Longitudinal Patterns of Symptoms in Patients Undergoing Chemotherapy

How do patient-reported symptoms manifest during a 180-day period, and are longitudinal symptoms associated with mortality in patients undergoing chemotherapy for a gastrointestinal, gynecologic, or thoracic cancer in routine oncology practice settings?In this secondary analysis of a cluster randomized clinical trial of patient-reported outcomes that included 3725 patients undergoing chemotherapy, pain, fatigue, and deficits in physical function and overall well-being were the most frequently reported symptoms. Moderate to severe deficits in physical function as well as moderate to severe pain, dyspnea, and decreased appetite were significantly associated with a higher hazard of mortality 180 days after starting chemotherapy.These results suggest that recognizing which symptoms are associated with an increased hazard of death may help to better support patients with high symptom burden and increased risk of mortality.

Corresponding Author: Roshan Paudel, PhD, MPH, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215 (roshan_paudel@dfci.harvard.edu).

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