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<p>Patients with head and neck cancer (HNC) frequently encounter symptom clusters following radiotherapy, which substantially affect their quality of life. This study aims to identify distinct symptom clusters in undergoing radiotherapy HNC patients and examine how self-perceived burden and social support mediate the relationship between symptom clusters and quality of life. A cross-sectional survey of 409 HNC patients (Jun–Dec 2024) was conducted. Symptoms were assessed using the M.D. Anderson Symptom Inventory-Head and Neck, self-perceived burden using the Self-Perceived Burden Scale for Cancer Patients, social support using the Medical Outcomes Study Social Support Survey, and quality of life using the Functional Assessment of Cancer Therapy-General. Exploratory factor analysis identified symptom clusters, structural equation modeling (SEM) tested mediation paths. Four distinct symptom clusters were identified in HNC patients undergoing radiation therapy: oropharyngeal, neurosensory, psychological, and gastrointestinal. Symptom clusters negatively predicted social support (β= − 0.449, <i>p</i> &lt; 0.05, explaining 20.2% variance). Symptom clusters and social support jointly predicted self-perceived burden (Symptom clusters:β = 0.490, Social support:β = − 0.131; <i>p</i> &lt; 0.05, explaining 31.6% variance). Symptom clusters, social support, and self-perceived burden collectively predicted quality of life (Symptom clusters:β= − 0.396, Social support:β = 0.150, Self-perceived burden:β= − 0.198; <i>p</i> &lt; 0.05, explaining 37.9% variance). Self-perceived burden significantly mediated the relationship between symptom clusters and quality of life(indirect effect = − 0.041, 95% CI − 0.256 to − 0.007), social support mediation was non-significant, and no chain mediation existed. It was found that symptom clusters in HNC patients receiving radiation therapy have a direct negative impact on their quality of life. These symptoms also indirectly affect quality of life through self-perceived burden mediation. Future interventions should focus on reducing patient’s burden and improving Social support. Additionally, exploring the relationship between symptoms, psychological factors, and social factors, and creating a comprehensive care system that addresses symptom management, psychological empowerment, and social support enhancement could help improve patients’ quality of life.</p>

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Effect of symptom clusters on quality of life in patients with head and neck cancer treated with radiotherapy: a cross-sectional study

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  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Rui Zhao,
  • Tingting Ding,
  • Huili Ma,
  • Yanhui Ma,
  • Ailian He,
  • Jiaxun Kang,
  • Yaosong Zhao

摘要

Patients with head and neck cancer (HNC) frequently encounter symptom clusters following radiotherapy, which substantially affect their quality of life. This study aims to identify distinct symptom clusters in undergoing radiotherapy HNC patients and examine how self-perceived burden and social support mediate the relationship between symptom clusters and quality of life. A cross-sectional survey of 409 HNC patients (Jun–Dec 2024) was conducted. Symptoms were assessed using the M.D. Anderson Symptom Inventory-Head and Neck, self-perceived burden using the Self-Perceived Burden Scale for Cancer Patients, social support using the Medical Outcomes Study Social Support Survey, and quality of life using the Functional Assessment of Cancer Therapy-General. Exploratory factor analysis identified symptom clusters, structural equation modeling (SEM) tested mediation paths. Four distinct symptom clusters were identified in HNC patients undergoing radiation therapy: oropharyngeal, neurosensory, psychological, and gastrointestinal. Symptom clusters negatively predicted social support (β= − 0.449, p < 0.05, explaining 20.2% variance). Symptom clusters and social support jointly predicted self-perceived burden (Symptom clusters:β = 0.490, Social support:β = − 0.131; p < 0.05, explaining 31.6% variance). Symptom clusters, social support, and self-perceived burden collectively predicted quality of life (Symptom clusters:β= − 0.396, Social support:β = 0.150, Self-perceived burden:β= − 0.198; p < 0.05, explaining 37.9% variance). Self-perceived burden significantly mediated the relationship between symptom clusters and quality of life(indirect effect = − 0.041, 95% CI − 0.256 to − 0.007), social support mediation was non-significant, and no chain mediation existed. It was found that symptom clusters in HNC patients receiving radiation therapy have a direct negative impact on their quality of life. These symptoms also indirectly affect quality of life through self-perceived burden mediation. Future interventions should focus on reducing patient’s burden and improving Social support. Additionally, exploring the relationship between symptoms, psychological factors, and social factors, and creating a comprehensive care system that addresses symptom management, psychological empowerment, and social support enhancement could help improve patients’ quality of life.