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Symptom Burden Trajectory in Nasopharyngeal Carcinoma Patients Undergoing
Radiotherapy in Southwest China: A Prospective Longitudinal Study

Y. Li and X. Hu 1
1

1
Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing,
Sichuan University, Sichuan University, China

Background: Nasopharyngeal carcinoma (NPC) is most common in East and Southeast Asia,
especially in southwest China. Radiotherapy (RT) is the main treatment for NPC. However, NPC patients
suffer from numerous various cancer-/RT-related symptoms during RT, which lead to heavy symptom
burden, low quality of life, impaired psychosomatic conditions, and even the interruption of
radiotherapy and poor prognosis.

Objective: To explore symptom burden trajectory and its classification characteristics of NPC patients
during RT in southwest China.

Methods: Data were collected using the MD Anderson Symptom Inventory with Head & Neck module
(weekly during RT, T1-T7), a general information questionnaire (baseline) and another five
psychosocial scales (baseline). Mplus and Latent Growth Mixture Model was used to fit the latent class
track of symptom burden, and R was used to compare the baseline differences in demographic,
health-related and psychosocial characteristics among different latent classes.

Results: A total of 255 patients were included in this longitudinal study. The score of weekly symptom
burden (mean±SD) surged from 14.30±15.99 (T1) to 74.32±28.54 (T7) in the period of RT, while the severity
of each symptom varied over time. Two distinct classes of symptom burden trajectories were found: high
symptom burden group (n=32, 14.22%) and low symptom burden group (n=193, 85.78%); symptom burden
of patients in both groups worsened over time. Higher female proportion (40.6%, p=0.038) was observed
in high symptom burden group; at baseline, NPC patients in this group were less likely to exercise regularly
(p=0.016) and shown a higher level of anxiety (p<0.01), depression (p<0.01) and distress (p<0.01), and a lower
level of positive coping style (p=0.002).

Conclusion: NPC patients in southwest China experienced increasing symptom burden during RT,
and the patients with better psychosocial status exhibited better symptom burden trajectory, which
provided a theoretical basis for developing tailored interventions to alleviate their symptom burden.

Keywords: nasopharyngeal carcinoma, radiotherapy, symptom burden, trajectory

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Poster Presentation Abstracts
Correspondence: Xiaolin Hu, Department of Nursing, West China Hospital, Sichuan University/West
China School of Nursing, Sichuan University, Sichuan University, China
E-mail: huxiaolin1220@126.com

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