Abstract: Objective: To investigate the changes in symptoms of Nasopharyngeal Carcinoma (NPC) patients with concurrent radiotherapy and chemotherapy at different treatment stages and explore its influencing factors. Methods: Totally 111 NPC patients with concurrent radiotherapy and chemotherapy were included. The M.D. Anderson Symptom Inventory Head and Neck module, Cancer Fatigue Scale and Cancer Loneliness Scale were performed at one day before radiotherapy (T1), 15th radiotherapy (T2), 30th radiotherapy (T3), and one month after discharge from the hospital (T4). Results: The scores of the four different stages of symptom distress in patients were T1 (1.48±0.42), T2 (2.89±0.44), T3 (2.55±0.44), T4 (1.98±0.39). The interference scores were T1 (1.47±0.87), T2 (2.79±0.56), T3 (2.36±0.96), T4 (1.77±0.68). The factors affecting symptom distress were the place of residence, the presence or absence of family members, the stage of radiotherapy and chemotherapy, cancer loneliness, and cancer fatigue. Conclusion: NPC patients with concurrent radiotherapy and chemotherapy show dynamic changes of symptoms in different treatment stages. The patients have high level of symptom distress during radiotherapy and chemotherapy. Clinic nurses should pay attention to patients' symptom distress and provide patients with full and dynamic nursing intervention, in order to reduce symptom troubles and improve the quality of life.

Key words: Nasopharyngeal Carcinoma; symptom distress; longitudinal investigation; influencing factors