Research hotspots and trends in cancer-related fatigue from 2020 to 2025: a co-word analysis

Background: Cancer-related fatigue (CRF) is a common, debilitating symptom among cancer patients that severely impairs quality of life and treatment adherence. Research on CRF has expanded rapidly alongside new treatment options, yet global research hotspots and trends poorly mapped.Objective: This study aimed to identify CRF research hotspots and trends from 2020 to 2025, to inform understanding of the latest advances and emerging research priorities in this field.Methods: We retrieved eligible CRF-related articles published between 2020 to 2025, and extracted keywords from the included studies as analytical units. Bibliographic Item Co-occurrence Matrix Builder (BICOMB) was used to screen high-frequency keywords and build a keyword co-occurrence matrix. Graphical Clustering Toolkit (gCLUTO) was applied for cluster analysis, while SPSS 25.0 software was used for strategic diagram analysis to identify CRF research hotspots and their distribution patterns.Results: From 22,305 initial PubMed records, 17,149 eligible articles were included. In total, 13,847 keywords were extracted, and 56 high-frequency keywords were screened. Nine major research hotspot clusters were identified via cluster and strategic diagram analyses.Conclusions: CRF research from 2020 to 2025 focuses on pathogenic mechanisms, clinical intervention and symptom management, and epidemiology and influencing factors across nine core hotspots. More attention should be paid to emerging research directions, standardized clinical management, and research translation to improve cancer survivors’ quality of life.