Symptom clusters using the EORTC QLQ-C15-PAL in palliative radiotherapy

Area of Science:

• Oncology
• Palliative Care
• Symptom Science

Background:

• Advanced cancer patients experience numerous, interrelated symptoms.
• Symptom clusters (2+ concurrent symptoms) are recommended for improved palliative care.
• Understanding symptom dynamics is crucial for effective symptom management.

Purpose of the Study:

• To identify and analyze symptom clusters in advanced cancer patients undergoing palliative radiation therapy (RT).
• To examine the stability and fluctuation of symptom clusters over a 10-day period post-RT.

Main Methods:

• Utilized principal component analysis (PCA), exploratory factor analysis (EFA), and hierarchical cluster analysis (HCA).
• Analyzed data from the European Organisation for Research and Treatment of Cancer Quality of Life-C15-Palliative (EORTC QLQ-C15-PAL) at baseline, day 5, and day 10 post-RT.
• Included 109 patients at baseline, with a majority presenting with prostate cancer and bone metastases.

Main Results:

• Identified 2-4 symptom clusters at each time point.
• Physical functioning consistently clustered with shortness of breath.
• Pain and pain interference clustered with nausea at baseline, and with sleep at follow-up intervals.
• Cluster stability varied, with Cronbach's alpha values ranging from 0.53 to 0.90.

Conclusions:

• Symptom clusters demonstrated fluctuation within a short timeframe after palliative RT.
• Despite dynamic changes, certain symptom associations (e.g., physical functioning/shortness of breath, pain/sleep) were recurrent.
• Further research is needed to validate these dynamic symptom clusters for clinical application.