在肿瘤患者中疲劳是一个常见的问题。导致肿瘤相关疲乏（cancer-related fatigue，CRF）重要的因素包括肿瘤生长、细胞毒性化疗、生物反应修饰、分子靶向治疗（特别是小分子酪氨酸激酶抑制剂和VEGF/EGFR单克隆抗体）、放疗、贫血、疼痛、情感压抑、睡眠障碍、营养不良等。在当代的肿瘤治疗中，CRF的筛查和治疗已经成为支持性护理的焦点。因此我们系统综述了肿瘤患者的CRF、流行情况、发病机制、筛查、临床评估和治疗方法。CRF的管理包括对潜在可逆原因的特定治疗(如治疗贫血、代谢或内分泌异常，以及管理疼痛、失眠、抑郁或焦虑)，症状治疗，非特异性症状治疗包括教育、咨询、药物(如精神刺激剂和其他觉醒药物)和非药物治疗(如运动、瑜伽、针灸)。更重要的是我们介绍了运动疗法、贫血治疗、改善睡眠障碍、心理认知干预、身心干预、药物和中医治疗。目前最有效的疗法是运动疗法，除非禁忌，大多数CRF患者进行个体化适度有氧运动可以改善CRF。

Fatigue is a common problem in cancer patients. Main factors contributing to CRF are progressive tumor, cytotoxic chemotherapy, biologic response modifiers, molecularly targeted therapy (particularly the small molecular tyrosine kinase inhibitors and monoclonal antibodies targeting the VEGF/EGFR), radiotherapy, anemia, pain, emotional distress, sleep disturbance, and malnutrition. Therefore, CRF screening and treatment has become the focus of supportive care in contemporary cancer treatment. Here, we systematically reviewed definitions, epidemiology, pathogenesis, screening, clinical assessment and treatment of CRF in cancer survivors. Moreover, management of CRF includes specific treatment for potentially reversible causes (treating anemia, metabolic or endocrine abnormalities, as well as managing pain, insomnia, depression or anxiety) and symptomatic treatment. Nonspecific symptomatic treatment includes education, counseling, pharmacologic (eg. psychostimulants and other wakefulness agents) and nonpharmacologic (eg. exercise, yoga, acupuncture) approaches. To be more important, we focus on exercise therapy, treatment of anemia, improvement of sleep disorders, psychological cognitive interventions, physical and psychological interventions, medical therapy and Chinese traditional medical treatment. Up to now, exercise therapy is the most effective therapy. Furthermore,
the individualized moderate aerobic exercise can improve CRF in most patients with CRF, if exercise is not contraindicated.