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Temporal Patterns of Symptoms During Treatment for Patients With Head and Neck Cancer and an Exploration of Risk Factors
Temporal Patterns of Symptoms During Treatment for Patients With Head and Neck Cancer and an Exploration of Risk Factors
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202104841
- ISBN
- 9798297620308
- DDC
- 610.73
- 서명/저자
- Temporal Patterns of Symptoms During Treatment for Patients With Head and Neck Cancer and an Exploration of Risk Factors
- 발행사항
- [Sl] : University of Pittsburgh, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 183 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-04, Section: B.
- 주기사항
- Advisor: Bender, Catherine M.
- 학위논문주기
- Thesis (Ph.D.)--University of Pittsburgh, 2025.
- 초록/해제
- 요약Background: Head and neck cancer (HNC) and its treatment result in substantial symptom burden. The severity of symptoms varies between patients and over time, and can lead to interrupted treatment regimens, decreased quality of life, and increased health care utilization. Understanding the heterogeneity of symptom trajectories may inform symptom management and risk stratification. Objectives: This dissertation examined the longitudinal symptom severity experiences of patients during radiation therapy (RT), explored clinical- and patient-specific risk factors of severe symptoms, and explored genotypic (microRNA-related SNP) associations with trajectory group membership.Methods: Symptoms were assessed using the MD Anderson Symptom Inventory-Head and Neck Module (MDASI-HN). Symptoms were dichotomized during peak treatment (weeks 5-7) as low (5) or moderate/high (≥5). The five symptoms with the highest proportion of severe ratings during this period, pain, fatigue, taste changes, mucus in the mouth or throat, and dry mouth, were selected for the analysis. Weekly averages were analyzed using group-based trajectory modeling (GBTM) to identify distinct symptom trajectories across oral symptoms (taste changes, mucus in the mouth or throat, and dry mouth), pain, and fatigue. Risk factors were evaluated using GBTM. A subset of participants with genomic data underwent exploratory SNP analysis to assess associations between microRNA-related genetic variants and symptom severity trajectory group membership. Results: Three distinct symptom trajectories were identified per symptom domain, reflecting low, increasing, or high severity. Although risk factors varied across the symptoms, several were consistently associated with more severe trajectories, including neck disability, stage of disease, and nodal status. In the exploratory genetic analysis, microRNA-related SNPs demonstrated potential associations with group membership, including rs4639 with pain groups. While dry mouth and rs12976445 were not significantly associated with trajectory group membership in the unadjusted model, both were significantly associated with more severe trajectories after adjusting for nodal status. Results should be interpreted with caution given the pilot nature of the genomic study and require replication in larger samples. Conclusion: This study identified trajectories of severe symptoms in patients undergoing RT for HNC and highlighted key patient-, clinical- and biological risk factors associated with more severe symptoms. These findings support the need for personalized symptom monitoring and may guide future supportive care interventions.
- 일반주제명
- Nursing
- 일반주제명
- Oncology
- 일반주제명
- Genetics
- 키워드
- Pain and fatigue
- 키워드
- Radiation
- 키워드
- Trajectories
- 기타저자
- University of Pittsburgh Nursing
- 기본자료저록
- Dissertations Abstracts International. 87-04B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■00520260202104841
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■007cr#unu||||||||
■020 ▼a9798297620308
■035 ▼a(MiAaPQ)AAI32172974
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610.73
■1001 ▼aCummings, Meredith Hughes Collier.▼0(orcid)0000-0002-6611-2035
■24510▼aTemporal Patterns of Symptoms During Treatment for Patients With Head and Neck Cancer and an Exploration of Risk Factors
■260 ▼a[Sl]▼bUniversity of Pittsburgh▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a183 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-04, Section: B.
■500 ▼aAdvisor: Bender, Catherine M.
■5021 ▼aThesis (Ph.D.)--University of Pittsburgh, 2025.
■520 ▼aBackground: Head and neck cancer (HNC) and its treatment result in substantial symptom burden. The severity of symptoms varies between patients and over time, and can lead to interrupted treatment regimens, decreased quality of life, and increased health care utilization. Understanding the heterogeneity of symptom trajectories may inform symptom management and risk stratification. Objectives: This dissertation examined the longitudinal symptom severity experiences of patients during radiation therapy (RT), explored clinical- and patient-specific risk factors of severe symptoms, and explored genotypic (microRNA-related SNP) associations with trajectory group membership.Methods: Symptoms were assessed using the MD Anderson Symptom Inventory-Head and Neck Module (MDASI-HN). Symptoms were dichotomized during peak treatment (weeks 5-7) as low (5) or moderate/high (≥5). The five symptoms with the highest proportion of severe ratings during this period, pain, fatigue, taste changes, mucus in the mouth or throat, and dry mouth, were selected for the analysis. Weekly averages were analyzed using group-based trajectory modeling (GBTM) to identify distinct symptom trajectories across oral symptoms (taste changes, mucus in the mouth or throat, and dry mouth), pain, and fatigue. Risk factors were evaluated using GBTM. A subset of participants with genomic data underwent exploratory SNP analysis to assess associations between microRNA-related genetic variants and symptom severity trajectory group membership. Results: Three distinct symptom trajectories were identified per symptom domain, reflecting low, increasing, or high severity. Although risk factors varied across the symptoms, several were consistently associated with more severe trajectories, including neck disability, stage of disease, and nodal status. In the exploratory genetic analysis, microRNA-related SNPs demonstrated potential associations with group membership, including rs4639 with pain groups. While dry mouth and rs12976445 were not significantly associated with trajectory group membership in the unadjusted model, both were significantly associated with more severe trajectories after adjusting for nodal status. Results should be interpreted with caution given the pilot nature of the genomic study and require replication in larger samples. Conclusion: This study identified trajectories of severe symptoms in patients undergoing RT for HNC and highlighted key patient-, clinical- and biological risk factors associated with more severe symptoms. These findings support the need for personalized symptom monitoring and may guide future supportive care interventions.
■590 ▼aSchool code: 0178.
■650 4▼aNursing
■650 4▼aOncology
■650 4▼aGenetics
■653 ▼aGenetic biomarkers
■653 ▼aHead and neck cancer
■653 ▼aPain and fatigue
■653 ▼aRadiation
■653 ▼aSevere oral symptoms
■653 ▼aTrajectories
■690 ▼a0569
■690 ▼a0992
■690 ▼a0369
■71020▼aUniversity of Pittsburgh▼bNursing.
■7730 ▼tDissertations Abstracts International▼g87-04B.
■790 ▼a0178
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17359147▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
