The prevalence and severity of fatigue in meningioma patients and its association with patient-, tumor- and treatment-related factors

Kwong T Quach; Linda Dirven; Aliede M Vingerhoed; Jeroen de Bresser; Ruben Dammers; Eelke M Bos; Wouter A Moojen; Wilco C Peul; Martin J B Taphoorn; Amir H Zamanipoor Najafabadi; Wouter R van Furth

doi:10.1093/noajnl/vdad056

The prevalence and severity of fatigue in meningioma patients and its association with patient-, tumor- and treatment-related factors

Neurooncol Adv. 2023 May 19;5(1):vdad056. doi: 10.1093/noajnl/vdad056. eCollection 2023 Jan-Dec.

Authors

Kwong T Quach¹, Linda Dirven^{2

3}, Aliede M Vingerhoed¹, Jeroen de Bresser⁴, Ruben Dammers⁵, Eelke M Bos⁵, Wouter A Moojen^{1

6

7}, Wilco C Peul^{1

6}, Martin J B Taphoorn^{2

3}, Amir H Zamanipoor Najafabadi¹, Wouter R van Furth¹

Affiliations

¹ Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.
² Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
³ Department of Neurology, Haaglanden Medical Center, the Hague, the Netherlands.
⁴ Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
⁵ Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
⁶ Department of Neurosurgery, Haaglanden Medical Center, the Hague, the Netherlands.
⁷ Department of Neurosurgery, Haga Teaching Hospital, the Hague, the Netherlands.

Abstract

Background: Fatigue is a commonly reported and severe symptom in primary brain tumor patients, but the exact occurrence in meningioma patients is unknown. This study aimed to determine the frequency and severity of fatigue in meningioma patients as well as associations between the level of fatigue and patient-, tumor-, and treatment-related factors.

Methods: In this multicenter cross-sectional study, meningioma patients completed questionnaires on fatigue (MFI-20), sleep (PSQI), anxiety and depression (HADS), tumor-related symptoms (MDASI-BT), and cognitive functioning (MOS-CFS). Multivariable regression models were used to evaluate the independent association between fatigue and each patient-, tumor-, and treatment-related factor separately, corrected for relevant confounders.

Results: Based on predetermined in- and exclusion criteria, 275 patients, on average 5.3 (SD = 2.0) year since diagnosis, were recruited. Most patients had undergone resection (92%). Meningioma patients reported higher scores on all fatigue subscales compared to normative data and 26% were classified as fatigued. Having experienced a complication due to resection (OR 3.6, 95% CI: 1.8-7.0), having received radiotherapy (OR 2.4, 95% CI: 1.2-4.8), a higher number of comorbidities (OR 1.6, 95% CI: 1.3-1.9) and lower educational level (low level as reference; high level OR 0.3, 95% CI: 0.2-0.7) were independently associated with more fatigue.

Conclusions: Fatigue is a frequent problem in meningioma patients even many years after treatment. Both patient- and treatment-related factors were determinants of fatigue, with the treatment-related factors being the most likely target for intervention in this patient population.

Keywords: central nervous system tumor; fatigue; long-term; meningioma; patient-reported outcome.