Ji YB, et al. – This research was designed to distinguish subgroups of cluster symptoms, compare demographic and clinical characteristics between subgroups, and investigate the relationships between inflammatory cytokines and cluster symptoms. The physicians proposed that in cancer patients, interleukin–6 (IL–6) levels were correlated with cluster symptoms. Clinicians had to identify patients at risk for more severe symptoms and formulate novel target interventions to improve symptom management.

• The clinicians enrolled 170 Chinese inpatients with cancer from two tertiary hospitals.
• They measured inflammatory markers including interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1RA), and tumor necrosis factor alpha (TNF-α).
• They examined inter-group differences and associations of inflammatory cytokines with the cluster symptoms with one-way analyses of variance and logistic regression.

• The clinicians categorized participants into subgroup 1 (all low symptoms), subgroup 2 (low pain and moderate fatigue) or subgroup 3 (moderate-to-high on all symptoms) based on cluster analysis.
• The 3 subgroups differed significantly in ECOG performance status, sex, residence, current treatment, education, economic status, and inflammatory cytokines levels (all P <0.05).
• Subgroup 3 had a significantly poorer ECOG physical performance status and higher IL-6 levels, were more often treated with combined chemoradiotherapy, and were more likely to be rural residents compared to Subgroup 1.
• As per the outcomes, IL-6 and ECOG physical performance status were significantly correlated with 1.246-fold (95% confidence intervals: 1.114-1.396) and 31.831-fold (95%CI; 6.017-168.385) increased risk of subgroup 3.