疲劳是儿童癌症治疗之后令人苦恼且普遍存在的长期后遗症，需要进行纵向研究以调查疲劳随时间的发展情况。本研究的目标是计算儿童癌症治疗后疲劳纵向发展的生长曲线，并研究生物心理社会预测因素的影响。参与者来自患者监测计划，数据从医疗记录中提取。使用PedsQLTM多维度疲劳量表的家长代理和自我报告版本来重复评估儿童癌症治疗结束后长达5年的疲劳情况。疲劳情况共评估了2440次，参与者为761人（中值：3次），代理报告为2-8岁的年龄段；以及自我报告为990人，评估了2657次（中值：2次），年龄超过8岁。采用混合模型来建立生长曲线，并分别分析对固体肿瘤（ST）、血肿瘤和中枢神经系统肿瘤（CNS）患者的预测因素的影响。治疗结束时，CNS肿瘤患者的认知疲劳较ST肿瘤患者更多，无论是代理报告（-11.30，p<.001）还是自我报告（-6.78，p=.002），代理报告的一般疲劳也更多（-6.78，p=.002）。随时间变化的唯一显著差异是关于自我报告的睡眠休息疲劳。CNS组的原始分数每年下降0.87个单位（95% CI -1.64; -0.81，p=.031），相对于ST组。总体上，父母的困扰是与疲劳增加最相关的变量，而免疫疗法是最常见的医学预测因素。对于CNS组来说，国家癌症儿童中心化护理减轻了疲劳，但对其他诊断没有影响。治疗过CNS肿瘤的儿童和青少年在治疗结束后报告的疲劳程度比其他参与者更严重，这种差异随时间的推移而保持。本研究的结果可能有助于更早地识别疲劳症状未恢复的儿童。

Fatigue is a distressing and prevalent long-term sequela of treatment for childhood cancer, and there is a need for longitudinal studies to investigate the development of fatigue over time. The objective of this study was to calculate growth-curves for the longitudinal development of fatigue after treatment for childhood cancer, and to investigate the effects of biopsychosocial predictors.Participants were recruited from a patient monitoring program and data extracted from medical records. Parent-proxy and self-report versions of PedsQLTM Multidimensional Fatigue Scale were used to repeatedly assess fatigue up to 5 years after the end of treatment for childhood cancer. Fatigue was assessed 2440 times for 761 participants (median:3) with proxy-reports (age 2-8 years) and 2657 times for 990 participants with self-reports (above 8 years) (median:2). Mixed models were used to establish growth-curves and to analyze the effect of predictors separately for participants with solid tumors (ST), hemato-oncological malignancies and central nervous system-tumors (CNS).CNS-tumors were associated with more cognitive fatigue than ST at the end of treatment, for both proxy-reports (-11.30, p<.001) and self-reports (-6.78, p=.002), and for proxy-reports of general fatigue (-6.78, p=.002). The only significant difference in change over time was for self-reports of sleep-rest fatigue. The raw scores for the CNS-group decreased with -0.87 per year (95% CI -1.64; -0.81, p=.031) compared to the ST-group. Parental distress was overall the variable most associated with increased fatigue, while immunotherapy was the most frequent medical predictor. National centralization of childhood cancer care decreased fatigue for the CNS-group, but not for other diagnoses.Children and adolescents treated for CNS-tumors reported more fatigue than other participants after the end of treatment, and this difference remained over time. Results from this study may help to facilitate the early recognition of children with insufficient recovery of fatigue symptoms.