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Distinct Trajectories of Symptom Burden Development in Patients With Stage IV Cancer
Cornelia A Verberkt1, Nicole E Billingy2, Annemarie Becker-Commissaris3
1IQ Health Science Department (C.A.V., N.E.B., I.W.), Radboud University Medical Center, Nijmegen, The Netherlands.
Journal of Pain and Symptom Management
|February 6, 2026
Summary
Approximately one-third of patients with stage IV cancer face high symptom burden. Younger age, lower education, comorbidities, and recent hospital admission predict this risk, enabling proactive clinical intervention for better quality of life.
Area of Science:
- Oncology
- Palliative Care
- Health Outcomes Research
Background:
- Stage IV cancer patients often have co-existing symptoms impacting quality of life.
- Identifying patients at risk for high symptom burden is currently challenging.
Purpose of the Study:
- To identify distinct symptom burden trajectories in advanced cancer patients.
- To determine characteristics predicting high symptom burden risk.
Main Methods:
- Pooled data from two prospective studies (N=841).
- Assessed symptom burden using EORTC QLQ-C30 over 12 months.
- Utilized group-based multi-trajectory modeling and multivariable logistic regression.
Main Results:
- Identified 5 symptom and 6 functioning subgroups.
- 29% of patients were at risk for high symptom burden (increased symptoms, low functioning).
- Predictors included younger age, lower education, comorbidities, and recent hospital admission.
Conclusions:
- One-third of stage IV cancer patients are at risk of high symptom burden.
- Distinct patient profiles can proactively identify at-risk individuals.
- Personalized symptom monitoring and treatment are crucial for improving quality of life.
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