{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:29:11Z","timestamp":1787761751944,"version":"build-2784847793"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The purpose of this study is to determine the incidence and severity of symptoms of patients with cervical cancer within 6 months after radiotherapy and chemotherapy, form a symptom burden report, evaluate the distribution characteristics of symptoms, identify symptom clusters, and provide a basis for clinical doctors and nurses to improve the symptom management of patients with cervical cancer after radiotherapy and chemotherapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The patients with cervical cancer within 6 months after radiotherapy and chemotherapy were recruited to investigate their symptom burden. Exploratory factor analysis was used to identify symptom clusters.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 250 patients participated in the study. The study found that the most common symptom among the 40 symptoms was fatigue, and the most serious symptom was nocturia. Based on the occurrence rate and severity of symptoms, nine symptom clusters were identified, including psycho\u2013emotion-related symptom cluster, pain\u2013disturbed sleep-related symptom cluster, menopausal symptom cluster, tinnitus\u2013dizziness-related symptom cluster, urinary-related symptom cluster, dry mouth\u2013bitter taste-related symptom cluster, intestinal-related symptom cluster, memory loss\u2013numbness-related symptom cluster, and emaciation-related symptom cluster. The three most serious symptom clusters are pain\u2013disturbed sleep-related symptom cluster, urinary-related symptom cluster, and memory loss\u2013numbness-related symptom cluster.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The symptoms of patients with cervical cancer within 6 months after radiotherapy and chemotherapy are complex, and nine symptom clusters can be identified according to the incidence and severity of symptoms. We can find the potential biological mechanism of each symptom cluster through the discussion of previous mechanism research and clinical research. The number of symptom clusters and the number of symptoms within the symptom cluster are closely related to the symptom evaluation scale selected for the study. Therefore, the symptom cluster study urgently needs a targeted symptom evaluation scale that can comprehensively reflect the patient\u2019s condition.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00520-023-07802-7","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T08:05:42Z","timestamp":1684224342000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Symptom burden survey and symptom clusters in patients with cervical cancer: a cross-sectional survey"],"prefix":"10.1007","volume":"31","author":[{"given":"Kai-nan","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-han","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-ying","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-hang","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"7802_CR1","unstructured":"World Health Organization (WHO). World cancer report 2020.2020. URL: https:\/\/www.iarc.fr\/cards_page\/world-cancer-report\/."},{"issue":"2","key":"7802_CR2","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.ygyno.2017.08.009","volume":"147","author":"ST Heijkoop","year":"2017","unstructured":"Heijkoop ST, Nout RA, Quint S, Mens JWM, Heijmen BJM, Hoogeman MS (2017) Dynamics of patient reported quality of life and symptoms in the acute phase of online adaptive external beam radiation therapy for locally advanced cervical cancer. Gynecol Oncol 147(2):439\u2013449","journal-title":"Gynecol Oncol"},{"issue":"4","key":"7802_CR3","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/j.soncn.2016.08.001","volume":"32","author":"A Barsevick","year":"2016","unstructured":"Barsevick A (2016) Defining the symptom cluster: how far have we come? Semin Oncol Nurs 32(4):334\u2013350","journal-title":"Semin Oncol Nurs"},{"issue":"4","key":"7802_CR4","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1001\/jamapsychiatry.2017.0025","volume":"74","author":"AM Chekroud","year":"2017","unstructured":"Chekroud AM, Gueorguieva R, Krumholz HM, Trivedi MH, Krystal JH, McCarthy G (2017) Reevaluating the efficacy and predictability of antidepressant treatments: a symptom clustering approach. JAMA Psychiatry 74(4):370\u2013378","journal-title":"JAMA Psychiatry"},{"issue":"1","key":"7802_CR5","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.jpainsymman.2005.05.015","volume":"31","author":"AM Barsevick","year":"2006","unstructured":"Barsevick AM, Whitmer K, Nail LM, Beck SL, Dudley WN (2006) Symptom cluster research: conceptual, design, measurement, and analysis issues. J Pain Symptom Manage 31(1):85\u201395","journal-title":"J Pain Symptom Manage"},{"issue":"5","key":"7802_CR6","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/j.jpainsymman.2009.09.012","volume":"39","author":"A Molassiotis","year":"2010","unstructured":"Molassiotis A, Wengstr\u00f6m Y, Kearney N (2010) Symptom cluster patterns during the first year after diagnosis with cancer. J Pain Symptom Manage 39(5):847\u2013858","journal-title":"J Pain Symptom Manage"},{"issue":"4","key":"7802_CR7","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1097\/00002820-200507000-00005","volume":"28","author":"HJ Kim","year":"2005","unstructured":"Kim HJ, McGuire DB, Tulman L, Barsevick AM (2005) Symptom clusters: concept analysis and clinical implications for cancer nursing. Cancer Nurs 28(4):270\u2013284","journal-title":"Cancer Nurs"},{"issue":"3","key":"7802_CR8","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/j.1547-5069.2005.00037.x","volume":"37","author":"KP Parker","year":"2005","unstructured":"Parker KP, Kimble LP, Dunbar SB, Clark PC (2005) Symptom interactions as mechanisms underlying symptom pairs and clusters. J Nurs Scholarsh 37(3):209\u2013215","journal-title":"J Nurs Scholarsh"},{"issue":"1","key":"7802_CR9","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s12894-017-0255-x","volume":"17","author":"H Ren","year":"2017","unstructured":"Ren H, Tang P, Zhao Q, Ren G (2017) Symptom clusters and related factors in bladder cancer patients three months after radical cystectomy. BMC Urol 17(1):65","journal-title":"BMC Urol"},{"issue":"1","key":"7802_CR10","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1188\/20.ONF.89-100","volume":"47","author":"L Lee","year":"2020","unstructured":"Lee L, Ross A, Griffith K, Jensen RE, Wallen GR (2020) Symptom clusters in breast cancer survivors: a latent class profile analysis. Oncol Nurs Forum 47(1):89\u2013100","journal-title":"Oncol Nurs Forum"},{"issue":"5","key":"7802_CR11","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1016\/j.jpainsymman.2019.02.002","volume":"57","author":"J Russell","year":"2019","unstructured":"Russell J, Wong ML, Mackin L, Paul SM, Cooper BA, Hammer M, Conley YP, Wright F, Levine JD, Miaskowski C (2019) Stability of symptom clusters in patients with lung cancer receiving chemotherapy. J Pain Symptom Manage 57(5):909\u2013922","journal-title":"J Pain Symptom Manage"},{"issue":"4","key":"7802_CR12","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1055\/s-0038-1666807","volume":"107","author":"JL Bagot","year":"2018","unstructured":"Bagot JL, Marechaud N, Deana N, Wendling J (2018) Homeopathic treatment of insomnia and symptom clusters related to cerebral chemotoxicity in oncology. Homeopathy 107(4):292\u2013298","journal-title":"Homeopathy"},{"issue":"6","key":"7802_CR13","doi-asserted-by":"publisher","first-page":"E304","DOI":"10.1097\/NCC.0000000000000730","volume":"43","author":"WKW So","year":"2020","unstructured":"So WKW, Law BMH, Chan DNS, Xing W, Chan CWH, McCarthy AL (2020) The effect of nonpharmacological interventions on managing symptom clusters among cancer patients: a systematic review. Cancer Nurs 43(6):E304\u2013E327","journal-title":"Cancer Nurs"},{"key":"7802_CR14","first-page":"807974","volume":"12","author":"L Zhang","year":"2022","unstructured":"Zhang L, Wang J, Chen T, Tian M, Zhou Q, Ren J (2022) Symptom clusters and quality of life in cervical cancer patients receiving concurrent chemoradiotherapy: the mediating role of illness perceptions. Front. Psychiatry 12:807974","journal-title":"Psychiatry"},{"issue":"3","key":"7802_CR15","first-page":"398","volume":"38","author":"CL Wang","year":"2017","unstructured":"Wang CL, Wu WY, Lou HM et al (2017) Analysis of symptom clusters in Chinese cervical cancer patients undergoing radiotherapy, chemoradiotherapy, or postoperative chemoradiotherapy. Eur J Gynaecol Oncol 38(3):398\u2013403","journal-title":"Eur J Gynaecol Oncol"},{"issue":"7","key":"7802_CR16","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1002\/1097-0142(20001001)89:7<1634::AID-CNCR29>3.0.CO;2-V","volume":"89","author":"CS Cleeland","year":"2000","unstructured":"Cleeland CS, Mendoza TR, Wang XS et al (2000) Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. Cancer 89(7):1634\u20131646","journal-title":"Cancer"},{"issue":"9","key":"7802_CR17","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1016\/0959-8049(94)90182-1","volume":"30A","author":"RK Portenoy","year":"1994","unstructured":"Portenoy RK, Thaler HT, Kornblith AB et al (1994) The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30A(9):1326\u20131336","journal-title":"Eur J Cancer"},{"issue":"10","key":"7802_CR18","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1038\/nrclinonc.2014.127","volume":"11","author":"JE Bower","year":"2014","unstructured":"Bower JE (2014) Cancer-related fatigue--mechanisms, risk factors, and treatments. Nat Rev Clin Oncol 11(10):597\u2013609","journal-title":"Nat Rev Clin Oncol"},{"issue":"1","key":"7802_CR19","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1038\/npp.2011.205","volume":"37","author":"E Haroon","year":"2012","unstructured":"Haroon E, Raison CL, Miller AH (2012) Psychoneuroimmunology meets neuropsychopharmacology: translational implications of the impact of inflammation on behavior. Neuropsychopharmacology 37(1):137\u2013162","journal-title":"Neuropsychopharmacology"},{"issue":"1","key":"7802_CR20","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.jpainsymman.2016.08.005","volume":"53","author":"RR Reich","year":"2017","unstructured":"Reich RR, Lengacher CA, Alinat CB et al (2017) Mindfulness-based stress reduction in post-treatment breast cancer patients: immediate and sustained effects across multiple symptom clusters. J Pain Symptom Manage 53(1):85\u201395","journal-title":"J Pain Symptom Manage"},{"issue":"1","key":"7802_CR21","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.jpainsymman.2015.07.013","volume":"51","author":"ST Dong","year":"2016","unstructured":"Dong ST, Costa DS, Butow PN et al (2016) Symptom clusters in advanced cancer patients: an empirical comparison of statistical methods and the impact on quality of life. J Pain Symptom Manage 51(1):88\u201398","journal-title":"J Pain Symptom Manage"},{"issue":"Suppl 1","key":"7802_CR22","doi-asserted-by":"publisher","first-page":"S112","DOI":"10.1016\/S0889-1591(02)00077-6","volume":"17","author":"KW Kelley","year":"2003","unstructured":"Kelley KW, Bluth\u00e9 RM, Dantzer R et al (2003) Cytokine-induced sickness behavior. Brain Behav Immun 17(Suppl 1):S112\u2013S118","journal-title":"Brain Behav Immun"},{"issue":"5","key":"7802_CR23","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1159\/000079408","volume":"11","author":"BN Lee","year":"2004","unstructured":"Lee BN, Dantzer R, Langley KE et al (2004) A cytokine-based neuroimmunologic mechanism of cancer-related symptoms. Neuroimmunomodulation 11(5):279\u2013292","journal-title":"Neuroimmunomodulation"},{"issue":"3","key":"7802_CR24","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1080\/0167482X.2017.1291624","volume":"38","author":"K Weidner","year":"2017","unstructured":"Weidner K, Croy I, Siepmann T, Br\u00e4hler E, Beutel M, Bittner A (2017) Menopausal syndrome limited to hot flushes and sweating a representative survey study. J Psychosom Obstet Gynaecol 38(3):170\u2013179","journal-title":"J Psychosom Obstet Gynaecol"},{"issue":"3","key":"7802_CR25","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1136\/ijgc-2020-002032","volume":"31","author":"A Brennan","year":"2021","unstructured":"Brennan A, Brennan D, Rees M, Hickey M (2021) Management of menopausal symptoms and ovarian function preservation in women with gynecological cancer. Int J Gynecol Cancer 31(3):352\u2013359","journal-title":"Int J Gynecol Cancer"},{"issue":"2","key":"7802_CR26","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1097\/NCC.0000000000000252","volume":"39","author":"J Huang","year":"2016","unstructured":"Huang J, Gu L, Zhang L, Lu X, Zhuang W, Yang Y (2016) Symptom clusters in ovarian cancer patients with chemotherapy after surgery: a longitudinal survey. Cancer Nurs 39(2):106\u2013116","journal-title":"Cancer Nurs"},{"issue":"4","key":"7802_CR27","doi-asserted-by":"publisher","first-page":"E706","DOI":"10.1097\/NCC.0000000000000988","volume":"45","author":"RA Pozzar","year":"2022","unstructured":"Pozzar RA, Hammer MJ, Cooper BA et al (2022) Stability of symptom clusters in patients with gynecologic cancer receiving chemotherapy. Cancer Nurs 45(4):E706\u2013E718","journal-title":"Cancer Nurs"},{"issue":"6","key":"7802_CR28","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1002\/ana.24951","volume":"81","author":"NP Staff","year":"2017","unstructured":"Staff NP, Grisold A, Grisold W, Windebank AJ (2017) Chemotherapy-induced peripheral neuropathy: a current review. Ann Neurol 81(6):772\u2013781","journal-title":"Ann Neurol"},{"issue":"2","key":"7802_CR29","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1188\/12.ONF.157-165","volume":"39","author":"CH Cherwin","year":"2012","unstructured":"Cherwin CH (2012) Gastrointestinal symptom representation in cancer symptom clusters: a synthesis of the literature. Oncol Nurs Forum 39(2):157\u2013165","journal-title":"Oncol Nurs Forum"},{"issue":"2","key":"7802_CR30","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.21037\/tcr-20-2589","volume":"10","author":"J Chorbi\u0144ska","year":"2021","unstructured":"Chorbi\u0144ska J, Krajewski W, Zdrojowy R (2021) Urological complications after radiation therapy-nothing ventured, nothing gained: a narrative review. Transl Cancer Res 10(2):1096\u20131118","journal-title":"Transl Cancer Res"},{"issue":"5","key":"7802_CR31","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1007\/s11894-014-0383-3","volume":"16","author":"AH Harb","year":"2014","unstructured":"Harb AH, Abou Fadel C, Sharara AI (2014) Radiation enteritis. Curr Gastroenterol Rep 16(5):383","journal-title":"Curr Gastroenterol Rep"},{"issue":"2","key":"7802_CR32","doi-asserted-by":"publisher","first-page":"140","DOI":"10.21037\/apm.2018.08.06","volume":"8","author":"E McKenzie","year":"2019","unstructured":"McKenzie E, Zhang L, Zaki P et al (2019) Re-analysis of symptom clusters in advanced cancer patients attending a palliative outpatient radiotherapy clinic. Ann Palliat Med 8(2):140\u2013149","journal-title":"Ann Palliat Med"},{"key":"7802_CR33","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.ejon.2019.07.004","volume":"42","author":"S Chow","year":"2019","unstructured":"Chow S, Wan BA, Pidduck W et al (2019) Symptom clusters in patients with breast cancer receiving radiation therapy. Eur J Oncol Nurs 42:14\u201320","journal-title":"Eur J Oncol Nurs"},{"issue":"1","key":"7802_CR34","doi-asserted-by":"publisher","first-page":"E20","DOI":"10.1188\/12.ONF.E20-E30","volume":"39","author":"HJ Kim","year":"2012","unstructured":"Kim HJ, Barsevick AM, Beck SL, Dudley W (2012) Clinical subgroups of a psychoneurologic symptom cluster in women receiving treatment for breast cancer: a secondary analysis. Oncol Nurs Forum 39(1):E20\u2013E30","journal-title":"Oncol Nurs Forum"},{"issue":"6","key":"7802_CR35","doi-asserted-by":"publisher","first-page":"e13322","DOI":"10.1111\/ecc.13322","volume":"29","author":"HC Hong","year":"2020","unstructured":"Hong HC, Kim YM, Min A (2020) Symptom clusters in childhood cancer survivors in Korea: a latent class analysis. Eur J Cancer Care (Engl) 29(6):e13322","journal-title":"Eur J Cancer Care (Engl)"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-023-07802-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-023-07802-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-023-07802-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T09:08:09Z","timestamp":1686388089000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-023-07802-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,16]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["7802"],"URL":"https:\/\/doi.org\/10.1007\/s00520-023-07802-7","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,16]]},"assertion":[{"value":"9 January 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 May 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study obtained ethical approval from the Ethics Committee of Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Written informed consent for publication was obtained from all participants.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"338"}}