晚期非小细胞肺癌患者表皮生长因子受体酪氨酸激酶抑制剂治疗期间症状群特征及对生活质量的影响OA

Objective To analyze the characteristics of symptom clusters and their impact on quality of life in patients with advanced non-small cell lung cancer(NSCLC)during treatment with epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKI).Method A total of 98 patients with advanced NSCLC who received EGFR-TKI treatment in our hospital from March 2022 to October 2025 were selected as the study subjects.The MD Anderson symptom inventory-lung cancer(MDASI-LC)and the European Cancer Research and Treatment quality of life questionnaire-core 30(EORTC QLQ-C30)V3.0 were used to assess the characteristics of symptom clusters and quality of life during treatment.Exploratory factor analysis(EFA)was used to extract symptom clusters,and multiple linear regression analysis was performed to explore the impact of each symptom cluster on quality of life.Result The mean age of the patients was(65.92±8.32)years,with a male-to-female ratio of 1:1,and most patients received third-generation EGFR-TKI treatment.After 12 weeks of treatment,the scores of fatigue,nausea,sleep disturbance,distress,forgetfulness,drowsiness,dry mouth,sadness,vomiting,numbness,and constipation on the MDASI-LC scale were significantly higher than baseline,while the scores of pain,shortness of breath,decreased appetite,and cough were significantly lower than baseline(all P＜0.05).After 12 weeks of treatment,the scores of global health status(63.20±8.64 vs 59.10±9.25),physical function,role function,social function,pain,dyspnea,appetite loss,and constipation on the EORTC QLQ-C30 V3.0 scale were significantly lower than baseline,while the scores of fatigue,nausea and vomiting,insomnia,diarrhea,and financial difficulties were significantly higher than baseline(all P＜0.05).Factor analysis was performed on the MDASI-LC data of patients after 12 weeks of treatment(KMO=0.78,Bartlett's test P＜0.001),and a total of 4 symptom clusters were extracted,namely fatigue-emotional symptom cluster(25.10%),respiratory symptom cluster(17.85%),gastrointestinal symptom cluster(14.60%),and neurosensory symptom cluster(10.90%),with a cumulative variance contribution rate of 68.45%.Pearson correlation analysis showed that the fatigue-emotional symptom cluster,respiratory symptom cluster,gastrointestinal symptom cluster,and neurosensory symptom cluster were all negatively correlated with the scores of global health,social function,role function,and emotional function in patients(all P＜0.05).Regression analysis was conducted with the scores of each functional domain of the EORTC QLQ-C30 as dependent variables and the factor scores of symptom clusters as independent variables,after adjusting for age and gender.The results showed that global health was mainly affected by the fatigue-emotional symptom cluster(β=-0.441),social function was mainly affected by the neurosensory symptom cluster(β=-0.271),role function was mainly affected by the fatigue-emotional symptom cluster(β=-0.362),and emotional function was mainly affected by the fatigue-emotional symptom cluster(β=-0.571)and skin-mucosal symptom cluster(β=-0.216)(all P＜0.05).Conclusion Patients with advanced NSCLC frequently experience fatigue-emotional symptom cluster,gastrointestinal symptom cluster,respiratory symptom cluster,and neurosensory symptom cluster during EGFR-TKI treatment,accompanied by a decline in global health status.Among them,the fatigue-emotional symptom cluster and gastrointestinal symptom cluster have the most significant impact on patients'quality of life.