Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Pain Symptom Manage. 2011 Aug;42(2):202-12. doi: 10.1016/j.jpainsymman.2010.10.257. Epub 2011 Mar 12.
Aggregates of concurrent symptoms, known as symptom clusters (SxCls), have been described in predominantly cross-sectional samples of lung cancer (LC) patients undergoing treatment.
The objective of this study was to delineate SxCls in LC survivors up to five years after diagnosis, investigate their stability over time, and identify determinants of SxCl development and resolution.
A sensitivity approach involving multiple exploratory and confirmatory analyses was applied to an eight-year prospective cohort study that annually assessed 2405 patients with LC for symptom burden with the Lung Cancer Symptom Scale and Linear Analogue Self-Assessment.
A single robust SxCl of fatigue, cough, and dyspnea was identified in 14.6%, 12.9%, 14.1%, 14.6%, and 15.4% of participants at Years 1-5 after diagnosis, respectively. Participants with the SxCl (SxCl (+)) were more likely to die than those without it; but this tendency diminished over time. SxCl persistence varied, with ≥40% of surviving patients annually transitioning to or from the SxCl(+) state until Year 4, after which the SxCl became increasingly stable. The SxCl was more likely to develop among male survivors who underwent surgery, received radiation, and were current smokers.
A single SxCl comprising dyspnea, fatigue, and cough has a stable prevalence among LC survivors up to five years after diagnosis but is not stable among individuals. Initially, after diagnosis, the SxCl is associated with a greater risk of death; however, after Year 2, the SxCl becomes increasingly stable and provides a marker for parenchymal lung injury.
在接受治疗的肺癌（LC）患者的主要横断面样本中，已经描述了同时出现的症状聚集，称为症状簇（SxCls）。
本研究的目的是描绘诊断后五年内 LC 幸存者的 SxCls，研究其随时间的稳定性，并确定 SxCl 发展和缓解的决定因素。
采用敏感性方法，包括多次探索性和验证性分析，对一项为期八年的前瞻性队列研究进行了研究，该研究每年使用肺癌症状量表和线性模拟自我评估评估 2405 名 LC 患者的症状负担。
在诊断后 1 年至 5 年的参与者中，分别有 14.6%、12.9%、14.1%、14.6%和 15.4%的患者出现单一的疲劳、咳嗽和呼吸困难的 SxCl。有 SxCl（SxCl（+））的患者比没有 SxCl 的患者更有可能死亡；但这种趋势随着时间的推移而减弱。SxCl 的持续性存在差异，有≥40%的存活患者每年从 SxCl（+）状态过渡到或退出 SxCl（+）状态，直到第 4 年，此后 SxCl 变得越来越稳定。SxCl 更有可能在接受手术、放疗和吸烟的男性幸存者中发展。
在诊断后五年内，LC 幸存者中存在一种由呼吸困难、疲劳和咳嗽组成的单一 SxCl，其患病率稳定，但在个体中不稳定。最初，在诊断后，SxCl 与更高的死亡风险相关；然而，在第 2 年后，SxCl 变得越来越稳定，并成为肺实质损伤的标志物。
