Symptom Clusters and Social Support in Patients With Lung Cancer Undergoing Anti-Programmed Death 1/Programmed Death Ligand 1 Immunotherapy: A Cross-sectional Analysis.

BACKGROUND

Anti-programmed death 1/programmed death ligand 1 immunotherapy has greatly advanced lung cancer treatment; however, the symptom clusters experienced by patients during immunotherapy, their influencing factors, and the correlation with social support warrant further attention.

OBJECTIVES

The aims of this study were to explore symptom clusters in patients with lung cancer undergoing anti-programmed death 1/programmed death ligand 1 immunotherapy and investigate their relationship with social support.

METHODS

We studied 133 patients with lung cancer admitted to a Chinese oncology unit. A cross-sectional survey assessed symptoms using the MD Anderson Symptom Inventory and social support using the Social Support Rating Scale. Sociodemographic and disease data were also collected. Exploratory factor analysis was used to identify symptom clusters, and binary logistic regression analysis was used to analyze the influencing factors.

RESULTS

Patients experienced various symptoms, with fatigue and cough being the most common and severe. Exploratory factor analysis revealed 3 clusters: general, lung cancer-specific, and gastrointestinal symptoms. Logistic regression showed that male sex was associated with general and lung cancer-specific symptom clusters. In contrast, previous radiotherapy was associated with the gastrointestinal cluster ( P  < .05). Social support was negatively correlated with the severity of some symptom clusters.

CONCLUSION

The 3 symptom clusters adversely affected patients undergoing immunotherapy. Low social support exacerbated symptom severity.

IMPLICATIONS FOR PRACTICE: Male patients should be monitored for general and lung cancer-specific symptoms, and those with a history of radiotherapy should be monitored for gastrointestinal symptoms. We recommend enhancing social support to alleviate symptom severity and tailoring symptom management strategies for individualized patient care.