- 期刊
因應胰臟癌藥物治療發展之護理照護
Nursing Care Regarding the Development of Chemotherapy for Treating Pancreatic Cancer
摘要
胰臟癌是致命的疾病，治療藥物選擇有限且預後不佳。自gemcitabine成為胰臟癌的首選用藥之後，經過諸多臨床試驗，試著與gemcitabine併用來治療胰臟癌，但結果都不盡理想。近五年來的臨床試驗結果發現：gemcitabine與erlotinib或nabpaclitaxel併用、FOLFIRINOX複合性化療處方或是S-1單獨使用等，與gemcitabine單獨使用相比，具有相當或更優越的療效，也讓胰臟癌的第一線治療多了新的選擇。隨著藥物治療的發展會伴隨著相關的副作用，例如白血球減少、腹瀉及噁心嘔吐等，護理人員必須增進藥物相關的知識，給予適當衛教，監測其可能出現的副作用。另外治療藥物的費用會增加經濟壓力及導致憂鬱，護理人員必須能夠警覺此問題，提供相關經濟補助資源及心理支持。因此，未來在胰臟癌的藥物發展，除了致力發展副作用較小且療效更佳的藥物之外，也必須爭取相關的健保給付；而護理人員則需要持續充實關於胰臟癌藥物的新知，發揮同理心及整體性的了解病人的身、心、靈及社會經濟的需求，以給予病人最大的幫助。
並列摘要
Pancreatic cancer is a highly lethal disease with limited drug choices for treatment and grave prognosis. Since gemcitabine became the standard first-line therapy, many clinical trials have taken place for combination therapy with gemcitabine. However, the results have not been promising. Over the last five years, gemcitabine together with either erlotinib or nabpaclitaxel, the FOLFIRINOX combinational regimen, or S-1 alone, have been found to be of superior or similar efficacy to gemcitabine alone. Therefore, the alternatives available as firstline therapy for advanced pancreatic cancer are relatively diversified at present. However, such new treatment regimens bring additional problems with respect to treatment-related adverse effects, for example, leukopenia, diarrhea, nausea and vomiting. Nurses need to build on their knowledge of chemotherapy, which will allow them to educate patients and monitor the side effects of the various chemotherapy drugs. Moreover, the cost of these treatments options will add to patient stress both economically and psychosocially. Nurses need to be aware of these problems and should provide mental support and information on financial resources. In the future, we must not only develop more effective treatment approaches with fewer side effects, but also apply for reimbursement from the National Health Insurance. In order to provide better care for pancreatic cancer patients, nurses need not only learn about these new therapeutic options but also attempt to embrace a more empathetic and holistic understanding of the biopsycho- social issues affecting pancreatic cancer patients.