom management strategies, targeting specific dimensions to address associated impairments in quality of life and functioning.

British Journal of Cancer
Cancer survivorship and care
DOIOpen Access PDFOpenAlex
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