{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:01:30Z","timestamp":1790805690391,"version":"4.1.0"},"reference-count":134,"publisher":"Harborside Press, LLC","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Physical activity (PA) and psychosocial interventions are recommended management strategies for cancer-related fatigue (CRF). Randomized trials support the use of mind\u2013body techniques, whereas no data show benefit for homeopathy or naturopathy. <jats:bold>Methods:<\/jats:bold> We used data from CANTO (ClinicalTrials.gov identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01993498\">NCT01993498<\/jats:ext-link>), a multicenter, prospective study of stage I\u2013III breast cancer (BC). CRF, evaluated after primary treatment completion using the EORTC QLQ-C30 (global CRF) and QLQ-FA12 (physical, emotional, and cognitive dimensions), served as the independent variable (severe [score of \u226540\/100] vs nonsevere). Outcomes of interest were adherence to PA recommendations (\u226510 metabolic equivalent of task [MET] h\/week [GPAQ-16]) and participation in consultations with a psychologist, psychiatrist, acupuncturist, or other complementary and alternative medicine (CAM) practitioner (homeopath and\/or naturopath) after CRF assessment. Multivariable logistic regression examined associations between CRF and outcomes, adjusting for sociodemographic, psychologic, tumor, and treatment characteristics. <jats:bold>Results:<\/jats:bold> Among 7,902 women diagnosed from 2012 through 2017, 36.4% reported severe global CRF, and 35.8%, 22.6%, and 14.1% reported severe physical, emotional, and cognitive CRF, respectively. Patients reporting severe global CRF were less likely to adhere to PA recommendations (60.4% vs 66.7%; adjusted odds ratio [aOR], 0.82; 95% CI, 0.71\u20130.94; <jats:italic>P<\/jats:italic>=.004), and slightly more likely to see a psychologist (13.8% vs 7.5%; aOR, 1.29; 95% CI, 1.05\u20131.58; <jats:italic>P<\/jats:italic>=.014), psychiatrist (10.4% vs 5.0%; aOR, 1.39; 95% CI, 1.10\u20131.76; <jats:italic>P<\/jats:italic>=.0064), acupuncturist (9.8% vs 6.5%; aOR, 1.46; 95% CI, 1.17\u20131.82; <jats:italic>P<\/jats:italic>=.0008), or CAM practitioner (12.5% vs 8.2%; aOR, 1.49; 95% CI, 1.23\u20131.82; <jats:italic>P<\/jats:italic>&lt;.0001). There were differences in recommendation uptake by CRF dimension, including that severe physical CRF was associated with lower adherence to PA (aOR, 0.74; 95% CI, 0.63\u20130.86; <jats:italic>P<\/jats:italic>=.0001) and severe emotional CRF was associated with higher likelihood of psychologic consultations (aOR, 1.37; 95% CI, 1.06\u20131.79; <jats:italic>P<\/jats:italic>=.017). <jats:bold>Conclusions:<\/jats:bold> Uptake of recommendations to improve CRF, including adequate PA and use of psychosocial services, seemed suboptimal among patients with early-stage BC, whereas there was a nonnegligible interest in homeopathy and naturopathy. Findings of this large study indicate the need to implement recommendations for managing CRF in clinical practice.<\/jats:p>","DOI":"10.6004\/jnccn.2021.7051","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T21:20:04Z","timestamp":1644268804000},"page":"98-110","source":"Crossref","is-referenced-by-count":8,"title":["Uptake of Recommendations for Posttreatment Cancer-Related Fatigue Among Breast Cancer Survivors"],"prefix":"10.6004","volume":"19","author":[{"given":"Antonio","family":"Di Meglio","sequence":"first","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile","family":"Charles","sequence":"additional","affiliation":[{"name":"2D\u00e9partement de Soins de Support, Gustave Roussy, Villejuif;"},{"name":"3Laboratoire de Psychopathologie et Processus de Sant\u00e9, Universit\u00e9 Paris Descartes-Sorbonne Paris Cit\u00e9, Boulogne-Billancourt;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Martin","sequence":"additional","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Havas","sequence":"additional","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnauld","family":"Gbenou","sequence":"additional","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Daniel","family":"Flaysakier","sequence":"additional","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Laure","family":"Martin","sequence":"additional","affiliation":[{"name":"4UNICANCER, Paris;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibille","family":"Everhard","sequence":"additional","affiliation":[{"name":"4UNICANCER, Paris;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enora","family":"Laas","sequence":"additional","affiliation":[{"name":"5Medical Oncology, Institut Curie, Paris;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Chopin","sequence":"additional","affiliation":[{"name":"6Medical Oncology, Centre L\u00e9on Berard, Lyon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Vanlemmens","sequence":"additional","affiliation":[{"name":"7Medical Oncology, Centre Oscar Lambret, Lille;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Jouannaud","sequence":"additional","affiliation":[{"name":"8Medical Oncology, Institut Jean Godinot, Reims;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Levy","sequence":"additional","affiliation":[{"name":"9Medical Oncology, Centre Fran\u00e7ois Baclesse, Caen;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Rigal","sequence":"additional","affiliation":[{"name":"10Medical Oncology, Centre Henri Becquerel, Rouen;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Fournier","sequence":"additional","affiliation":[{"name":"11Medical Oncology, Institut Bergoni\u00e9, Bordeaux;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Soulie","sequence":"additional","affiliation":[{"name":"12Medical Oncology, Institut de Canc\u00e9rologie de L'ouest-Paul Papin, Angers;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Scotte","sequence":"additional","affiliation":[{"name":"2D\u00e9partement de Soins de Support, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Pistilli","sequence":"additional","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Dumas","sequence":"additional","affiliation":[{"name":"13Universite de Paris, ECEVE UMR 1123 INSERM, Paris; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwenn","family":"Menvielle","sequence":"additional","affiliation":[{"name":"14Institut Pierre Louis d\u2019\u00c9pid\u00e9miologie et de Sant\u00e9 Publique, Sorbonne Universit\u00e9, INSERM, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Michiels","sequence":"additional","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Dauchy","sequence":"additional","affiliation":[{"name":"2D\u00e9partement de Soins de Support, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Vaz-Luis","sequence":"additional","affiliation":[{"name":"1INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"ref101","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1002\/cncr.10245","article-title":"Fatigue in cancer patients compared with fatigue in the general United States population","volume":"94","author":"Cella","year":"2002","journal-title":"Cancer"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1093\/jnci\/85.5.365","article-title":"The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology","volume":"85","author":"Aaronson","year":"1993","journal-title":"J Natl Cancer Inst"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"e000562","DOI":"10.1136\/esmoopen-2019-000562","article-title":"UNICANCER: French prospective cohort study of treatment-related chronic toxicity in women with localised breast cancer (CANTO)","volume":"4","author":"Vaz-Luis","year":"2019","journal-title":"ESMO Open"},{"key":"ref801","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1038\/nrclinonc.2014.127","article-title":"Cancer-related fatigue\u2014mechanisms, risk factors, and treatments","volume":"11","author":"Bower","year":"2014","journal-title":"Nat Rev Clin Oncol"},{"key":"ref1271","doi-asserted-by":"crossref","first-page":"4827","DOI":"10.1007\/s00520-021-06040-z","article-title":"QualFatigue study: which factors influence the use of specific interventions for breast cancer survivors with fatigue? 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