鼻咽癌病患放射治療中斷的原因及分析

Interruption of Radiotherapy Treatment in Nasopharynaeal Cancer Patients

陳玉萍(Y. P. Chen) ； 曾雁明( N.M. Tsang) ； 曾振淦(C. K. Tseng) ； 洪志宏(J. H. Hong)

《放射治療與腫瘤學》 4卷4期 (1997/12) Pp. 251-257

https://doi.org/10.6316/TRO/199704(4)251

摘要

目的：隨著醫療科技的進步，許多鼻咽癌癌症患者經治療俊存活下来。然而遇去数＋年的醫療研究，重黯放在静断及燎效上；封鼻咽癌病患未完成全程治瘴的原因及其生活品矍則很少被研究、探尉。本文藉由了解鼻咽癌病人中断治療的因素，試圖解诀或改善無法全程治療的原因，協助病人增加治療的機會。
材料與方法：林口長庚醫院放射腫瘤科自1979至1994年共16年内， 259位鼻咽癌患者未完成全程放射糠治療，進行原因歌查及分析。資料来源乃根據病展記载、電話會談連聚及信件通訊追踪焉依據。
結果：259位中断治療之鼻咽癌病患有115位(44.4%）個案無法忍受治療從引起的副作用及害怕治療合併症。 52位(20.1%）因病情嚴重、虚弱、自覺治療無效且對是否患病仍存疑。採用偏方療法有48位（18.5%）。17位（6.6%）病患有社會與經濟問题。因路途遥遠及交通不便，故對院治療有13位（5%）。有7位（2.7%）個案乃因其它科醫师認為不適合繼續放射治療，改用手術或化學治療。而因家庭因素反對任何正統治療，以求神拜佛、吃香灰仙丹者共7位（2.7%）。
結論：放射治療的副作用及合併症，是病患無法完成全程治療的最大因素，佔44.4%；醫療人員應加强對放射治療引起之副作用的照顾及事先纷病人的教青，部份病患對另類療法抱持極大希望，需探討另類療法對于癌病上之功效。故臨床醫療小組需加强癌患社會、經濟、心理、教育等的支援及建殷，俾使病患排除困難，鼓勵病患接受全程治瘴业完成之。
［放射治療與腫瘤學1997；4:251-257］

關鍵字

鼻咽癌 ； 放射線治療 ； 中斷治療

並列摘要

Purpose: The survival of nasopharyngeal cancer (NPC) patient improved after the advance in the diagnostic technology and in megavoltage facility of radiotherapy. Radiotherapy has become the standard local treatment for NPC, and failure in completion of the treatment will almost lose the chance for cure. There are few articles to explore and analyze the reasons why NPC patients interrupted or even refused the radiotherapy treatment. The aim of this study is to investigate the problem.
Material and Methods: There are 2,860 NPC cases registered in Radiation Oncology Department of Chang Gung Memorial Hospital from 1979 to 1994. Two hundred and fifty-nine patients did not complete their treatment after registration. The survey from hospital records, telephone or mail contacts were used to analyze the reasons why these patients escaped from the treatment of local irradiation.
Results: One hundred and fifteen (44.4%) in these 259 patients cannot tolerate the acute reactions of the treatment or fear for the thought of the expected long-term sequels. Fifty-two patients (20.1%) had poor general condition, or psychologically ignored the disease. Forty-eight patients tried alternative treatments instead of the radiotherapy and seventeen suffered from economic problem. The last 14 patients either lacked the support from family or converted to have chemotherapy only by the referring physician.
Conclusion: Adverse effect of radiation therapy in NPC is one of the important reasons to causing the cessation of the treatment. Alternative treatments are another motivation causing interruption of local treatment. Fail to have faith on the curable by radiotherapy and fear for the complications remained the main causes of interruption. It is important to encourage and help the NPC patients and their family to go through the local treatment.
[Therapeut Radiol Oncol 1997; 4:251-257]

並列關鍵字

Nasopharyngeal cancer ； Radiotherapy ； Treatment interruption