Objective  To evaluate the effect of intensity modulated radiotherapy (IMRT) combined withhormonal therapy on fatigue in patients with locally advanced prostate cancer.

Methods  IMRT combinedwith hormonal therapy were administered to the patients with locally advanced prostate cancer who met theinclusion criteria. Long-term follow-up was performed using the Fatigue Symptom Inventory (FSI) beforetreatment (A), at the end of IMRT (B), and three months (C), 12 months (D), 24 months (E), 36 months(F), and 48 months (G) after IMRT. Three dimensions of fatigue were assessed during follow-up: severity,perceived interference with quality of life, and duration in the past week, meanwhile, we used Cox regressionmodel to evaluate the risk factors.

Results  Totally, 97 patients were enrolled from February 2007 toNovember 2013. Median follow-up time was 43.9 months. The fatigue index was related to the factors ofPSA, Gleason, ECOG and education(P<0.05), however, not related to the age or TNM staging(P>0.05).PSA and ECOG score were the independent risk factors of cancer-related fatigue. No significant differencewas measured in fatigue among each follow-up time points (P>0.05), but the most severe fatigue occurred attime points B and C. The score for interference with quality of life was significantly higher at each followuptime points after the radiotherapy than the baseline (P<0.05), especially the scores for interference withgeneral level of activity, ability to concentrate and mood. The score for duration of fatigue fluctuated acrossthe time points, with significantly increased scores at time points D, E, and F (P<0.05).

Conclusion  Forlocally advanced prostate cancer patients with a high ECOG score, a Gleason score >8 points, PSA levels>20 ng/ml and high education, the attention should be paid to the interference of fatigue with quality oflife, especially general level of activity, ability to concentrate and mood, after radiotherapy combined withhormonal therapy.