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宫颈癌患者同步放化疗相关症状:潜在类别分析和网络分析的应用

Symptoms associated with concurrent chemoradiotherapy in patients with cervical cancer: Application of latent profile analysis and network analysis.

作者信息

Lu Xiangyu, Zheng Lingling, Jin Xue, Wang Yuejia, Wu Shengwu, Lv Yin, Du Hua

机构信息

School of Nursing, Anhui Medical University, Hefei, China.

Department of Radiation Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

出版信息

Asia Pac J Oncol Nurs. 2024 Dec 27;12:100649. doi: 10.1016/j.apjon.2024.100649. eCollection 2025 Dec.

Abstract

OBJECTIVE

This study aims to explore symptom subgroups and influencing factors among patients undergoing concurrent chemoradiotherapy (CCRT) for cervical cancer, to construct a symptom network, and to identify core symptoms within the overall sample and its various subgroups.

METHODS

A cross-sectional survey was conducted with 378 patients undergoing CCRT for cervical cancer from June 2023 to May 2024 at a tertiary hospital in Anhui Province. Participants completed the General Information Questionnaire, the Symptom Assessment Scale for Patients Undergoing CCRT for Intermediate and Advanced Cervical Cancer, and the Dyadic Coping Inventory. Latent profile analysis (LPA) identified symptom subgroups, while multivariate logistic regression examined influences on these subgroups. Symptom networks were developed using R language to analyze centrality indices and identify core symptoms.

RESULTS

Patients were classified into three subgroups: low symptom burden ( ​= ​200, 52.91%), moderate symptom burden with prominent intestinal response ( ​= ​75, 19.84%), and high symptom burden ( ​= ​103, 27.25%). Multivariate logistic regression indicated that age, tumor stage, chemotherapy frequency, and dyadic coping (DC) were predictive of subgroup membership ( ​< ​0.05). Network analysis revealed sadness (  ​= ​1.320) as the core symptom for the overall sample, nausea (  ​= ​0.801) for the low symptom burden group, and vomiting (  ​= ​0.705, 0.796) for both the moderate symptom burden with intestinal response prominence group and the high symptom burden group.

CONCLUSIONS

Three symptom subgroups exist among patients undergoing CCRT for cervical cancer, with sadness, nausea, and vomiting identified as core symptoms. Health care professionals should provide individualized symptom management tailored to these subgroups.

摘要

目的

本研究旨在探讨宫颈癌同步放化疗(CCRT)患者的症状亚组及其影响因素,构建症状网络,并确定总体样本及其各亚组中的核心症状。

方法

2023年6月至2024年5月,对安徽省某三级医院378例接受CCRT治疗的宫颈癌患者进行了横断面调查。参与者完成了一般信息问卷、中晚期宫颈癌CCRT患者症状评估量表和二元应对量表。潜在剖面分析(LPA)确定症状亚组,多因素逻辑回归分析这些亚组的影响因素。使用R语言构建症状网络,分析中心性指标并确定核心症状。

结果

患者被分为三个亚组:低症状负担组(n = 200,52.91%)、肠道反应突出的中度症状负担组(n = 75,19.84%)和高症状负担组(n = 103,27.25%)。多因素逻辑回归分析表明,年龄、肿瘤分期、化疗次数和二元应对方式(DC)可预测亚组归属(P < 0.05)。网络分析显示,总体样本的核心症状为悲伤(β = 1.320),低症状负担组为恶心(β = 0.801),肠道反应突出的中度症状负担组和高症状负担组均为呕吐(β = 0.705,0.796)。

结论

宫颈癌CCRT患者存在三个症状亚组,悲伤、恶心和呕吐被确定为核心症状。医护人员应针对这些亚组提供个性化的症状管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2288/11786907/2a28ed436b2d/gr1.jpg

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