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Exploring the Dynamics of Postoperative Radiotherapy Symptom Networks in Oral Cancer Patients: A Cross-Lagged Panel
Head & Neck
|March 14, 2026
Summary
Oral cancer patients undergoing radiotherapy experience evolving symptom networks. Pain and vomiting were early predictors, while distress, fatigue, and drowsiness significantly impacted later symptoms, guiding targeted interventions.
Area of Science:
- Oncology
- Symptom Science
- Network Analysis
Background:
- Oral cancer treatment, particularly radiotherapy, causes adverse reactions requiring better symptom management.
- Cross-sectional data limits understanding of causal symptom relationships in oral cancer patients.
Purpose of the Study:
- To apply Causal Layered Process Networks (CLPN) analysis to map symptom networks in oral cancer patients during radiotherapy.
- To identify predictive symptom relationships and potential intervention points over time.
Main Methods:
- Longitudinal study of 246 oral cancer patients from March to October 2024.
- Symptom assessment at four radiotherapy time points (T0, T1, T2, T3) using the M. D. Anderson Symptom Inventory.
- Construction of CLPNs using R to analyze symptom influences and network stability.
Main Results:
- Pain and vomiting showed high outgoing influence from T0 to T1.
- Distress at T1 predicted sleep disturbance, fatigue, and drowsiness at T2.
- Mouth/throat sores at T2 predicted pain, dental issues, and swallowing difficulties at T3.
- Fatigue and drowsiness had the highest incoming influence throughout radiotherapy.
Conclusions:
- Core symptoms develop dynamically in oral cancer patients during radiotherapy.
- Inter-symptom relationships evolve, offering insights for timely, tailored interventions.
- CLPN analysis provides a framework for understanding multidimensional symptom distress.
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