2324 - Does Curative Radiotherapy Impact Fatigue Onset in Gynecological Cancer Patients? A 20-Year Single Institutional Experience in 501 Patients

Purpose/Objective(s): This study evaluated the impact of radiotherapy (RT) on fatigue in patients with gynecological cancer (GC), a common symptom that affects physical and psychological health.

Materials/Methods: A retrospective evaluation was conducted on GC patients undergoing radical treatment between December 2002 and September 2022. Characteristics such as age, comorbidities, total RT dose, and related toxicities were recorded. Fatigue levels were measured using the Cancer Linear Analogue Scale (CLAS) in three areas: quality of life (CLAS1), energy level (CLAS2), and ability to perform daily activities (CLAS3). Data were collected before RT (T0), after one month (T1), and after 12 months (T2). Two Scores (ScRT10 and ScRT20) were obtained by subtracting the CLAS values at T1 and T2 from the T0 values. A decrease of =2 points was considered clinically significant.

Results: A total of 501 patients were evaluated, with a median age of 72 years. The majority (64.6%) had no comorbidities, and 80% had an optimal performance status (ECOG: 0). RT alone was performed as exclusive treatment in 39.1% of patients and a sequential or concomitant systemic therapy was administered to 60.9% of patients. Only 16% of patients reported RT-related fatigue. At T1, fatigue was noted in 9.4% (CLAS1), 13.6% (CLAS2), and 13.2% (CLAS3); at T2, the rates were 13.2%, 15.84%, and 13.6%, respectively. The absence of comorbidities was associated with reduced energy levels at 12 months, and cervical histology was linked to worsening in CLAS2 and CLAS3. Additionally, a correlation was found between a total RT dose < 50 Gy and worsening fatigue (Table 1).