Symptom clustering in advanced cancer

被引:225
作者
Walsh, Declan
Rybicki, Lisa
机构
[1] Cleveland Clin Fdn, Cleveland, OH 44195 USA
[2] Cleveland Clin, Taussig Canc Ctr, Harry R Horvitz Ctr Palliat Med, Dept Quantitat Hlth Sci, Cleveland, OH 44106 USA
关键词
cancer; clusters; fatigue; gastrointestinal; symptoms;
D O I
10.1007/s00520-005-0899-z
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
A major goal of palliative medicine is to control symptoms that interfere with quality of life. Identification of symptoms that occur together (cluster) may aid in symptom management, resulting in greater therapeutic benefit to the patient. An analysis of 25 symptoms from 922 patients with advanced cancer was undertaken to determine if symptom clusters could be identified. Cluster analysis was done using an agglomerative hierarchical method with average linkage; the absolute value of the correlation between pairs of symptoms was used as the measure of similarity. A correlation of >= 0.68 was used to define the final clusters. Seven clusters were identified: (1) fatigue: anorexia-cachexia; (2) neuropsychological; (3) upper gastrointestinal; (4) nausea and vomiting; (5) aerodigestive; (6) debility; (7) pain. Recognition of symptom clusters should help understand symptom pathophysiology and target therapies that perhaps can be used to relieve multiple symptoms in that cluster. This could result in improved quality of life for patients with advanced cancer and perhaps reduce polypharmacy, lessen drug side effects, and have pharmacoeconomic benefits.
引用
收藏
页码:831 / 836
页数:6
相关论文
共 25 条
[1]  
BRUERA E, 1986, CANCER TREAT REP, V70, P1383
[2]  
Cleeland CS, 2000, CANCER-AM CANCER SOC, V89, P1634, DOI 10.1002/1097-0142(20001001)89:7<1634::AID-CNCR29>3.0.CO
[3]  
2-V
[4]  
Curtis E B, 1991, J Palliat Care, V7, P25
[5]  
Dodd M J, 2001, Oncol Nurs Forum, V28, P465
[6]   THE SYMPTOMS OF ADVANCED CANCER - IDENTIFICATION OF CLINICAL AND RESEARCH PRIORITIES BY ASSESSMENT OF PREVALENCE AND SEVERITY [J].
DONNELLY, S ;
WALSH, D ;
RYBICKI, L .
JOURNAL OF PALLIATIVE CARE, 1995, 11 (01) :27-32
[7]  
DONNELLY S, 1995, SEMIN ONCOL, V22, P67
[8]  
Fleishman Stewart B, 2004, J Natl Cancer Inst Monogr, P119
[9]   Coping with breast cancer: a cluster analytic approach [J].
Hack, TF ;
Degner, LF .
BREAST CANCER RESEARCH AND TREATMENT, 1999, 54 (03) :185-194
[10]   Symptom clustering in subjects with and without diabetes mellitus: A population-based study of 15,000 Australian adults [J].
Hammer, J ;
Howell, S ;
Bytzer, P ;
Horowitz, M ;
Talley, NJ .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2003, 98 (02) :391-398