Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5932
Peer-review started: January 22, 2021
First decision: April 29, 2021
Revised: May 8, 2021
Accepted: May 27, 2021
Article in press: May 27, 2021
Published online: July 26, 2021
The side effects of prostate cancer (PCa) treatment are very prominent, with cancer-related fatigue (CRF) being the most common. Fatigue is a distressing symptom that interferes with daily functioning and seriously affects patient quality of life during, and for many years after, treatment. However, compared with other types of cancer, such as breast cancer, little is known about the prevalence of PCa-related fatigue.
To determine the prevalence of CRF in patients with PCa.
A systematic search of EMBASE, PubMed, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, WANFANG DATA, Technology Journal Database and the Chinese Biological Medical Database was conducted up to July 28, 2020. Included studies measured the incidence of PCa-related fatigue and differentiated fatigue outcomes (incidence) between treatment modalities and fatigue assessment times. In our meta-analysis, both fixed and random-effects models were used to estimate the pooled prevalence of PCa-related fatigue. Subgroup analyses were performed using treatment modalities and fatigue assessment times. Publication and sensitivity bias analyses were performed to test the robustness of the associations.
Fourteen studies, involving 4736 patients, were eligible for the review. The pooled CRF prevalence was 40% in a total sample of 4736 PCa patients [95% confidence interval (CI): 29-52; P < 0.01; I2 = 98%]. The results of the subgroup analyses showed the prevalence of CRF after androgen deprivation therapy treatment, radical prostatectomy and radiotherapy to be 42% (95%CI: 20-67, P < 0.01, I2 = 91%), 21% (95%CI: 16-26, P = 0.87, I2 = 0%) and 40% (95%CI: 22-58, P < 0.01, I2 = 90%), respectively. The prevalence of acute and persistent fatigue was 44% (95%CI: 25-64; P < 0.01; I2 = 93%) and 29% (95%CI: 25-32; P = 0.30; I2 = 17%), respectively.
Our meta-analysis showed that fatigue is a common symptom in men with PCa, especially those using hormone therapy.
Core Tip: This study was a systematic review conducted to determine the prevalence of cancer-related fatigue in patients with prostate cancer. Compared with other types of cancer, little is known about the prevalence of prostate cancer treatment-related fatigue. In this study, we reviewed the data in 14 papers (4736 patients) and found that the pooled prevalence of cancer treatment-related fatigue was 40%. Interestingly, the prevalence of cancer-related fatigue was associated with the type of treatment that the patients received; those undergoing radical prostatectomy had the lowest prevalence of fatigue.