结直肠癌患者化疗期间症状群的临床特点与评估策略OA

Objective To investigate the clinical characteristics of symptom clusters in patients with colorec-tal cancer(CRC)during chemotherapy and propose effective assessment strategies.Methods Databases including PubMed,VIP and Wanfang were systematically searched from inception to February 7,2025.A search strategy combining subject headings and free words was adopted.Chinese search terms included"结直肠癌/结直肠肿瘤/结肠癌/结肠肿瘤/直肠癌/直肠肿瘤""化疗"and"症状群/症状对".English search terms included"colorectal cancer/colorectal neoplasm/colorectal tumor/colorectal malignancy/colorectal carcinoma""chemotherapy""syndrome/symptom cluster/symptom constellation".Two researchers independently searched and screened the literature,collected observational studies related to symptom clusters during chemo-therapy in patients with CRC that met the inclusion and exclusion criteria,and conducted statistical analysis.Results A total of 17 articles were included,involving 19 symptom clusters,mainly including gastrointestinal tract-related symptom clusters,psychological and emotional-related symptom clusters,chemotherapy side-effect symptom clusters,and peripheral nerve-related symptom clusters.Seven assessment tools for symptom clusters were identified,among which four were different versions of the M.D.Anderson Symptom Inventory and the Memorial Symptom Assessment Scale.Gastrointestinal symptom clusters and psychological symptom clusters caused by the disease before chemotherapy were the most severe.Gastrointestinal symptom clusters were the most severe after the first chemotherapy.Neurotoxicity symptoms gradually worsened within half a year after chemotherapy and then tended to be stable.Conclusion Patients with CRC present multiple symp-tom clusters during chemotherapy with dynamic changes.Clinically,it is necessary to consider the importance of population heterogeneity,identify high-risk groups,and formulate precise management strategies based on the characteristics of symptom changes.In the future,the unified assessment criteria for symptom clusters can be established,combined with advanced technologies such as machine learning to gradually improve the identifi-cation of symptom clusters and develop precise management plans for symptom clusters.