EORTC QLQ-C30 symptom components and their functional correlates during adjuvant chemotherapy for early breast cancer: a multivariate analysis. Data from GEICAM/2003-02 study.

Authors

Andrea Blasco, Roberto Pastor-Barriuso, Pilar Zamora-Auñón, Miguel Martín, Javier Salvador Bofill, Cristina Reboredo, María Marín, Agustín Barnadas, Mireia Margeli, José Manuel López-Vega, Ainhara Lahuerta, Angel Guerrero, Sonia Servitja, Isabel Alvarez, Enrique Aranda, Eduardo Martínez de Dueñas, Francisco Carabantes, Virginia Lope

Published in

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. Volume 35. Issue 11. Oct 10, 2026. Epub Oct 10, 2026.

Abstract

Understanding how multiple symptoms jointly impact functioning is essential for interpreting patient-reported outcomes (PROs) in oncology. We aimed to characterize the main dimensions underlying change-from-baseline (CFB) in symptom scores during adjuvant chemotherapy for early breast cancer, and to examine their associations with functional outcomes.
We analyzed EORTC QLQ-C30 CFB scores from 820 patients enrolled in the GEICAM/2003-02 trial. Principal component analysis (PCA) was used to summarize correlated symptom changes into a smaller number of components, and graphical LASSO network modelling was applied to explore relationships among Health-Related Quality of Life (HRQoL) domains. Associations between components and functional scales and global health status were assessed using Spearman correlations.
Three components were identified in the pooled sample, explaining 53.6% of the variance: a dominant general symptom burden component, a gastrointestinal component, and a diarrhea-specific component. The general component, primarily defined by fatigue, pain, appetite loss, insomnia, nausea/vomiting and dyspnea, showed consistent negative correlations with all functional scales and global health status. Similar patterns were observed across treatment arms, although gastrointestinal-related components differed. Graphical LASSO identified fatigue as the symptom most strongly connected to functional impairment.
Symptom changes during chemotherapy are not independent, but follow a multivariate structured pattern in which a general symptom burden, anchored by fatigue, plays a central role in functional decline. These findings suggest that multivariate approaches may provide a complementary exploratory framework for summarizing correlated patterns of treatment-related burden and generating hypotheses regarding PROs. Trial registration number ClinTrials.gov: GEICAM/2003-02: NCT00129389.

PMID:
42859303
Bibliographic data and abstract were imported from PubMed on 11 Oct 2026.

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