Quality of life in patients with pan-cancer undergoing concurrent chemoradiotherapy: a bibliometric analysis (1995-2024)

Abstract

Background: Chemoradiotherapy is a therapeutic approach that prolongs survival but may simultaneously negatively affect the quality of life (QOL) of cancer patients. Current research on quality of life (QOL) in pan-cancer patients undergoing concurrent chemoradiotherapy (CCRT) lacks systematic integration of bibliometric findings with clinical symptom data.

Methods: We retrieved 2762 articles from the Web of Science Core Collections. R-bibliometrix, VOSviewer, and CiteSpace were employed to conduct quantitative analysis and visualize research trends and factors influencing QOL. Complementarily, a cross-sectional study of 117 cervical cancer patients assessed symptom prevalence via CTCAE v5.0, with symptom clusters identified.

Results: The included articles were published between 1995 and 2024. The results revealed that the United States and China had the largest number of publications worldwide. Van Berge Henegouwen was the most productive author. The institution leading in this field was the University of Toronto. The International Journal of Radiation Oncology - Biology - Physics was the most productive journal. In addition, keywords with high burst strengths in recent years were 'open label', 'predictor', and 'preoperative chemoradiotherapy'. Tree-ring map of terms related to QOL was visualized and multiple clusters were found, respectively named as "malnutrition", "watch and wait", and so on. Clusters analyses of specific cancers were performed to reveal these unique differences. Finally, among cervical cancer patients, decreased appetite (79.5%), diarrhea (65.8%), and altered taste (59.0%) were the most prevalent symptoms, with three symptom clusters identified.

Conclusion: More attention was paid to long-term outcome and patient experience during treatment. Through pan-cancer research and in-depth analysis of specific cancers, we have identified various factors affecting QOL in patients undergoing chemoradiotherapy, including treatment methods, treatment-induced symptoms, psychological factors and so on, enabling us to tailor more personalized treatment plans that improve their overall well-being and enhance QOL during and after treatment.

Keywords: bibliometric; chemoradiotherapy; concurrent chemoradiotherapy (CCRT); oncology; quality of life.

Figure 1

Flow-chart of the study.

Figure 2

Analysis of countries. (A) Country scientific production; (B) The top 10 country with the most publications; (C) A visualization to describe the collaborations between countries/regions.

Figure 3

Dual map overlay of journals.

Figure 4

Analysis of co-authorship. (A) Network visualization of co-authorship of authors; (B) Overlay visualization of co-authorship of authors; (C) Network visualization of co-authorship of institutions.

Figure 5

Document analysis and hot spot prediction. (A) Most global cited documents; (B) Burst detection of keywords; (C) Tree-ring map centered on ‘quality of life’.

Figure 6

The keyword timeline cluster plot.

Figure 7

The types of clusters. (A) the clusters related to QOL; (B) the clusters involving different types of tumors; (C) The development of the clusters about head and neck cancer.

Figure 8

The development of the clusters about rectal cancer.