This cross-sectional study aimed to determine whether distinct dysphagia profiles exist among nasopharyngeal carcinoma (NPC) survivors after intensity-modulated radiotherapy (IMRT) and to examine how these profiles relate to broader symptom clusters through psychological pathways. The authors hypothesized that latent subgroups defined by dysphagia burden would differentially affect symptom clusters and that depression and anxiety would act as mediators. The stated goal was to inform precision symptom-management strategies for survivors.
A total of 271 NPC survivors were recruited from a tertiary cancer hospital in Guangzhou between January 2023 and December 2024. Participants completed standardized assessments covering swallowing function, psychological status (depression and anxiety), and other symptom measures. The study used a cross-sectional design; all analyses and conclusions derive from the single timepoint data collected during the recruitment window.
The investigators applied a sequence of statistical methods to characterize profiles and relationships:
These methods were used to quantify direct associations and indirect effects via psychological mediators.
Dysphagia prevalence among the study cohort was reported as 57.2% overall. The highest prevalence observed was 72.7% among survivors within 6 months after treatment. LPA identified two discrete subgroups by dysphagia burden:
These two latent profiles represent approximately equal-sized groups and distinguish survivors by the extent of swallowing-related impairment.
Exploratory factor analysis yielded three symptom clusters, named by the authors as:
In multivariable linear regression models, two variables significantly predicted greater severity across all three clusters: membership in the high dysphagia burden subgroup and higher anxiety scores (p < 0.05). These findings indicate that both a higher swallowing-symptom burden and anxiety are independently associated with more severe symptom clusters in NPC survivors after IMRT.
Parallel mediation analyses with bootstrap resampling examined whether depression and anxiety explained indirect effects of dysphagia subgroup membership on symptom clusters. The study reported the following mediation patterns:
These mediation results indicate that the relationship between higher dysphagia burden and more severe symptom clusters operates partly through increased depression and anxiety, though mediation patterns differed by cluster.
The study concludes that NPC survivors after IMRT present distinct dysphagia burden profiles, with roughly half the cohort classified in a high-burden group. A high dysphagia burden is directly associated with a larger overall symptom burden and also contributes indirectly to more severe symptom clusters via depression and anxiety.
The authors highlight the clinical need for early identification of survivors in the high-risk dysphagia subgroup and recommend an integrated management approach that pairs swallowing rehabilitation with psychological interventions to address depression and anxiety. This combined strategy is proposed to achieve more comprehensive symptom control in NPC survivorship care.
The abstract did not provide detailed limitations beyond the cross-sectional design implied by the methods. Specifics such as potential selection bias, measurement limitations, causality constraints, or the generalizability of findings were not reported in the source abstract. Any additional limitations or subgroup details beyond those in the abstract were not available in the provided source text.