Symptom Clusters by Edmonton Symptom Assessment System in Radiotherapy and Palliative Care Clinic

Area of Science:

• Palliative Care
• Oncology
• Symptom Management

Background:

• Effective palliative care requires accurate symptom identification and management.
• Patients undergoing palliative radiotherapy (PRT) often present complex symptom profiles.
• The Edmonton Symptom Assessment System (ESAS) is a tool used for symptom evaluation.

Purpose of the Study:

• To identify symptom clusters (SCs) in patients evaluated at a Radiotherapy and Palliative Care (RaP) clinic.
• To analyze the associations between identified SCs and clinical factors like performance status and PRT administration.
• To explore the relationship between SCs and patient survival outcomes.

Main Methods:

• Retrospective analysis of data from 215 patients referred to the RaP clinic (February 2017 - April 2020).
• Utilized principal component analysis (PCA) and k-means clustering (KMC) to identify symptom clusters based on ESAS scores.
• Examined correlations between SCs, ECOG performance status, tumor characteristics, PRT administration, and survival.

Main Results:

• PCA identified four SCs (physical, psychological, nausea/appetite, pain); KMC identified three SCs (pain/systemic, nausea/appetite/dyspnea, psychological).
• Worse ECOG performance status correlated with physical symptom clusters.
• Psychological SCs were linked to a lower likelihood of receiving PRT, but combined with pain/systemic clusters, increased PRT use.

Conclusions:

• Symptom cluster analysis provides valuable insights into symptom patterns in PRT patients.
• This analysis can aid in developing personalized symptom management strategies.
• Identifying symptom clusters may improve clinical decision-making for patients receiving palliative radiotherapy.