{"doi":"10.1093/neuonc/noaf256","title":"Bayesian adaptive randomized trial of blended cognitive behavioral therapy for severe fatigue in stable diffuse glioma","abstract":"<jats:title>AbstractAbstractAbstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>While severe fatigue is common in patients with diffuse glioma, no evidence-based treatment is currently available. The objective of this RCT was to evaluate the efficacy of blended cognitive behavioral therapy (bCBT) for severe fatigue.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>Severely fatigued patients (Checklist Individual Strength, fatigue-severity subscale [CIS-fatigue] ≥ 35) with diffuse glioma and stable disease were randomized to 12 weeks of bCBT or a waiting list condition (WLC). The primary endpoint was fatigue severity 2 weeks after intervention. This Bayesian adaptive trial included prespecified interim analyses for efficacy at n = 40, 50, 60, 70, and 80. Secondary outcomes—health-related quality of life (HRQoL), anxiety, future uncertainty, and depression—were assessed at 2 and 12 weeks after intervention.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>The trial was stopped for efficacy at the first interim analysis. Of 47 patients randomized, 40 patients reached the primary endpoint (mean age 53 years, 47% female). The posterior probability that CIS-fatigue scores were lower with bCBT than with WLC was 99.94%, with a large standardized effect size (Cohen’s d) of 1.12 [95% CI: 0.43–1.81]. At 2 weeks after intervention, 68% of patients were no longer severely fatigued after bCBT, compared to 24% in WLC. At 12 weeks follow-up, fatigue was still significantly lower in the bCBT group compared to WLC (d = 1.22). bCBT also demonstrated beneficial effects (d = 0.42-1.19) on anxiety, HRQoL, and future uncertainty.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>bCBT significantly reduces fatigue and improves anxiety and HRQoL in patients with diffuse glioma. These findings enable evidence-based supportive care strategies for reducing fatigue and enhancing HRQoL in this population.</jats:p>\n                  </jats:sec>","journal":"Neuro-Oncology","year":2026,"id":651988,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1700602,"name":"Jantine G Röttgering","orcid":null,"position":1,"is_corresponding":false},{"id":1700603,"name":"Vera Belgers","orcid":"0000-0002-5980-8202","position":2,"is_corresponding":false},{"id":1700604,"name":"Marieke E C Blom","orcid":null,"position":3,"is_corresponding":false},{"id":1700605,"name":"Brigit Thomassen","orcid":null,"position":4,"is_corresponding":false},{"id":1700606,"name":"Philip C De Witt Hamer","orcid":null,"position":5,"is_corresponding":false},{"id":1700607,"name":"Johanna M Niers","orcid":null,"position":6,"is_corresponding":false},{"id":1700608,"name":"Mathilde C M Kouwenhoven","orcid":null,"position":7,"is_corresponding":false},{"id":1700609,"name":"Henri P Bienfait","orcid":null,"position":8,"is_corresponding":false},{"id":1700610,"name":"Celine S Gathier","orcid":null,"position":9,"is_corresponding":false},{"id":1700611,"name":"Annette Compter","orcid":"0000-0001-9732-2150","position":10,"is_corresponding":false},{"id":1029254,"name":"Marjolein Geurts","orcid":"0000-0003-2369-0035","position":11,"is_corresponding":false},{"id":1700612,"name":"Tom J Snijders","orcid":null,"position":12,"is_corresponding":false},{"id":1700613,"name":"Peter M van de Ven","orcid":null,"position":13,"is_corresponding":false},{"id":1255884,"name":"Linda Douw","orcid":"0000-0001-7058-4062","position":14,"is_corresponding":false},{"id":1435368,"name":"Hans Knoop","orcid":"0000-0001-7763-3517","position":15,"is_corresponding":false},{"id":273501,"name":"Martin Klein","orcid":"0000-0001-5553-7911","position":16,"is_corresponding":false},{"id":1700600,"name":"Maxine Gorter","orcid":"0000-0001-7891-3625","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Bayesian adaptive randomized trial of blended cognitive behavioral therapy for severe fatigue in stable diffuse glioma","abstract":"<jats:title>AbstractAbstractAbstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>While severe fatigue is common in patients with diffuse glioma, no evidence-based treatment is currently available. The objective of this RCT was to evaluate the efficacy of blended cognitive behavioral therapy (bCBT) for severe fatigue.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>Severely fatigued patients (Checklist Individual Strength, fatigue-severity subscale [CIS-fatigue] ≥ 35) with diffuse glioma and stable disease were randomized to 12 weeks of bCBT or a waiting list condition (WLC). The primary endpoint was fatigue severity 2 weeks after intervention. This Bayesian adaptive trial included prespecified interim analyses for efficacy at n = 40, 50, 60, 70, and 80. Secondary outcomes—health-related quality of life (HRQoL), anxiety, future uncertainty, and depression—were assessed at 2 and 12 weeks after intervention.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>The trial was stopped for efficacy at the first interim analysis. Of 47 patients randomized, 40 patients reached the primary endpoint (mean age 53 years, 47% female). The posterior probability that CIS-fatigue scores were lower with bCBT than with WLC was 99.94%, with a large standardized effect size (Cohen’s d) of 1.12 [95% CI: 0.43–1.81]. At 2 weeks after intervention, 68% of patients were no longer severely fatigued after bCBT, compared to 24% in WLC. At 12 weeks follow-up, fatigue was still significantly lower in the bCBT group compared to WLC (d = 1.22). bCBT also demonstrated beneficial effects (d = 0.42-1.19) on anxiety, HRQoL, and future uncertainty.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>bCBT significantly reduces fatigue and improves anxiety and HRQoL in patients with diffuse glioma. These findings enable evidence-based supportive care strategies for reducing fatigue and enhancing HRQoL in this population.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41208030","pmcid":"PMC13070507","openalex_id":"https://openalex.org/W4416096761","authors":[],"funders":[{"funder_name":"Anita Veldman Foundation","grant_id":"CCA.2019.2-21","title":null}],"total_grants":1,"fwci":0.7465,"citation_percentile":0.75993855,"influential_citations":0,"citation_trend":[{"year":2026,"count":1}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://doi.org/10.1093/neuonc/noaf256","host_type":"journal"},{"url":"https://doi.org/10.1093/neuonc/noaf256","host_type":"publisher"},{"url":"https://academic.oup.com/neuro-oncology/advance-article-pdf/doi/10.1093/neuonc/noaf256/65249679/noaf256.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/neuro-oncology/article-pdf/28/3/693/65249679/noaf256.pdf","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41208030","host_type":"repository"},{"url":"https://pure.amsterdamumc.nl/en/publications/787b5795-9bc3-4d90-b4a4-973ffe1e5c52","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13070507/","host_type":"repository"},{"url":"https://pure.amsterdamumc.nl/en/publications/4aedffcf-940e-445f-9a0f-7738bc0a4264","host_type":"repository"},{"url":"https://pure.eur.nl/en/publications/694b764f-6d39-4533-a4ac-5e5160ce7de9","host_type":"repository"},{"url":"https://dspace.library.uu.nl/handle/1874/484445","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13070507/pdf/noaf256.pdf","host_type":"repository"},{"url":"https://pure.amsterdamumc.nl/ws/files/210655680/Bayesian-adaptive-randomized-trial-of-blended-cognitive-behavioral-therapy-for-severe-fatigue-in-stable-diffuse-glioma.pdf","host_type":"repository"},{"url":"https://pure.eur.nl/ws/files/234819501/noaf256.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC13070507","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC13070507?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Cancer-related cognitive impairment studies","Cancer survivorship and care","Posttraumatic Stress Disorder Research","Humans","Fatigue","Female","Male","Middle Aged","Glioma","Cognitive Behavioral Therapy","Bayes Theorem","Quality of Life","Adult","Brain Neoplasms","Aged","Follow-Up Studies","Prognosis"],"mesh_terms":["Adult","Aged","Bayes Theorem","Brain Neoplasms","Fatigue","Female","Follow-Up Studies","Glioma","Humans","Male","Middle Aged","Prognosis","Quality of Life","Cognitive Behavioral Therapy"],"keywords":["Randomized controlled trial","Anxiety","Cognitive behavioral therapy","Quality of life (healthcare)","Cognition","Cognitive behaviour therapy","Quality of life","Fatigue","Diffuse Glioma","Blended Cognitive Behavioral Therapy"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T11:27:23.037878Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}