目的 探讨消化道肿瘤患者在放疗期间核心症状群纵向轨迹的群体异质性，并分析其影响因素。 方法 采用纵向研究设计，使用便利抽样法选取2023年9月‒ 2024年5月在百度开云体育app第二附属医院放疗中心进行放疗的消化道肿瘤患者130例，采集患者随访3个时间点的数据；采用组基轨迹建模（group-based trajectory model，GBTM）识别其核心症状群内症状随时间变化遵循相似轨迹的患者亚组，采用单因素分析与多元logistic回归分析亚组的影响因素。 结果 共识别出低症状负担组、中症状负担组与高症状负担组3个轨迹亚组，3个亚组各症状严重程度得分的动态趋势均呈现由低到高再降低的趋势，且各症状组间、组内差异均具有统计学意义（P < 0.05），其中是否转移是高症状负担组的独立预测因素（P < 0.05）。 结论 消化道肿瘤患者在放疗期间的核心症状群存在显著异质性，医护人员应准确识别高危人群，提供针对性的症状管理方案，提高患者生活质量。

Objective To investigate the population heterogeneity of the longitudinal trajectory of core symptom group in patients with digestive tract tumors during radiotherapy and analyze its influencing factors. Methods This study was designed as a longitudinal study. A total of 130 patients with digestive tract tumors who received radiotherapy at a radiotherapy center of a Class A tertiary hospital in Shandong Province from September 2023 to May 2024 were selected by convenient sampling method for longitudinal tracking at 3 time points， and subgroups of patients whose symptoms followed a similar trajectory over time within their core symptom group were identified by subgroup locus modeling. Univariate analysis and multiple logistic regression were used to analyze the influencing factors of subgroups. Results Three trajectory subgroups of low symptom burden group， medium symptom burden group and high symptom burden group were identified. The dynamic trend of symptom severity scores in the three subgroups was consistent with the trend from low to high and then decreased， and the differences between and within symptom groups were statistically significant. Metastasis was an independent predictor for the high-symptom burden group. Conclusion There is significant heterogeneity in the core symptom groups of patients with digestive tract tumors during radiotherapy. Clinical staff should identify high-risk groups in time， providing targeted symptom management programs to improve the quality of patients’ lives.