Cancer‑related fatigue (CRF) is a frequent long‑term symptom in non‑metastasized breast cancer patients (BC). This 4‑year follow‑up intended to compare the long‑term effects of a 10‑week multimodal therapy (MT: sleep education, psychoeducation, eurythmy‑ and painting therapy) and combination therapy [CT: MT plus aerobic training (AT)] to AT‑control. BC‑patients were randomized or allocated by preference to three arms in a comprehensive cohort study. Primary outcome was a composite score including Pittsburgh Sleep Quality Index (PSQI) and Cancer Fatigue Scale (CFS‑D), captured at baseline, after 10 weeks of intervention (T1), 6 months later (T2), and after 4 years (T3). We exploratively tested for superiority of MT and CT versus AT after 4 years (T3) based on the statistical model of the main analysis. Of 126 (65 randomized) BC‑patients included, 105 started treatments and 79 were re‑assessed for long‑term effects (T3). MT and CT were superior over AT after 4 years regarding PSQI/CFS‑D and PSQI sum‑score, respectively (all p < 0.05), but not for CFS‑D. The multimodal and combination treatment for breast cancer patients with CRF indicates sustainable long‑term superiority over aerobic training for the outcomes sleep quality and combined sleep quality/fatigue. A confirmative randomized controlled trial is warranted.

Citation: Kröz, M., Quittel, F., Reif, M., Zerm, R., Pranga, D., Bartsch, C., Brinkhaus, B., Büssing, A., & Gutenbrunner, C. (2023). Four-year follow-up on fatigue and sleep quality of a three-armed partly randomized controlled study in breast cancer survivors with cancer-related fatigue. Scientific Reports, 13(1), Article 1. https://doi.org/10.1038/s41598-022-25322-y