A study on the temporal network characteristics of early post-chemotherapy core symptoms in colorectal cancer patients based on ecological momentary assessment
- 1Hainan Medical University, School of Nursing
- 2The Second Affiliated Hospital of Hainan Medical University, Nursing Department
Abstract
Background: Patients with colorectal cancer (CRC) often experience multiple concurrent symptoms during the early post-chemotherapy period, and both symptom severity and inter-symptom associations may change over time. Previous low-frequency assessments may not adequately capture short-term fluctuations.
Objective: To characterize the dynamic trajectories and network features of early symptoms in patients receiving postoperative adjuvant chemotherapy for CRC and to identify candidate symptoms for enhanced monitoring.
Methods: A prospective longitudinal study was conducted. Ecological momentary assessment (EMA) was performed three times daily for seven consecutive days after infusion in the first and second chemotherapy cycles and covered 13 symptoms. Linear mixed-effects models characterized symptom trajectories, and a multilevel vector autoregressive (mlVAR) model estimated temporal and contemporaneous networks. Edge uncertainty, centrality stability, sensitivity analyses, and between-cycle differences were evaluated.
Results: A total of 110 patients contributed 4,134 valid assessments (completion rate, 89.5%). All 13 symptoms showed significant time effects. Fatigue, loss of appetite, gastrointestinal symptoms, and sleep disturbance fluctuated, whereas numbness/tingling and depression showed cumulative trends. Loss of appetite, dry mouth, and nausea had comparatively high outgoing temporal associations. The strongest individual temporal edge was modest (standardized coefficient approximately 0.12). No statistically significant between-cycle differences were found in overall network structure or global strength.
Conclusion: Early post-chemotherapy symptoms showed dynamic changes and a broadly comparable network structure across the first two cycles. Loss of appetite, dry mouth, and nausea may be candidates for enhanced monitoring and future intervention research; the observational findings do not establish causal effects or intervention efficacy.
Related
- Leveraging ecological momentary assessment and dynamic structural equation modeling to identify idiographic antecedents of child irritability and defiance
- Ecological momentary assessment of anxiety and depression in individuals with early-treated phenylketonuria
- An Experimental Evaluation of Assessment Reactivity in Ecological Momentary Assessment of Alcoholics Anonymous Involvement and Alcohol-Related Outcomes: One Day at a Time
- Baseline depressive-symptom severity and divergent psychological trajectories during GIP and/or GLP-1 receptor agonist therapy: a prospective ecological momentary assessment study
- Sleep and the Daytime Course of Anhedonia in Adolescent Depression: An Ecological Momentary Assessment Study
BibTeX
@article{lv2026study,
title = {{A study on the temporal network characteristics of early post-chemotherapy core symptoms in colorectal cancer patients based on ecological momentary assessment}},
author = {Yuanfeng Lv and Longke Xu and Minxiang Li and Xiaoxia Cai and Lixiang Ye and Xinyu Wang and Xiaoshan Wang and Yanjing Chen and Yani Lu},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1942076},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1942076/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A study on the temporal network characteristics of early post-chemotherapy core symptoms in colorectal cancer patients based on ecological momentary assessment
AU - Yuanfeng Lv
AU - Longke Xu
AU - Minxiang Li
AU - Xiaoxia Cai
AU - Lixiang Ye
AU - Xinyu Wang
AU - Xiaoshan Wang
AU - Yanjing Chen
AU - Yani Lu
PY - 2026
DA - 2026/10/27
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1942076
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1942076/full
AB - Background: Patients with colorectal cancer (CRC) often experience multiple concurrent symptoms during the early post-chemotherapy period, and both symptom severity and inter-symptom associations may change over time. Previous low-frequency assessments may not adequately capture short-term fluctuations. Objective: To characterize the dynamic trajectories and network features of early symptoms in patients receiving postoperative adjuvant chemotherapy for CRC and to identify candidate symptoms for enhanced monitoring. Methods: A prospective longitudinal study was conducted. Ecological momentary assessment (EMA) was performed three times daily for seven consecutive days after infusion in the first and second chemotherapy cycles and covered 13 symptoms. Linear mixed-effects models characterized symptom trajectories, and a multilevel vector autoregressive (mlVAR) model estimated temporal and contemporaneous networks. Edge uncertainty, centrality stability, sensitivity analyses, and between-cycle differences were evaluated. Results: A total of 110 patients contributed 4,134 valid assessments (completion rate, 89.5%). All 13 symptoms showed significant time effects. Fatigue, loss of appetite, gastrointestinal symptoms, and sleep disturbance fluctuated, whereas numbness/tingling and depression showed cumulative trends. Loss of appetite, dry mouth, and nausea had comparatively high outgoing temporal associations. The strongest individual temporal edge was modest (standardized coefficient approximately 0.12). No statistically significant between-cycle differences were found in overall network structure or global strength. Conclusion: Early post-chemotherapy symptoms showed dynamic changes and a broadly comparable network structure across the first two cycles. Loss of appetite, dry mouth, and nausea may be candidates for enhanced monitoring and future intervention research; the observational findings do not establish causal effects or intervention efficacy.
SN - 2234-943X
ER -