Three distinct cancer-related fatigue trajectories were identified in elderly non-small cell lung cancer patients undergoing chemotherapy, with disease stage, anxiety, sleep quality, and social support serving as key predictive factors.
Cancer-related fatigue scores peaked at T3 and then gradually declined across the four chemotherapy time points.
Three distinct CRF trajectory classes were identified using latent class growth modeling as the best-fitting solution.
Disease stage, anxiety score, and sleep quality score were significant predictors of membership in the high-level gradual relief CRF trajectory group.
Disease stage, anxiety score, sleep quality score, and social support were all significant predictors of membership in the low-level rapid increase CRF trajectory group.
Significant factors affecting overall CRF levels included disease stage, treatment regimen, recurrence, anxiety and depression levels, sleep quality, and social support.
The study was a longitudinal design assessing elderly non-small cell lung cancer patients hospitalized and undergoing chemotherapy at a single tertiary hospital.
This research suggests that cancer-related fatigue (CRF) in elderly patients with non-small cell lung cancer follows a predictable pattern during chemotherapy: fatigue generally rises through the third assessment point before declining somewhat by the fourth. Across 108 hospitalized patients tracked at four time points, researchers found that fatigue was not uniform — three distinct groups emerged. One group started with low fatigue that increased slowly, another started with high fatigue that gradually improved, and the largest group started with low fatigue that rose rapidly. The study found that anxiety levels, sleep quality, how advanced the cancer was (disease stage), and the degree of social support a patient had were all important factors in predicting which fatigue pattern a patient would follow. This research suggests that psychological and social factors — not just the cancer itself or the chemotherapy regimen — play a meaningful role in how fatigue develops over the course of treatment. Specifically, patients with higher anxiety, poorer sleep, more advanced disease, and less social support were more likely to fall into more burdensome fatigue trajectory groups. Recurrence of disease and the specific treatment regimen used also contributed to fatigue levels overall. The practical implication of this research is that identifying patients at risk for worsening fatigue trajectories early in treatment may be possible by assessing anxiety, sleep quality, disease stage, and available social support. This could help healthcare teams target supportive care — such as psychological counseling, sleep interventions, or social support programs — to the patients most likely to experience rapidly escalating fatigue during chemotherapy.
Liu C, Wang H, Wen J, Xu T, Wang H, Wei X, et al.. (2026). Trajectory and predictive factors of cancer-related fatigue in hospitalized elderly patients with non-small cell lung cancer undergoing chemotherapy.. Medicine. https://doi.org/10.1097/MD.0000000000045277