宫颈癌近距离放疗患者癌症相关疲劳的异质性及影响因素：横断面分析

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing Pub Date : 2025-05-02 DOI:10.1016/j.apjon.2025.100714

Yanhua Li , Yuqi Liu , Zimo Zhang , Jun Ma , Ping Jiang , Panfeng Wang , Lijuan Sun

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引用次数: 0

摘要

目的研究宫颈癌腔内近距离放射治疗患者癌症相关性疲劳（CRF）的患病率和异质性，并确定相关的决定因素。方法本横断面研究纳入北京某三级医院于2023年3月至6月接受近距离放疗的105例宫颈癌患者。参与者完成了癌症疲劳量表、患者主观整体评估、医院焦虑和抑郁量表以及匹兹堡睡眠质量指数。使用潜类分析（LCA）来确定疲劳亚组。采用单因素和多因素分析，包括t检验、卡方检验、多元线性回归和逻辑回归，探讨影响因素。结果平均CRF评分为26.10±10.55（范围：0-60），其中36.2%的患者评分≥30。LCA确定了三个疲劳亚组：高、中、低疲劳，83.8%的患者分为中度和高度疲劳组。较高的教育程度、接受化疗、营养状况不佳和抑郁与较高的CRF呈正相关，而宫颈癌手术史和较高的家庭收入与较高的CRF呈负相关。这些变量解释了CRF中64.3%的方差。接受化疗、抑郁评分较高、营养状况较差的患者更有可能属于高疲劳组。结论肿瘤相关性疲劳在近距离放疗宫颈癌患者中普遍存在，尤其影响身体和情绪领域。疲劳严重程度组存在大量异质性。需要针对身体症状、心理困扰和营养状况进行量身定制的干预。进一步的研究更大，不同的样本是必要的，以验证这些发现。

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Heterogeneity and influencing factors of cancer-related fatigue among patients with cervical cancer undergoing brachytherapy: A cross-sectional analysis

Objective

This study aims to examine the prevalence and heterogeneity of cancer-related fatigue (CRF) among patients with cervical cancer undergoing intracavitary brachytherapy and to identify associated determinants.

Methods

This cross-sectional study included 105 patients with cervical cancer who received brachytherapy at a tertiary hospital in Beijing between March and June 2023. Participants completed the Cancer Fatigue Scale, Patient-Generated Subjective Global Assessment, Hospital Anxiety and Depression Scale, and Pittsburgh Sleep Quality Index. Latent class analysis (LCA) was used to identify fatigue subgroups. Influencing factors were explored using univariate and multivariate analyses, including t-tests, chi-square tests, multiple linear regression, and logistic regression.

Results

The mean CRF score was 26.10 ± 10.55 (range: 0–60), with 36.2% of patients scoring ≥ 30. LCA identified three fatigue subgroups: high, moderate, and low fatigue, with 83.8% of patients classified into the moderate and high fatigue groups. Higher educational attainment, receipt of chemotherapy, poor nutritional status, and depression were positively associated with greater CRF, while a history of cervical cancer surgery and higher household income were negatively associated. These variables explained 64.3% of the variance in CRF. Patients who received chemotherapy, had higher depression scores, and had poorer nutritional status were more likely to belong to the high-fatigue group.

Conclusions

Cancer-related fatigue is highly prevalent among patients with cervical cancer undergoing brachytherapy, particularly affecting physical and emotional domains. Substantial heterogeneity exists across fatigue severity groups. Tailored interventions addressing physical symptoms, psychological distress, and nutritional status are needed. Further research with larger, diverse samples is warranted to validate these findings.

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