PURPOSE: The objective of this study was to test the efficacy of 
cognitive-behavioral therapy plus hypnosis (CBTH) to control fatigue in patients 
with breast cancer undergoing radiotherapy. We hypothesized that patients in the 
CBTH group receiving radiotherapy would have lower levels of fatigue than 
patients in an attention control group.
PATIENTS AND METHODS: Patients (n = 200) were randomly assigned to either the 
CBTH (n = 100; mean age, 55.59 years) or attention control (n = 100; mean age, 
55.97 years) group. Fatigue was measured at four time points (baseline, end of 
radiotherapy, 4 weeks, and 6 months after radiotherapy). Fatigue was measured 
using the Functional Assessment of Chronic Illness Therapy (FACIT) -Fatigue 
subscale and Visual Analog Scales (VASs; Fatigue and Muscle Weakness).
RESULTS: The CBTH group had significantly lower levels of fatigue (FACIT) at the 
end of radiotherapy (z, 6.73; P < .001), 4-week follow-up (z, 6.98; P < .001), 
and 6-month follow-up (z, 7.99; P < .001) assessments. Fatigue VAS scores were 
significantly lower in the CBTH group at the end of treatment (z, 5.81; P < 
.001) and at the 6-month follow-up (z, 4.56; P < .001), but not at the 4-week 
follow-up (P < .07). Muscle Weakness VAS scores were significantly lower in the 
CBTH group at the end of treatment (z, 9.30; P < .001) and at the 6-month 
follow-up (z, 3.10; P < .02), but not at the 4-week follow-up (P < .13).
CONCLUSION: The results support CBTH as an evidence-based intervention to 
control fatigue in patients undergoing radiotherapy for breast cancer. CBTH is 
noninvasive, has no adverse effects, and its beneficial effects persist long 
after the last intervention session. CBTH seems to be a candidate for future 
dissemination and implementation.