Classification of the development trajectory of symptom distress and core influencing factors in patients with advanced lung cancer undergoing concurrent chemoradiotherapy based on the latent variable mixed growth model

Zou Xia; Li Haixiang; Wang Xiying; Zou Xiaoya; Li Xiaoqin

doi:10.13406/j.cnki.cyxb.004120

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Classification of the development trajectory of symptom distress and core influencing factors in patients with advanced lung cancer undergoing concurrent chemoradiotherapy based on the latent variable mixed growth model

Precision medicine in cancer and translational studies | 更新时间：2026-10-26

- Classification of the development trajectory of symptom distress and core influencing factors in patients with advanced lung cancer undergoing concurrent chemoradiotherapy based on the latent variable mixed growth model
- Journal of Chongqing Medical University Vol. 51, Issue 10, Pages: 1434-1440(2026)
- 作者机构：
  
  暨南大学附属广东省第二人民医院肿瘤科，广州 510220
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.004120
  CLC： R734.2
- Received：03 March 2026，
  
  Revised：2026-04-21，
  
  Accepted：27 April 2026，
  
  Published：28 October 2026
- 稿件说明：
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邹霞，李海香，王希英，等.基于潜变量混合增长模型的中晚期肺癌同步放化疗患者症状困扰的发展轨迹分类及核心影响因素分析[J].重庆医科大学学报，2026，51（10）：1434-1440.

Zou Xia,Li Haixiang,Wang Xiying,et al.Classification of the development trajectory of symptom distress and core influencing factors in patients with advanced lung cancer undergoing concurrent chemoradiotherapy based on the latent variable mixed growth model[J].Journal of Chongqing Medical University,2026,51(10):1434-1440.
邹霞，李海香，王希英，等.基于潜变量混合增长模型的中晚期肺癌同步放化疗患者症状困扰的发展轨迹分类及核心影响因素分析[J].重庆医科大学学报，2026，51（10）：1434-1440. DOI： 10.13406/j.cnki.cyxb.004120.

Zou Xia,Li Haixiang,Wang Xiying,et al.Classification of the development trajectory of symptom distress and core influencing factors in patients with advanced lung cancer undergoing concurrent chemoradiotherapy based on the latent variable mixed growth model[J].Journal of Chongqing Medical University,2026,51(10):1434-1440. DOI： 10.13406/j.cnki.cyxb.004120.

摘要

目的

探究中晚期肺癌同步放化疗患者症状困扰的发展轨迹类别并分析其差异的核心影响因素。

方法

选取2021年12月至2024年12月在暨南大学附属广东省第二人民医院接受同步放化疗的400例患者作为研究对象，采用症状困扰量表（symptom distress scale，SDS）评估患者在治疗前（T1）、治疗1周（T2）、治疗3周（T3）及治疗5周（T4）的症状困扰发展轨迹，通过增长混合模型分析最优类别数量并命名。通过单因素分析及多因素logistic回归分析，探讨患者症状困扰不同潜在类别差异的核心影响因素。

结果

400例受调查患者中共纳入380例资料有效者进行分析。结果显示，380例患者的症状演变模式经潜在类别分析可分为3种类型，低症状困扰稳定型98例（25.79%）、中等症状困扰加重型172例（45.26%）、高症状困扰稳定型110例（28.95%）。多因素logistic回归分析结果显示，毒副反应程度、自我护理能力、家庭关怀、社会支持均是患者症状困扰轨迹类型差异的核心影响因素，差异有统计学意义（

0.05）。

结论

中晚期肺癌患者同步放化疗期间症状困扰发展轨迹存在一定的异质性，且不同轨迹类型间影响因素存在差异，医护人员可构建多维度支持体系以缓解症状困扰，从而提高患者的治疗依从性及生活质量。

Abstract

Objective

To investigate the classification of the development trajectory of symptom distress in patients with advanced-stage lung cancer undergoing concurrent chemoradiotherapy，and to identify core influencing factors.

Methods

A total of 400 patients who underwent concurrent chemoradiotherapy in Guangdong Second Provincial General Hospital，Jinan University，from December 2021 to December 2024 were enrolled. Symptom Distress Scale（SDS） was used to assess the development trajectory of symptom distress before treatment（T1） and after 1，3，and 5 weeks of treatment（T2，T3，and T4，respectively），and growth mixture modeling was used to determine the optimal number of trajectory categories，which were subsequently labeled. The univariate and multivariate logistic regression analyses were used to identify the core influencing factors for the differences in trajectories of symptom distress.

Results

Among the 400 patients，380 patients with valid data were included for analysis. The results showed that the symptom evolution pattern of the 380 patients could be classified into three categories through latent class analysis，i.e.，a low-and-stable symptom distress trajectory in 98 patients（25.79%），a moderate-but-escalating symptom distress trajectory in 172 patients （45.26%），and a high-and-stable symptom distress trajectory in 110 patients（28.95%）. The multivariate logistic regression analysis showed that the severity of toxic and side effects，self-nursing ability，family care，and social support were all core influencing factors for the differences in symptom distress trajectories among patients，and such differences were statistically significant（

0.05）.

Conclusion

The development trajectory of symptom distress shows certain heterogeneity in patients with advanced lung cancer during concurrent chemoradiotherapy，and there are different influencing factors between the patients with different trajectories. Medical staff can establish a multi-dimensional support system to alleviate symptom distress and improve treatment compliance and quality of life of patients.

关键词

Keywords

references

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