In colorectal cancer (CRC) patients, apart from fatigue, psychological and physical symptoms often converge, affecting their quality of life and ability to work. Our objective was to ascertain symptom clusters within a year following CRC treatment and their longitudinal association with persistent fatigue and reduced work ability at the 3-month follow-up. We used data from MIRANDA, a multicenter cohort study enrolling adult CRC patients who are starting a 3-week in-patient rehabilitation within a year post-curative CRC treatment. Participants completed questionnaires evaluating symptoms at the start of rehabilitation (baseline) and after three months. We performed an exploratory factor analysis to analyze the clustering of symptoms at baseline. Longitudinal analysis was performed using a multivariable linear regression model with dichotomized symptoms at baseline as independent variables, and the change in fatigue and ability to work from baseline to 3-month-follow-up as separate outcomes, adjusted for covariates. We identified six symptom clusters: fatigue, gastrointestinal symptoms, pain, psychosocial symptoms, urinary symptoms, and chemotherapy side effects. At least one symptom from each factor was associated with higher fatigue or reduced ability to work at the 3-month follow-up. This study highlights the interplay of multiple symptoms in influencing fatigue and work ability among CRC patients post-rehabilitation.
在结直肠癌患者中，除疲劳外，心理与躯体症状常相互交织，影响其生活质量与工作能力。本研究旨在明确结直肠癌治疗后一年内的症状群特征，并探究其在三个月随访期间与持续性疲劳及工作能力下降的纵向关联。研究数据来源于MIRANDA多中心队列研究，该研究纳入在根治性结直肠癌治疗后一年内开始为期三周住院康复治疗的成年患者。参与者分别在康复治疗开始时（基线）及三个月后完成症状评估问卷。我们采用探索性因子分析法对基线症状进行聚类分析，并运用多变量线性回归模型进行纵向分析：以基线二分类症状作为自变量，以疲劳程度和工作能力从基线至三个月随访期间的变化作为独立结局变量，同时校正协变量影响。研究识别出六大症状群：疲劳症状群、胃肠道症状群、疼痛症状群、心理社会症状群、泌尿系统症状群及化疗副作用症状群。每个症状群中至少存在一种症状与三个月随访期间加重的疲劳感或下降的工作能力显著相关。本研究揭示了结直肠癌患者康复后多种症状相互影响、共同作用于疲劳程度与工作能力的复杂机制。
肿瘤(癌症)患者之家