Objectives : Chemotherapy with gemcitabine and cisplatin (GC) is a standard treatment for advanced urothelial carcinoma. However, cancer-related fatigue (CRF) is frequently observed in patients receiving GC-chemotherapy. This study employed the Cancer Fatigue Scale (CFS) as a novel method to monitor CRF during GC-chemotherapy for the therapeutic effects of Juzentaihoto (JTT), a traditional Japanese (Kampo) medicine.
Methods : In this prospective single-center randomized study, 25 patients with advanced urothelial carcinoma were randomly divided into the JTT group and the control group prior to GC-chemotherapy. The 15-item CFS questionnaire was used to monitor CRF by providing a total score based on physical, affective, and cognitive subscores. CFS results were monitored daily during GC-chemotherapy for 2 weeks. Physical findings and appetite were evaluated as secondary outcomes, and adverse drug reactions were recorded.
Results : Ultimately, 10 patients in the JTT group and 12 patients in the control group were analyzed. Notable peaks in CFS total score and subscores were observed on days 6 and 10 after chemotherapy induction. Total CFS score and the affective CFS subscore were significantly decreased in the JTT group at multiple time points. Patients receiving JTT also showed significant suppression of appetite loss in the second half of the study. No adverse drug effects were noted for JTT.
Conclusions : The CFS could monitor the status of CRF during GC-chemotherapy and might be a useful method for CRF assessment. JTT may be a safe therapeutic option for CRF management in patients undergoing treatment for advanced urothelial carcinoma.

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