{"title":"肺癌患者放疗期间症状群和前哨症状的识别：一项纵向研究","authors":"Jiang Zhang, Song Li, Jiang Wu, Bingkun Yang, Xiangxiu Tan, Guilan Zhang, Xijuan Zhao","doi":"10.2147/CMAR.S536992","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study longitudinally examined symptom clusters and sentinel symptoms in lung cancer patients across radiotherapy phases, providing a theoretical foundation for targeted symptom management.</p><p><strong>Methods: </strong>In this prospective longitudinal study, 244 patients were recruited via convenience sampling from a tertiary cancer hospital in Southwest China between January and December 2024. Data were collected using the General Demographic Questionnaire and MD Anderson Symptom Inventory (including the lung cancer module). Assessments occurred at four time points: T1 (one day before radiotherapy), T2 (after 10 sessions), T3 (after 20 sessions), and T4 (at end of radiotherapy). Exploratory factor analysis identified symptom clusters from symptoms with >20% incidence, while Apriori algorithm modeling analyzed intra-cluster associations to determine sentinel symptoms.</p><p><strong>Results: </strong>Five symptom clusters emerged: psychological (sadness, distress, sleep disturbance), respiratory (chest tightness, shortness of breath), lung cancer-specific (coughing, expectoration), radiotherapy side-effect (dry mouth, pain, decreased appetite), and perceptual (at T1: pain, numbness, at T2: dry mouth, pain, decreased appetite, numbness, constipation, at T3 and T4: forgetfulness, somnolence, fatigue, nausea, constipation). At T1, distress, shortness of breath, and coughing were sentinel symptoms for the psychological, respiratory, and lung cancer-specific clusters, respectively. Pain was the sentinel for the radiotherapy side-effect cluster at T3, and somnolence for the perceptual cluster at T4.</p><p><strong>Conclusion: </strong>Lung cancer patients exhibit multiple stable symptom clusters during radiotherapy, with sentinel symptoms varying by phase. These insights offer new perspectives on timed assessments and precision nursing interventions, while providing key theoretical and practical guidance for building early warning models and intelligent symptom management pathways.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2307-2318"},"PeriodicalIF":2.6000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514952/pdf/","citationCount":"0","resultStr":"{\"title\":\"Identification of Symptom Clusters and Sentinel Symptoms During Radiotherapy in Lung Cancer Patients: A Longitudinal Study.\",\"authors\":\"Jiang Zhang, Song Li, Jiang Wu, Bingkun Yang, Xiangxiu Tan, Guilan Zhang, Xijuan Zhao\",\"doi\":\"10.2147/CMAR.S536992\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study longitudinally examined symptom clusters and sentinel symptoms in lung cancer patients across radiotherapy phases, providing a theoretical foundation for targeted symptom management.</p><p><strong>Methods: </strong>In this prospective longitudinal study, 244 patients were recruited via convenience sampling from a tertiary cancer hospital in Southwest China between January and December 2024. Data were collected using the General Demographic Questionnaire and MD Anderson Symptom Inventory (including the lung cancer module). Assessments occurred at four time points: T1 (one day before radiotherapy), T2 (after 10 sessions), T3 (after 20 sessions), and T4 (at end of radiotherapy). Exploratory factor analysis identified symptom clusters from symptoms with >20% incidence, while Apriori algorithm modeling analyzed intra-cluster associations to determine sentinel symptoms.</p><p><strong>Results: </strong>Five symptom clusters emerged: psychological (sadness, distress, sleep disturbance), respiratory (chest tightness, shortness of breath), lung cancer-specific (coughing, expectoration), radiotherapy side-effect (dry mouth, pain, decreased appetite), and perceptual (at T1: pain, numbness, at T2: dry mouth, pain, decreased appetite, numbness, constipation, at T3 and T4: forgetfulness, somnolence, fatigue, nausea, constipation). At T1, distress, shortness of breath, and coughing were sentinel symptoms for the psychological, respiratory, and lung cancer-specific clusters, respectively. Pain was the sentinel for the radiotherapy side-effect cluster at T3, and somnolence for the perceptual cluster at T4.</p><p><strong>Conclusion: </strong>Lung cancer patients exhibit multiple stable symptom clusters during radiotherapy, with sentinel symptoms varying by phase. These insights offer new perspectives on timed assessments and precision nursing interventions, while providing key theoretical and practical guidance for building early warning models and intelligent symptom management pathways.</p>\",\"PeriodicalId\":9479,\"journal\":{\"name\":\"Cancer Management and Research\",\"volume\":\"17 \",\"pages\":\"2307-2318\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514952/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Management and Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/CMAR.S536992\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Management and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/CMAR.S536992","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Identification of Symptom Clusters and Sentinel Symptoms During Radiotherapy in Lung Cancer Patients: A Longitudinal Study.
Purpose: This study longitudinally examined symptom clusters and sentinel symptoms in lung cancer patients across radiotherapy phases, providing a theoretical foundation for targeted symptom management.
Methods: In this prospective longitudinal study, 244 patients were recruited via convenience sampling from a tertiary cancer hospital in Southwest China between January and December 2024. Data were collected using the General Demographic Questionnaire and MD Anderson Symptom Inventory (including the lung cancer module). Assessments occurred at four time points: T1 (one day before radiotherapy), T2 (after 10 sessions), T3 (after 20 sessions), and T4 (at end of radiotherapy). Exploratory factor analysis identified symptom clusters from symptoms with >20% incidence, while Apriori algorithm modeling analyzed intra-cluster associations to determine sentinel symptoms.
Results: Five symptom clusters emerged: psychological (sadness, distress, sleep disturbance), respiratory (chest tightness, shortness of breath), lung cancer-specific (coughing, expectoration), radiotherapy side-effect (dry mouth, pain, decreased appetite), and perceptual (at T1: pain, numbness, at T2: dry mouth, pain, decreased appetite, numbness, constipation, at T3 and T4: forgetfulness, somnolence, fatigue, nausea, constipation). At T1, distress, shortness of breath, and coughing were sentinel symptoms for the psychological, respiratory, and lung cancer-specific clusters, respectively. Pain was the sentinel for the radiotherapy side-effect cluster at T3, and somnolence for the perceptual cluster at T4.
Conclusion: Lung cancer patients exhibit multiple stable symptom clusters during radiotherapy, with sentinel symptoms varying by phase. These insights offer new perspectives on timed assessments and precision nursing interventions, while providing key theoretical and practical guidance for building early warning models and intelligent symptom management pathways.
期刊介绍：
Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include:
◦Epidemiology, detection and screening
◦Cellular research and biomarkers
◦Identification of biotargets and agents with novel mechanisms of action
◦Optimal clinical use of existing anticancer agents, including combination therapies
◦Radiation and surgery
◦Palliative care
◦Patient adherence, quality of life, satisfaction
The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.
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