Abstract：
OBJECTIVE: Breast cancer patients experience symptoms and side effects from multimodal treatments, which often include menopausal symptoms resulting from cytotoxic chemotherapy or estrogen suppression therapy. This study aimed to explore the symptom network and clusters and its relationship to quality of life (QoL) in breast cancer patients who receive multimodal cancer treatment and experience treatment-related menopausal symptoms.
METHODS: A correlational study was conducted. Breast cancer patients receiving multimodal cancer treatment and experiencing treatment-related menopausal symptoms were included while they were receiving radiation therapy (N = 250). Symptoms, functions and QoL were assessed using the EORTC QLQ-C30 and BR45. Network analysis, principal component analysis, exploratory factor analysis, and multiple linear regression analysis were conducted.
RESULTS: Fatigue was the most central symptom in the symptom-only network as well as in the network consisting of symptoms and QoL. Fatigue, systemic therapy side effects, appetite loss, and cognitive symptoms demonstrated significant associations with QoL. The cancer and treatment related symptom cluster consisted of fatigue, cognitive symptoms, emotional symptoms and systemic therapy side effects. Breast cancer therapy-specific symptoms, such as arm symptoms, skin mucosis symptoms, and breast symptoms, formed a cluster with pain.
CONCLUSIONS: Fatigue was the most central symptom in breast cancer patients receiving multimodal cancer treatment and experiencing menopausal symptoms. Evaluation of fatigue and providing interventions to manage fatigue would contribute to improvement of QoL of breast cancer patients receiving multimodal cancer treatments. Future network analysis and symptom cluster studies should specify the population of interest and the treatment phase using comprehensive symptom evaluation tools.
METHODS: A correlational study was conducted. Breast cancer patients receiving multimodal cancer treatment and experiencing treatment-related menopausal symptoms were included while they were receiving radiation therapy (N = 250). Symptoms, functions and QoL were assessed using the EORTC QLQ-C30 and BR45. Network analysis, principal component analysis, exploratory factor analysis, and multiple linear regression analysis were conducted.
RESULTS: Fatigue was the most central symptom in the symptom-only network as well as in the network consisting of symptoms and QoL. Fatigue, systemic therapy side effects, appetite loss, and cognitive symptoms demonstrated significant associations with QoL. The cancer and treatment related symptom cluster consisted of fatigue, cognitive symptoms, emotional symptoms and systemic therapy side effects. Breast cancer therapy-specific symptoms, such as arm symptoms, skin mucosis symptoms, and breast symptoms, formed a cluster with pain.
CONCLUSIONS: Fatigue was the most central symptom in breast cancer patients receiving multimodal cancer treatment and experiencing menopausal symptoms. Evaluation of fatigue and providing interventions to manage fatigue would contribute to improvement of QoL of breast cancer patients receiving multimodal cancer treatments. Future network analysis and symptom cluster studies should specify the population of interest and the treatment phase using comprehensive symptom evaluation tools.
摘要：
目标：乳腺癌患者经历多模式治疗的症状和副作用，通常包括细胞毒性化疗或雌激素抑制治疗引起的更年期症状。本研究旨在探讨接受多模式癌症治疗并经历与治疗相关的更年期症状的乳腺癌患者的症状网络和簇及其与生活质量（QoL）的关系。
方法：进行相关研究。包括接受多模式癌症治疗并在接受放射治疗时经历治疗相关更年期症状的乳腺癌患者(N=250)。症状,使用EORTCQLQ-C30和BR45评估功能和生活质量。网络分析,主成分分析，探索性因素分析，并进行多元线性回归分析。
结果：疲劳是仅症状网络以及由症状和QoL组成的网络中最主要的症状。疲劳,全身治疗副作用，食欲减退,认知症状与QoL显著相关。癌症和治疗相关的症状群包括疲劳，认知症状,情绪症状和全身治疗副作用。乳腺癌治疗特异性症状，如手臂症状，皮肤粘液病症状，和乳房症状，形成了一个痛苦的集群。
结论：疲劳是接受多模式癌症治疗并出现更年期症状的乳腺癌患者的最主要症状。评估疲劳并提供干预措施来管理疲劳将有助于改善接受多模式癌症治疗的乳腺癌患者的QoL。未来的网络分析和症状聚类研究应使用综合症状评估工具指定感兴趣的人群和治疗阶段。
方法：进行相关研究。包括接受多模式癌症治疗并在接受放射治疗时经历治疗相关更年期症状的乳腺癌患者(N=250)。症状,使用EORTCQLQ-C30和BR45评估功能和生活质量。网络分析,主成分分析，探索性因素分析，并进行多元线性回归分析。
结果：疲劳是仅症状网络以及由症状和QoL组成的网络中最主要的症状。疲劳,全身治疗副作用，食欲减退,认知症状与QoL显著相关。癌症和治疗相关的症状群包括疲劳，认知症状,情绪症状和全身治疗副作用。乳腺癌治疗特异性症状，如手臂症状，皮肤粘液病症状，和乳房症状，形成了一个痛苦的集群。
结论：疲劳是接受多模式癌症治疗并出现更年期症状的乳腺癌患者的最主要症状。评估疲劳并提供干预措施来管理疲劳将有助于改善接受多模式癌症治疗的乳腺癌患者的QoL。未来的网络分析和症状聚类研究应使用综合症状评估工具指定感兴趣的人群和治疗阶段。
