Identification of symptom clusters and associated factors based on disease characteristics in patients with esophageal cancer undergoing radiotherapy or chemoradiotherapy.

OBJECTIVE: To identify symptom clusters in patients with esophageal cancer undergoing radiotherapy or chemoradiotherapy, and to analyze their associated disease-related factors. METHODS: A total of 289 patients receiving radiotherapy or chemoradiotherapy for esophageal cancer were recruited from the oncology departments of a tertiary general hospital in Nanjing between December 2021 and December 2023. Data were collected using a general information questionnaire and the esophageal cancer symptom assessment scale. Exploratory factor analysis and multiple linear regression were employed for statistical analysis. RESULTS: The most prevalent symptoms were dysphagia (73.55%), fatigue (66.52%), weight loss (66.29%), sleep disturbance (62.58%), dry mouth (61.87%), shortness of breath (58.39%), nausea (57.42%), and pruritus (57.00%). Higher symptom incidence was associated with greater severity and distress. Four distinct symptom clusters were identified: psychosomatic, dysphagia, adverse reaction, and reflux-cough. Clinical stage, lesion location, and treatment modality emerged as independent predictors of symptom cluster severity (P < 0.05). CONCLUSION: Patients with esophageal cancer undergoing radiotherapy or chemoradiotherapy experience multiple concurrent symptoms that form identifiable clusters. Clinical nursing staff should prioritize the leading symptoms within each cluster and develop targeted interventions based on symptom severity and distress levels, thereby improving symptom management effectiveness and enhancing patients' quality of life during the treatment and recovery period.