Longitudinal patterns of symptoms in patients undergoing chemotherapy: secondary analysis of a cluster randomized trial

The longitudinal patterns or patient-reported outcomes and their association with mortality of patients undergoing chemotherapy in routine oncology care are largely unexplored. Secondary analysis of the SIMPRO trial at six US centers included patients who started a new chemotherapy regimen for gastrointestinal, gynecologic, or thoracic cancer, and completed at least one symptom questionnaire within 180 days. Overall, 3735 patients (median age 67 years; IQR 59-74; 59% female) submitted 35 059 symtom questionnaires. 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 the chemotherapy. The authors conclude that these rsults suggest that recognizing which symptoms are associated with an increased hazard of death may help better support patients with high symptom burden and increased risk of mortality.