OBJECTIVE: The combination of irinotecan-bevacizumab is effective in patients 
with glioblastoma relapse but fatigue is a commonly reported side effect. The 
objective of this study was to evaluate the level and evolution of fatigue in a 
series of patients treated with therapeutic combination.
PATIENTS AND METHODS: We used two self-evaluation tools to quantify the physical 
and emotional aspects of this fatigue. The Norris Visual Analog Scale (VAS 
Norris) and the Multidimensional Fatigue Inventory-20 (MFI) tools were 
undertaken by 39 patients with glioblastoma relapse treated with 
irinotecan-bevacizumab, initially before the first cycle and thereafter with 
each cycle up until tumor progression.
RESULTS: Analysis of the results of the VAS Norris scale did not demonstrate an 
increase in emotional fatigue but did show an increase in physical fatigue that 
did not reach statistical significance. With regards to the MFI 20 tool, 
analysis of the results demonstrated a significant increase in general 
(P=0.0260) as well as physical (P=0.0141) fatigue but there was no difference in 
the other indices.
CONCLUSION: This study demonstrated a progressive increase in physical fatigue 
in patients with glioblastoma relapse treated with irinotecan-bevacizumab. We 
suspect that this is as a direct consequence of the treatment. There are however 
other confounding factors: insidious tumour progression not detected on 
follow-up imaging or delayed side effects of the initial 
radiotherapy-chemotherapy.