Heterogeneity and influencing factors of cancer-related fatigue among patients with cervical cancer undergoing brachytherapy: A cross-sectional analysis.

Objective: This study aims to examine the prevalence and heterogeneity of cancer-related fatigue (CRF) among patients with cervical cancer undergoing intracavitary brachytherapy and to identify associated determinants. Methods: This cross-sectional study included 105 patients with cervical cancer who received brachytherapy at a tertiary hospital in Beijing between March and June 2023. Participants completed the Cancer Fatigue Scale, Patient-Generated Subjective Global Assessment, Hospital Anxiety and Depression Scale, and Pittsburgh Sleep Quality Index. Latent class analysis (LCA) was used to identify fatigue subgroups. Influencing factors were explored using univariate and multivariate analyses, including t-tests, chi-square tests, multiple linear regression, and logistic regression. Results: The mean CRF score was 26.10 ​± ​10.55 (range: 0-60), with 36.2% of patients scoring ≥ 30. LCA identified three fatigue subgroups: high, moderate, and low fatigue, with 83.8% of patients classified into the moderate and high fatigue groups. Higher educational attainment, receipt of chemotherapy, poor nutritional status, and depression were positively associated with greater CRF, while a history of cervical cancer surgery and higher household income were negatively associated. These variables explained 64.3% of the variance in CRF. Patients who received chemotherapy, had higher depression scores, and had poorer nutritional status were more likely to belong to the high-fatigue group. Conclusions: Cancer-related fatigue is highly prevalent among patients with cervical cancer undergoing brachytherapy, particularly affecting physical and emotional domains. Substantial heterogeneity exists across fatigue severity groups. Tailored interventions addressing physical symptoms, psychological distress, and nutritional status are needed. Further research with larger, diverse samples is warranted to validate these findings.