Fatigue after pediatric bone sarcoma: prevalence and associated factors in pediatric and adult patients and survivors after treatment.

Authors

Hinke van der Hoek, Heleen Maurice-Stam, Laura R Beek, Jennifer van Dijk, Marjolein E M Langemeijer, Relinde W Slooff-Lentink, Alied M van der Aa-van Delden, Hendrik W B Schreuder, Lianne M Haveman, Willem P Bekkering, Leonie G Tigelaar, Johannes H M Merks, Martha A Grootenhuis, Raphaële R L van Litsenburg

Published in

Journal of cancer survivorship : research and practice. Jul 01, 2026. Epub Jul 01, 2026.

Abstract

Fatigue is a common long-term complaint in childhood cancer patients and survivors. Treatment of pediatric bone sarcomas is intensive and can lead to physical, functional and psychosocial challenges; however, little is known about fatigue in this group. This study aimed to gain insight into fatigue and related demographic, medical, psychosocial, and lifestyle factors in pediatric bone sarcoma patients and survivors.
Patients treated for pediatric bone sarcoma, ≥ 2 years post-diagnosis and after completion of treatment with no evidence of disease, completed PedsQL™ Multidimensional Fatigue Scale and PROMIS® fatigue measures. Prevalence and mean scores were compared with Dutch normative data using binomial tests, one-sample t-tests, and ANOVA. Linear regression analyses examined associations of fatigue with demographic and medical factors, psychological difficulties (measured with emotion thermometers), pain (measured with a numeric rating scale), and physical activity (using an accelerometer).
In total, 139 patients participated. In children (N = 44), 51.6% (95% CI 34.0-69.2) reported moderate to severe fatigue, significantly higher than the weighted norm (29.8%), while adults (N = 95) (11.5%, 95% CI 4.4-18.6) did not differ from the weighted norm (12.1%). Children scored worse than the norm on all fatigue measures (Cohen's d range = 0.58 to 1.10); adults did not significantly differ. Longer time since end of treatment was associated with less cognitive fatigue. More psychological difficulties and pain were associated with more fatigue, while higher levels of physical activity were associated with less fatigue.
Children after pediatric bone sarcoma experience more fatigue than the norm. More psychological difficulties, more pain, and less physical activity are associated with more fatigue. Medical factors are limited to time since end of treatment, where a longer time is associated with less cognitive fatigue.
Screening for fatigue and associated factors during treatment and follow-up may help identify and support patients at risk.

PMID:
42384352
Bibliographic data and abstract were imported from PubMed on 01 Jul 2026.

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