Analysis of changing trajectory and core influencing factors of symptom disturbance in patients with cervical cancer radiotherapy

CHEN Guoping; DOU Qijin; WU Yaqin

doi:10.12102/j.issn.1009-6493.2024.23.001

Abstract：Objective:To explore the change trajectory of symptoms and distress in patients with cervical cancer radiotherapy and analyze the decision tree of core influencing factors.Methods:A total of 260 patients with cervical cancer who received radiotherapy in our hospital from January 2020 to December 2022 were selected by convenience sampling method.Baseline investigation was conducted by General Data Questionnaire,Rhodes Adaptive Symptom Distress Scale,Simplified Fear of Disease Progression Scale,Social Support Rating Scale and Body Image Scale.Symptom distress levels of patients were investigated before,after,3 months after and 6 months after radiotherapy,and latent variable growth model was used to identify symptom distress trajectory categories.Finally,core influencing factors of symptom distress trajectory categories were analyzed by decision tree.Results:Rhodes Adaptive Symptom Distress Scale scores were 68.14±14.57,62.54±11.36,71.52±16.32,75.35±18.58 before,after,3 months after and 6 months after radiotherapy.The change trend of symptom distress score of cervical cancer radiotherapy patients identified two symptom distress tracks in moderate symptom distress group(83.85%)and high symptom distress group(16.15%).Decision tree model showed that education level,occupational status,cancer fatigue,toxicity,Simplified Fear of Disease Progression Scale score,Social Support Rating Scale score and Body Image Scale score could all predict the trajectory of symptom distress of cervical cancer radiotherapy patients,and toxicity was the most important predictor of symptom distress trajectory category.Conclusion:The symptoms of cervical cancer patients from before radiotherapy to 6 months after radiotherapy were divided into moderate symptoms and high symptoms.Clinically,high-risk patients who may progress into the high symptom distress group can be identified according to the education level,occupational status,cancer fatigue,toxicity,Simplified Fear of Disease Progression Scale score,Social Support Rating Scale score and Body Image Scale score factors,and intervention programs based on the degree of toxicity and side effects,Body Image Scale score and other variables can be formulated according to the importance ranking of the predictive variables of the decision tree,so as to improve the symptom distress level of patients with cervical cancer radiotherapy.