Symptom clusters in oesophageal cancer patients during varying phases of postoperative chemotherapy: a scoping review

OBJECTIVES: To summarise the symptom clusters (SCs), assessment tools and their evolution at different stages of postsurgical chemotherapy in oesophageal cancer patients, providing reference for future research design and precise symptom management. DESIGN: A systematic search and literature review were conducted according to the Joanna Briggs Institute Scoping Review Methodology framework and PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. DATA SOURCES: Databases searched include PubMed, Cumulative Index to Nursing and Allied Health Literature (CINHAL), Web of Science, Embase, the Cochrane Library, Scopus, China National Knowledge Infrastructure, Wanfang, VIP Chinese Journal and China Biomedical Literature Database. The search covered the period from database inception to 30 November 2024, and references were traced backward. ELIGIBILITY CRITERIA: Patients aged ≥18 years with postsurgical oesophageal cancer undergoing adjuvant chemotherapy; studies focusing on SCs before, during or after chemotherapy; original quantitative research; published in Chinese or English. Exclusion criteria included neoadjuvant or palliative chemotherapy, reviews, conference abstracts and inaccessible full-text articles. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened, extracted and cross-checked the data. Content analysis was employed to summarise the SCs, assessment tools and phase-related changes. RESULTS: A total of 11 studies were included (8 in Chinese, 3 in English). Twelve SCs were identified, with gastrointestinal-related, eating-related and physical function-related clusters being the most common. Eleven assessment tools were used, with MD Anderson Symptom Inventory-Gastrointestinal Cancer Module and its Chinese version being the most frequently applied. Difficulty eating was the most prominent SC before chemotherapy, gastrointestinal symptoms were the most severe during chemotherapy and psychological-physical symptoms dominated in the postchemotherapy phase. CONCLUSIONS: The composition of SCs in oesophageal cancer chemotherapy evolves dynamically across different stages. However, the existing evidence is mainly derived from small sample cross-sectional studies, with high heterogeneity in tools and methods. Standardised assessment criteria and longitudinal validation are needed to develop stage-specific, evidence-based interventions that can be widely applied.