Peer-reviewed article
Exploring evidence of fatigue in survivors of paediatric brain tumours: a systematic review
Wood J, Verity S ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined fatigue in children who have survived brain tumours. Researchers searched three medical databases and analysed 20 studies, finding that 19 showed clear evidence of fatigue in survivors. Fatigue significantly affected survivors' school performance, self-image and friendships, reducing their overall quality of life. The review found fatigue was often worse in brain tumour survivors than in survivors of other childhood cancers. However, the review identified major gaps in the research, including poor definition of what fatigue means and lack of comparison groups in most studies.
Key points
- 19 of 20 studies showed conclusive evidence of fatigue in paediatric brain tumour survivors
- Fatigue significantly impacts academic attainment, self-concept and social relationships
- Three studies found fatigue was worse in brain tumour survivors compared to survivors of other paediatric cancers
- 12 of 20 studies lacked comparison groups, limiting how widely findings can be applied
- Fatigue construct was poorly defined across studies, with physical treatment effects not distinguished from cognitive impairment effects
Limitations
The review cannot identify specific effective interventions because the included studies did not define fatigue consistently and most lacked comparison groups. The countries where studies were conducted are not specified in the metadata.
Abstract
Aims As the number of survivors of childhood brain tumor grows, fatigue is being increasingly recorded as a long-term consequence of both the cancer itself and the treatment received. Survivors of childhood brain tumour report more significant fatigue than children with other cancers, often impacting all aspects of life, including academic attainment, self-concept and social relationships with peers, leading to reduced health-related quality of life. This study aimed to systematically evaluate the evidence for fatigue in paediatric brain tumour survivors. Method A systematic search using EMBASE, MEDLINE and PsycINFO identified 20 papers meeting the inclusion criteria. Scientific rigor was used throughout by following Scottish Intercollegiate Guidelines Network (2015) guidance for systematic reviews. Quality Assessment of Evidence Rating tool - Fatigue (QAERT) was developed with substantial inter-rater agreement found. Result 19 of the 20 studies reviewed showed conclusive evidence of fatigue in survivors of paediatric brain tumour. One study offered adequate evidence that there was no difference in levels of fatigue in paediatric cancer survivors, including survivors of paediatric brain tumour, when compared to healthy controls. Three studies found that fatigue was worse in survivors of paediatric brain tumour when compared to survivors of other paediatric cancers Conclusion This review provides evidence for the presence of fatigue in survivors of paediatric brain tumour. However, the construct of fatigue was poorly defined throughout, with fatigue associated with physical effects of treatment and fatigue associated with long-term cognitive impairment not distinguished. This poor construct validity, coupled with a lack of comparison groups in 12 of the 20 studies, reduces the generalizability of the data and its usefulness for developing effective psychological interventions. Further research is needed, built on a clear fatigue construct definition, and including well defined exclusion criteria, to provide a sound basis for improving the quality of life of these children.