Objective To explore the chain mediating effect of fear of disease progression with symptom burden between economic toxicity and quality of life in CyberKnife⁃treated patients with pulmonary carcinoma. Methods A total of 252 CyberKnife⁃treated patients with pulmonary carcinoma were selected by employing the convenience sampling method. General data inventory, Comprehensive Scores for Financial Toxicity Based on The Patient⁃Reported Outcome Measures (COST⁃PROM) scale, Fear of Progression Questionnaire⁃Short Form (FoP⁃Q⁃SF), M.D. Anderson Symptom Inventory (MDASI), and Functional Assessment of Cancer Therapy⁃Generic (FACT⁃G) scale were used for performing investigation. The correlation between scores of various scales in CyberKnife⁃treated patients with pulmonary carcinoma was analyzed. The model 6 in the Process program was adopted to conduct regression analysis and mediating effect validation through the Bootstrap method. Results The COST⁃PROM scale, FoP⁃Q⁃SF, MDASI, and FACT⁃G scale scores of CyberKnife⁃treated patients with pulmonary carcinoma were 18.39±3.99, 26.86±8.91, 70.47±31.91, and 56.13±19.19, respectively. The score of FACT⁃G scale negatively correlated with the scores of FoP⁃Q⁃SF and MDASI, whereas positively correlated with COST⁃PROM score (P<0.05). There was a chain mediating effect of fear of disease progression with symptom burden between economic toxicity and quality of life in CyberKnife⁃treated patients with pulmonary carcinoma, with the value of mediating effect of 0.190, accounting 28.36% for total effect. Conclusion Economic toxicity not only directly affects the quality of life in CyberKnife⁃treated patients with pulmonary carcinoma, but also indirectly affects the quality of life of patients through the chain path of fear of disease progression and symptom burden. Medical and nursing personnel should pay equal attention to psychological intervention, symptom management and financial support of patients to improve their overall health outcomes.

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