{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:19:10Z","timestamp":1790270350750,"version":"4.1.0"},"reference-count":66,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009509","name":"Kementerian Riset Teknologi Dan Pendidikan Tinggi Republik Indonesia","doi-asserted-by":"publisher","award":["2258\/UN1\/DITLIT\/DIT-LIT\/PT\/2020"],"award-info":[{"award-number":["2258\/UN1\/DITLIT\/DIT-LIT\/PT\/2020"]}],"id":[{"id":"10.13039\/501100009509","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012521","name":"Universitas Gadjah Mada","doi-asserted-by":"publisher","award":["1642\/UN1\/FKKMK.1.3\/PPKE\/PT\/2023"],"award-info":[{"award-number":["1642\/UN1\/FKKMK.1.3\/PPKE\/PT\/2023"]}],"id":[{"id":"10.13039\/501100012521","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This study aims to characterize patient-reported chemotherapy-induced toxicity in patients with breast cancer, determine its association with treatment regimens and patient characteristics, identify toxicity symptom clusters within a specific chemotherapy timeframe and analyze the correlation between symptom clusters within and between the timeframe to understand the changes and influences across chemotherapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Forty-six patient-reported toxicities during neoadjuvant\/adjuvant chemotherapy for breast cancer were evaluated using adapted CTCAE version 4.0. Chi-Square\/Fisher\u2019s Exact test was performed to analyze the difference in the incidence of toxicity symptoms by chemotherapy regimens. Poisson regression performed to assess factors associated with patient\u2019s total chemotherapy toxicity. Exploratory factor analysis (EFA) conducted to identify symptom clusters at T1 (first half) and T2 (second half of planned cycle). Factor scores were generated and Spearman correlation performed to explore the factor scores correlation between symptom clusters.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 142 patients with stage I-III breast cancer were included. The incidence of several toxicities differed significantly among three chemotherapy regimens. Subjects age \u226551 years are associated with lower number of reported toxicity (IRR\/incidence rate ratio = 0.94, 95% confidence interval\/CI 0.88 to 0.99, p = 0.042). Receiving more chemotherapy cycles are associated with higher number of reported toxicity (IRR = 1.06, 95% CI 1.03 to 1.10, p&lt;0.001). Two symptom clusters identified at T1 (psychoneurological-pain\/PNP-T1 and gastrointestinal-psychological\/GIP-T1 cluster) and three at T2 (psychoneurological-pain\/PNP-T2, epithelial\/EPI-T2, and gastrointestinal cluster\/GI-T2), with moderate-strong positive correlation between PNP-T1 and GIP-T2 (p&lt;0.001), PNP-T1 and PNP-T2 (p&lt;0.001), and GIP-T1 and PNP-T2 (p&lt;0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study investigated 46 patient-reported toxicities prospectively during adjuvant\/neoadjuvant chemotherapy for early breast cancer. Anthracycline-taxane combination regimen had higher proportions of toxicity incidence. Subject\u2019s age and number of chemotherapy cycles significantly associated with total number of toxicity symptoms. Two symptom clusters at T1 and three at T2 were identified, with significant correlation between symptom clusters within and between chemotherapy timeframe.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0298928","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T18:56:43Z","timestamp":1708714603000},"page":"e0298928","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Patient-reported outcomes and symptom clusters pattern of chemotherapy-induced toxicity in patients with early breast cancer"],"prefix":"10.1371","volume":"19","author":[{"given":"Juan Adrian","family":"Wiranata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9236-9435","authenticated-orcid":true,"given":"Susanna 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of life of women with breast cancer?","volume":"16","author":"SY Hwang","year":"2013","journal-title":"J Breast Cancer."},{"key":"pone.0298928.ref007","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.breast.2022.04.001","article-title":"\u201cAlas \u2026 my sickness becomes my family\u2019s burden\u201d: A nested qualitative study on the experience of advanced breast cancer patients across the disease trajectory in Indonesia.","volume":"63","author":"YS Prabandari","year":"2022","journal-title":"The Breast"},{"key":"pone.0298928.ref008","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1634\/theoncologist.5-3-250","article-title":"The Consequences of Diarrhea Occurring During Chemotherapy for Colorectal Cancer: A Retrospective Study.","volume":"5","author":"RB Arbuckle","year":"2000","journal-title":"Oncologist"},{"key":"pone.0298928.ref009","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1200\/JCO.2010.31.3049","article-title":"Impact of comorbidity on chemotherapy use and outcomes in solid tumors: a systematic review.","volume":"29","author":"L Lee","year":"2011","journal-title":"J Clin Oncol"},{"key":"pone.0298928.ref010","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1002\/onco.13822","article-title":"Relative Dose Intensity of Chemotherapy and Survival in Patients with Advanced Stage Solid Tumor Cancer: A Systematic Review and Meta-Analysis.","volume":"26","author":"CM Nielson","year":"2021","journal-title":"Oncologist"},{"key":"pone.0298928.ref011","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1093\/ije\/dyp174","article-title":"How to assess the external validity of therapeutic trials: a conceptual approach.","volume":"39","author":"OM Dekkers","year":"2010","journal-title":"Int J Epidemiol."},{"key":"pone.0298928.ref012","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1001\/archinternmed.2009.306","article-title":"Reporting of Safety Results in Published Reports of Randomized Controlled Trials","volume":"169","author":"I Pitrou","year":"2009","journal-title":"Arch Intern Med"},{"key":"pone.0298928.ref013","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/nrclinonc.2015.222","article-title":"Patient-reported outcomes in the evaluation of toxicity of anticancer treatments.","volume":"13","author":"M Di Maio","year":"2016","journal-title":"Nat Rev Clin Oncol"},{"key":"pone.0298928.ref014","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/1472-6963-13-211","article-title":"A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting.","volume":"13","author":"J Chen","year":"2013","journal-title":"BMC Health Serv Res"},{"key":"pone.0298928.ref015","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1002\/(SICI)1097-0142(20000301)88:5<1175::AID-CNCR30>3.0.CO;2-N","article-title":"Symptom and quality of life survey of medical oncology patients at a veterans affairs medical center: a role for symptom assessment","volume":"5","author":"VT Chang","year":"2000","journal-title":"Cancer"},{"key":"pone.0298928.ref016","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.soncn.2016.08.004","article-title":"Cancer Symptom Cluster Management.","volume":"32","author":"KL Kwekkeboom","year":"2016","journal-title":"Semin Oncol Nurs"},{"key":"pone.0298928.ref017","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1136\/bmjspcare-2021-003325","article-title":"Symptom clusters in patients receiving chemotherapy: A systematic review","volume":"12","author":"CS Harris","year":"2022","journal-title":"BMJ Support Palliat Care"},{"key":"pone.0298928.ref018","doi-asserted-by":"crossref","first-page":"e0184360","DOI":"10.1371\/journal.pone.0184360","article-title":"Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study.","volume":"12","author":"A Pearce","year":"2017","journal-title":"PLoS One."},{"key":"pone.0298928.ref019","doi-asserted-by":"crossref","first-page":"3084","DOI":"10.1002\/cncr.32898","article-title":"Congruence of patient\u2010 and clinician\u2010reported toxicity in women receiving chemotherapy for early breast cancer","volume":"126","author":"KA Nyrop","year":"2020","journal-title":"Cancer"},{"key":"pone.0298928.ref020","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1038\/s41572-019-0111-2","article-title":"Breast cancer.","volume":"5","author":"N Harbeck","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"pone.0298928.ref021","volume-title":"Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0.","author":"National Cancer Institute","year":"2010"},{"key":"pone.0298928.ref022","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1097\/01.NCC.0000305757.58615.c8","article-title":"Statistical Approaches to Modeling Symptom Clusters in Cancer Patients.","volume":"31","author":"H-J Kim","year":"2008","journal-title":"Cancer Nurs"},{"key":"pone.0298928.ref023","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1477-7525-12-32","article-title":"Item response theory and factor analysis as a mean to characterize occurrence of response shift in a longitudinal quality of life study in breast cancer patients","volume":"12","author":"A Anota","year":"2014","journal-title":"Health Qual Life Outcomes"},{"key":"pone.0298928.ref024","volume-title":"MINAP: Stata module to calculate minimum average partial correlation for principal components","author":"S. Soldz","year":"2002"},{"key":"pone.0298928.ref025","first-page":"291","volume-title":"Implementing Horn\u2019s parallel analysis for principal component analysis and factor analysis","author":"A. Dinno","year":"2009"},{"key":"pone.0298928.ref026","volume-title":"Multivariate data analysis","author":"JF Hair","year":"2009","edition":"7"},{"key":"pone.0298928.ref027","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.jrp.2010.03.002","article-title":"Item selection, evaluation, and simple structure in personality data","volume":"44","author":"E Pettersson","year":"2010","journal-title":"J Res Pers"},{"key":"pone.0298928.ref028","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1207\/S15327752JPA8001_18","article-title":"Starting at the Beginning: An Introduction to Coefficient Alpha and Internal Consistency.","volume":"80","author":"DL Streiner","year":"2003","journal-title":"J Pers Assess."},{"key":"pone.0298928.ref029","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1037\/1040-3590.7.3.286","article-title":"Factor analysis in the development and refinement of clinical assessment instruments","volume":"7","author":"FJ Floyd","year":"1995","journal-title":"Psychol Assess"},{"key":"pone.0298928.ref030","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1023\/A:1008191211004","article-title":"A Meta-Analysis of Variance Accounted for and Factor Loadings in Exploratory Factor Analysis.","volume":"11","author":"RA Peterson","year":"2000","journal-title":"Mark Lett."},{"key":"pone.0298928.ref031","doi-asserted-by":"crossref","DOI":"10.4324\/9781003149286","volume-title":"A Step-By-Step Guide to Exploratory Factor Analysis with Stata","author":"MW Watkins","year":"2021"},{"key":"pone.0298928.ref032","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1080\/10447318.2015.1087664","article-title":"A Review of Exploratory Factor Analysis Decisions and Overview of Current Practices: What We Are Doing and How Can We Improve?","volume":"32","author":"MC Howard","year":"2016","journal-title":"Int J Hum Comput Interact."},{"key":"pone.0298928.ref033","article-title":"Understanding and Using Factor Scores: Considerations for the Applied Researcher.","volume":"14","author":"C DiStefano","year":"2009","journal-title":"Practical Assessment, Research & Evaluation (PARE)."},{"key":"pone.0298928.ref034","author":"K Williams","year":"2016","journal-title":"Patient-reported outcome measures Literature review"},{"key":"pone.0298928.ref035","doi-asserted-by":"crossref","first-page":"dju244","DOI":"10.1093\/jnci\/dju244","article-title":"Development of the National Cancer Institute\u2019s Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE).","volume":"106","author":"E Basch","year":"2014","journal-title":"JNCI Journal of the National Cancer Institute"},{"key":"pone.0298928.ref036","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1634\/theoncologist.2018-0590","article-title":"Patient-Reported Toxicities During Chemotherapy Regimens in Current Clinical Practice for Early Breast Cancer.","volume":"24","author":"KA Nyrop","year":"2019","journal-title":"Oncologist"},{"key":"pone.0298928.ref037","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1093\/jnci\/djq097","article-title":"Impact of cultural and linguistic factors on symptom reporting by patients with cancer","volume":"102","author":"XS Wang","year":"2010","journal-title":"J Natl Cancer Inst"},{"key":"pone.0298928.ref038","doi-asserted-by":"crossref","first-page":"4806","DOI":"10.1158\/1078-0432.CCR-09-0344","article-title":"Cancer Pharmacoethnicity: Ethnic Differences in Susceptibility to the Effects of Chemotherapy","volume":"15","author":"PH O\u2019Donnell","year":"2009","journal-title":"Clinical Cancer Research"},{"key":"pone.0298928.ref039","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s10147-011-0349-5","article-title":"Pharmacoethnicity of docetaxel-induced severe neutropenia: integrated analysis of published phase II and III trials.","volume":"18","author":"R Yano","year":"2013","journal-title":"Int J Clin Oncol"},{"key":"pone.0298928.ref040","article-title":"Cross-cultural differences in somatic awareness and interoceptive accuracy: A review of the literature and directions for future research.","author":"C. Ma-Kellams","year":"2014","journal-title":"Frontiers in Psychology. Frontiers Media S.A."},{"key":"pone.0298928.ref041","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00520-021-06399-z","article-title":"The role of spirituality in symptom experiences among adults with cancer","volume":"30","author":"M Miller","year":"2022","journal-title":"Supportive Care in Cancer"},{"key":"pone.0298928.ref042","author":"C Hackett","year":"2018","journal-title":"The Age Gap in Religion Around The World"},{"key":"pone.0298928.ref043","doi-asserted-by":"crossref","first-page":"e10883","DOI":"10.2196\/10883","article-title":"Exploring the Experiences of Cancer Patients With Chemotherapy-Induced Ototoxicity: Qualitative Study Using Online Health Care Forums.","volume":"5","author":"SE Pearson","year":"2019","journal-title":"JMIR Cancer"},{"key":"pone.0298928.ref044","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s44178-022-00008-7","article-title":"Nail pigmentation induced by chemotherapy: an observational study of patients with early-stage breast cancer","volume":"1","author":"K Jiang","year":"2022","journal-title":"Holistic Integrative Oncology"},{"key":"pone.0298928.ref045","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.clbc.2022.02.002","article-title":"Ocular Toxicity in Breast Cancer Management: Manual for The Oncologist.","volume":"22","author":"F Canino","year":"2022","journal-title":"Clin Breast Cancer"},{"key":"pone.0298928.ref046","doi-asserted-by":"crossref","first-page":"e214158","DOI":"10.1001\/jamaoncol.2021.4158","article-title":"Geriatric Assessment\u2013Driven Intervention (GAIN) on Chemotherapy-Related Toxic Effects in Older Adults With Cancer.","volume":"7","author":"D Li","year":"2021","journal-title":"JAMA Oncol"},{"key":"pone.0298928.ref047","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1471-2407-13-6","article-title":"Differences in the symptom experience of older versus younger oncology outpatients: a cross-sectional study","volume":"13","author":"JK Cataldo","year":"2013","journal-title":"BMC Cancer"},{"key":"pone.0298928.ref048","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1037\/a0013221","article-title":"Psychosocial adjustment among cancer survivors: Findings from a national survey of health and well-being","volume":"28","author":"ES Costanzo","year":"2009","journal-title":"Health Psychology"},{"key":"pone.0298928.ref049","doi-asserted-by":"crossref","first-page":"2531","DOI":"10.1002\/cam4.3794","article-title":"Symptom clusters experienced by breast cancer patients at various treatment stages: A systematic review","volume":"10","author":"WKW So","year":"2021","journal-title":"Cancer Med"},{"key":"pone.0298928.ref050","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.soncn.2007.01.006","article-title":"Clinical Management of Symptom Clusters","volume":"23","author":"L. Williams","year":"2007","journal-title":"Semin Oncol Nurs."},{"key":"pone.0298928.ref051","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.3892\/ol.2015.2944","article-title":"Depression in cancer patients: Pathogenesis, implications and treatment (Review).","volume":"9","author":"R. Hamish","year":"2015","journal-title":"Oncol Lett."},{"key":"pone.0298928.ref052","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.neubiorev.2021.08.024","article-title":"Chemo-brain: An activation likelihood estimation meta-analysis of functional magnetic resonance imaging studies.","volume":"130","author":"LJ Bernstein","year":"2021","journal-title":"Neurosci Biobehav Rev"},{"key":"pone.0298928.ref053","doi-asserted-by":"crossref","first-page":"700","DOI":"10.2522\/ptj.20100330","article-title":"Impact of Psychological Factors in the Experience of Pain","volume":"91","author":"SJ Linton","year":"2011","journal-title":"Phys Ther"},{"key":"pone.0298928.ref054","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1002\/pon.3531","article-title":"Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients","volume":"23","author":"EK Choi","year":"2014","journal-title":"Psychooncology"},{"key":"pone.0298928.ref055","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/svms.2003.36617","article-title":"Principles of chemotherapy.","volume":"18","author":"JA McKnight","year":"2003","journal-title":"Clin Tech Small Anim Pract"},{"key":"pone.0298928.ref056","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.ejphar.2013.09.071","article-title":"Anticipatory nausea and vomiting due to chemotherapy","volume":"722","author":"C Kamen","year":"2014","journal-title":"Eur J Pharmacol"},{"key":"pone.0298928.ref057","doi-asserted-by":"crossref","first-page":"4901","DOI":"10.1007\/s00520-016-3346-4","article-title":"Prevalence of cancer chemotherapy-related problems, their relation to health-related quality of life and associated supportive care: a cross-sectional survey.","volume":"24","author":"R Wagland","year":"2016","journal-title":"Supportive Care in 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