Nervenheilkunde 2011; 30(08): 610-612
DOI: 10.1055/s-0038-1628401
Ulmer Heft
Schattauer GmbH

Tumorassoziierte Fatigue

Cancer-related fatigue
D. Brummer
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
A.-K. Fladung
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
B. J. Connemann
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
› Author Affiliations
Further Information

Publication History

Eingegangen am: 20 April 2011

angenommen am: 12 May 2011

Publication Date:
23 January 2018 (online)


Das Fatigue-Syndrom bei Krebspatienten ist ein häufiges Problem, das die Therapieadhärenz gefährdet. Die Pathogenese ist nach wie vor nicht ganz verstanden, jedoch scheinen physische, emotionale und medikamentöse Ursachen eine Rolle zu spielen. Dieser Artikel fasst den aktuellen Kenntnisstand bei tumor-assoziierter Fatigue zusammen und erörtert pharmakologische und supportive Maßnahmen.


Fatigue is a commonly reported symptom in patients with cancer putting compliance at risk. Pathophysiology is not fully understood, physiologic complications, treatment-related adverse effects and psychological comorbidities are contributing factors. This article presents an overview of clinical trials regarding nonpharmacologic and pharmacologic interventions.

  • Literatur

  • 1 Aaronson N, Ahmedzai S, Bergman B. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85 (05) 365-76.
  • 2 Berger A. Treating fatigue in cancer patients. The Oncologist 2003; 08 (Suppl. 01) 10-4.
  • 3 Breitbart W, Cella D. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. Semin Hematol 1997; 34: 4-12.
  • 4 Breitbart W. Identifying patients at risk for, and treatment of major psychiatric complications of cancer. Support Care Cancer 1995; 03: 45-60.
  • 5 Bruera E, Roca E, Cedaro L. Action of oral methylprednisolone in terminal cancer patients: a prospective randomized double-blind study. Cancer Treat Rep 1985; 69: 751-4.
  • 6 Bruera E. et al. Patient-controlled methylphenidate for cancer fatigue: a double-blind, randomized, placebo-controlled trial. J Clinical Oncology 2006; 24 (13) 2073-8.
  • 7 Burks TF. New agents for the treatment of cancerrelated fatigue. Cancer 2001; 92: 1714-8.
  • 8 Butler JM. et al. A phase III, double-blind, placebocontrolled prospective randomized clinical trial of d-threo-methylphenidate HCl in brain tumor patients receiving radiation therapy. International J Radiation Oncology, Biology, Physics 2007; 69 (05) 1496-501.
  • 9 Carroll JK, Kohli S, Mustian KM, Roscoe JA, Morrowa GR. Pharmacologic treatment of cancer-related fatigue. The Oncologist 2007; 12 (Suppl. 01) 43-51.
  • 10 Cella D, Davis K, Breitbart W, Curt G. Fatigue Coalition. Cancer-related fatigue: prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. J Clin Oncol 2001; 19 (14) 3385-91.
  • 11 Cella D, Mo F, Peterman A. Anemia fatigue and quality of life in people with cancer and HIV infection. Blood 1996; 88: A-146.
  • 12 Cullum JL, Wojciechowski AE, Pelletier G. Bupropion sustained release treatment reduces fatigue in cancer patients. Can J Psychiatry 2004; 49: 139-44.
  • 13 Curt GA. et al. Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 2000; 05: 353-60.
  • 14 Duffy JD, Campbell J. Bupropion for the treatment of fatigue associated with multiple sclerosis. Psychosomatics 1994; 35: 170-1.
  • 15 Goodnick PJ. Bupropion in chronic fatigue syndrome. Am J Psychiatry 1990; 147: 1091.
  • 16 Gabrilove JL, Cleeland CS, Livingston RB. Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: Improvements in hemoglobin and quality of life are similar to three-timesweekly dosing. J Clin Oncol 2001; 19: 2875-82.
  • 17 Kaempfer S, Lindsey A. Energy expenditure in cancer: a Review. Cancer Nurs 1986; 09: 194-9.
  • 18 Kaleita TA. et al. Pilot study of modafinil for treatment of neurobehavioral dysfunction and fatigue in adult patients with brain tumors. J Clin Oncol ASCO Meeting Abstract 1503. 2006
  • 19 Littlewood TJ. et al. Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: Results of a randomized, double-blind, placebocontrolled trial. J Clin Oncol 2001; 19: 2865-74.
  • 20 Love R. et al. Side effects and emotional distress during cancer therapy. Cancer 1989; 63: 604-12.
  • 21 Lower E. et al. Efficacy of dexmethylphenidate for the treatment of fatigue after cancer chemotherapy: A randomized clinical trial. Journal of Pain and Symptom Management 2009; 38 (05) 650-62.
  • 22 Mar Fan HG. et al. A randomised, placebo-controlled, double-blind trial of the effects of d-methylphenidate on fatigue and cognitive dysfunction in women undergoing adjuvant chemotherapy for breast cancer. Supportive Care in Cancer 2008; 16 (06) 577-83.
  • 23 Minton O. et al. Drug therapy for the management of cancer-related fatigue. Cochrane Database of Systematic Reviews: Reviews. Chichester, UK: John Wiley & Sons; 2010
  • 24 Mock V. Evidence-based treatment for cancer-related fatigue. Journal of the National Cancer Institute Monographs 2004; 32: 112-8.
  • 25 Morrow GR. et al. The positive effect of the psychostimulant modafinil on fatigue from cancer that persists after treatment is completed. J Clin Oncol, ASCO Meeting Abstract 8012. 2005
  • 26 Morrow GR. et al. Management of cancer-related fatigue. Cancer Invest 2005; 23: 229-39.
  • 27 Morrow GR. et al. Differential effects of paroxetine on fatigue and depression: A randomized, doubleblind trial from the University of Rochester Cancer Center Community Clinical Oncology Program. J Clin Oncol 2003; 21: 4635-41.
  • 28 Moss EL et al.. An open-label study of the effects of bupropion SR on fatigue, depression and quality of life of mixed-sitecancer patients and their partners. Psychooncology 2006; 15: 259-67.
  • 29 NCCN 2010 National Comprehensive Cancer Network. Clinical practice guidelines in oncology Cancer related fatigue V6. 1 April 2010
  • 30 Roscoe JA. et al. Effect of paroxetine hydrochloride(Paxil) on fatigue and depression in breast cancer patients receiving chemotherapy. Breast Cancer Res Treat 2005; 89: 243-9.
  • 31 Ryan JL. et al. Mechanisms of cancer-related fatigue. Review. The Oncologist 2007; 12 (Suppl. 01) 22-34.
  • 32 St Pierre B, Kaspar C, Lindsey A. Fatigue mechanisms in patients with cancer: effects of tumor necrosis factor and exercise on skeletal muscle. Oncol Nurs Forum 1992; 19: 419-25.
  • 33 Vogelzang N. et al. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. Semin Hematol 1997; 34: 4-12.
  • 34 Weinshenker BG. et al. A double-blind, randomized, crossover trial of pemoline in fatigue associated with multiple sclerosis. Neurology 1992; 42: 1468-71.
  • 35 Yellen S. et al. Measuring fatigue and other anemia related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage 1997; 13: 63-74.