Fatigue related to radiotherapy for breast and/or gynaecological cancer: a systematic review


  • Tereza Raquel de M Alcântara-Silva PhD,

    Music Therapist and Professor, Corresponding author
    • School of Music and Performing Arts, Federal University of Goias, Goiânia, GO, Brazil
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  • Ruffo Freitas-Junior PhD, MD,

    1. Medical School, Federal University of Goias, Goiânia, GO, Brazil
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  • Nilceana MA Freitas PhD, MD,

    1. Radiotherapy Service, Goias Anticancer Association (ACCG), Brazilian Center of Radiotherapy, Oncology and Mastology (CEBROM), Araújo Jorge Hospital, Goiânia, GO, Brazil
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  • Graziela DP Machado MSc, RN

    1. Laboratory of Radiobiology and Oncogenetics, Radiotherapy Service, Araújo Jorge Hospital, Goias Anticancer Association (ACCG), Goiânia, GO, Brazil
    2. Residency Preceptor in Oncology Nursing, Hospital Araújo Jorge, ACCG, Goiânia, GO, Brazil
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Correspondence: Tereza Raquel de M Alcântara-Silva, Music Therapist and Professor, Escola de Música e Artes Cênicas, Universidade Federal de Goiás, Rua T-38 N. 1097, Apto 101 Setor Bueno, 74223-045 Goiânia (GO), Brazil. Telephone: +55 62 3521 1125.

E-mail: terezaraquel.mas@gmail.com


Aims and objectives

To assess the profile, evaluation criteria and fatigue treatment.


Fatigue, characterised by tiredness, weakness or lack of energy, involves physical, cognitive and emotional aspects. Its aetiology is not well defined and the prevalence ranges from 30–70% in women with breast cancer, reaching up to 80% when they are undergoing radiotherapy. This is one of the most frequent side effects of radiotherapy, and it may interfere with self-esteem, social activities and quality of life.


Literature systematic review.


A search for studies published from 2000–2010 was carried out in Pubmed, Scielo and Bireme databases, using the descriptors fatigue and radiotherapy and their correlates in Portuguese.


We selected 12 articles of 1085 found. The number of studies involving breast cancer was higher than those related to gynaecological cancer. Functional Assessment of Cancer Therapy-Fatigue was the most used scale specifically for the evaluation of fatigue. Pretreatment fatigue level may be an important risk factor to aggravate it during radiotherapy and decrease the quality of life. Five studies proposed interventions, all of them involving nonpharmacological therapies: cognitive-behavioural therapy associated with hypnosis, moderate-intensity physical exercises, stretching programmes, yoga and polarity therapy. The studies showed good results in relation to fatigue, physical and psychological aspects, and quality of life.


Early detection of fatigue, using appropriate scales, is relevant to propose suitable treatments and achieve better clinical conditions, adherence and continuity of radiotherapy treatment, aiming to ensure more effective responses.

Relevance to clinical practice

Fatigue is a frequent symptom in patients undergoing radiotherapy. It may become a factor that limits or prevents the continuity of radiotherapy and therefore should be diagnosed in the initial appointments, so that it can be properly treated.