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

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