To investigate the trajectories of symptom clusters in rectal cancer patients undergoing neoadjuvant chemotherapy and to analyze their correlation with postoperative recovery indicators.

A convenience sampling method was used to select 120 rectal cancer patients admitted to a tertiary grade A hospital in Shanghai city from April to December 2024 as study subjects.Patient symptom burden was assessed at five time points,namely before neoadjuvant chemotherapy(T1),after the first chemotherapy cycle(T2),after the second chemotherapy cycle(T3),after the third chemotherapy cycle(T4),and 3-5 days before surgery(T5).Exploratory factor analysis was employed to extract symptom clusters.Latent class growth modeling(LCGM) was used to identify the trajectory classes of the symptom clusters.Postoperative recovery indicators,including body weight,diet type,wound healing status,bowel function,and complication severity,were compared among different trajectory classes of symptom clusters.

There three stable symptom clusters were consistently identified across the five time points in rectal cancer patients,namely a core neurotoxicity symptom cluster,a gastrointestinal reaction symptom cluster,and a psychological stress symptom cluster.The cumulative variance contribution rate ranged from 66.71% to 80.60%.Patient symptom burden increased at T3 and peaked at T4.LCGM identified three trajectory classes for the core neurotoxicity symptom cluster,two for the gastrointestinal reaction symptom cluster,and two for the psychological stress symptom cluster.Statistically significant differences(all P<0.05) were found in body weight,diet type,bowel function,and complication severity among different trajectory classes of the core neurotoxicity symptom cluster.Significant differences(all P<0.05) were found in body weight,bowel function,and complication severity among different trajectory classes of the gastrointestinal reaction symptom cluster.Significant differences(all P<0.05) were found in body weight,diet type,and wound healing status among different trajectory classes of the psychological stress symptom cluster.

Symptom clusters in rectal cancer patients undergoing neoadjuvant chemotherapy show a progressively worsening trend with group heterogeneity.The trajectory classes of each symptom cluster have a certain impact on patients' postoperative recovery indicators.