{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:07:49Z","timestamp":1792786069353,"version":"4.5.0"},"reference-count":72,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Anita Veldman Foundation","award":["CCA.2019.2-21"],"award-info":[{"award-number":["CCA.2019.2-21"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>AbstractAbstractAbstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While severe fatigue is common in patients with diffuse glioma, no evidence-based treatment is currently available. The objective of this RCT was to evaluate the efficacy of blended cognitive behavioral therapy (bCBT) for severe fatigue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Severely fatigued patients (Checklist Individual Strength, fatigue-severity subscale [CIS-fatigue] \u2265\u202f35) with diffuse glioma and stable disease were randomized to 12 weeks of bCBT or a waiting list condition (WLC). The primary endpoint was fatigue severity 2 weeks after intervention. This Bayesian adaptive trial included prespecified interim analyses for efficacy at n\u202f=\u202f40, 50, 60, 70, and 80. Secondary outcomes\u2014health-related quality of life (HRQoL), anxiety, future uncertainty, and depression\u2014were assessed at 2 and 12 weeks after intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The trial was stopped for efficacy at the first interim analysis. Of 47 patients randomized, 40 patients reached the primary endpoint (mean age 53 years, 47% female). The posterior probability that CIS-fatigue scores were lower with bCBT than with WLC was 99.94%, with a large standardized effect size (Cohen\u2019s d) of 1.12 [95% CI: 0.43\u20131.81]. At 2 weeks after intervention, 68% of patients were no longer severely fatigued after bCBT, compared to 24% in WLC. At 12 weeks follow-up, fatigue was still significantly lower in the bCBT group compared to WLC (d\u2009=\u20091.22). bCBT also demonstrated beneficial effects (d\u2009=\u20090.42-1.19) on anxiety, HRQoL, and future uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>bCBT significantly reduces fatigue and improves anxiety and HRQoL in patients with diffuse glioma. These findings enable evidence-based supportive care strategies for reducing fatigue and enhancing HRQoL in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuonc\/noaf256","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:04:12Z","timestamp":1762520652000},"page":"693-703","source":"Crossref","is-referenced-by-count":3,"title":["Bayesian adaptive randomized trial of blended cognitive behavioral therapy for severe fatigue in stable diffuse glioma"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7891-3625","authenticated-orcid":false,"given":"Maxine","family":"Gorter","sequence":"first","affiliation":[{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Anatomy and Neurosciences , De Boelelaan 1117 , Amsterdam, (M.G.O., M.E.C.B., L.D.)","place":["The Netherlands"]},{"name":"Cancer Center Amsterdam, Brain Tumor Center , Amsterdam, (M.G.O., J.G.R., V.B., M.E.C.B., B.T., P.C.D.W.H., J.M.N., M.C.M.K., L.D., M.K.)","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jantine G","family":"R\u00f6ttgering","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Brain Tumor Center , Amsterdam, (M.G.O., J.G.R., V.B., M.E.C.B., B.T., P.C.D.W.H., J.M.N., M.C.M.K., L.D., M.K.)","place":["The Netherlands"]},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Medical Psychology , De Boelelaan 1117 , Amsterdam, (J.G.R., M.K.)","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5980-8202","authenticated-orcid":false,"given":"Vera","family":"Belgers","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Brain Tumor Center , Amsterdam, (M.G.O., J.G.R., V.B., M.E.C.B., B.T., P.C.D.W.H., J.M.N., M.C.M.K., L.D., M.K.)","place":["The Netherlands"]},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Neurology , De Boelelaan 1117 , Amsterdam, (V.B., B.T., J.M.N., M.C.M.K.)","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke E C","family":"Blom","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Anatomy and Neurosciences , De Boelelaan 1117 , Amsterdam, (M.G.O., M.E.C.B., L.D.)","place":["The Netherlands"]},{"name":"Cancer Center Amsterdam, Brain Tumor Center , Amsterdam, (M.G.O., J.G.R., V.B., M.E.C.B., B.T., P.C.D.W.H., J.M.N., M.C.M.K., L.D., M.K.)","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigit","family":"Thomassen","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Brain Tumor Center , Amsterdam, (M.G.O., J.G.R., V.B., M.E.C.B., B.T., P.C.D.W.H., J.M.N., M.C.M.K., L.D., M.K.)","place":["The Netherlands"]},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Neurology , De Boelelaan 1117 , Amsterdam, (V.B., B.T., J.M.N., M.C.M.K.)","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip C","family":"De Witt Hamer","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Brain Tumor Center , Amsterdam, (M.G.O., J.G.R., V.B., M.E.C.B., B.T., P.C.D.W.H., J.M.N., M.C.M.K., L.D., M.K.)","place":["The Netherlands"]},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Neurosurgery , De Boelelaan 1117 , Amsterdam, (P.C.D.W.H.)","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M","family":"Niers","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Brain Tumor Center , Amsterdam, (M.G.O., J.G.R., V.B., M.E.C.B., B.T., P.C.D.W.H., J.M.N., M.C.M.K., L.D., M.K.)","place":["The Netherlands"]},{"name":"Amsterdam UMC location Vrije Universiteit Amsterdam, Neurology , De Boelelaan 1117 , Amsterdam, (V.B., B.T., J.M.N., M.C.M.K.)","place":["The 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