頭頸部癌症病患接受放射治療之急性皮膚反應相關因素分析

Analysis of Acute Skin Reactions for Patients of Head and Neck Cancer Receiving Radiation Therapy

黃國明(Kuo-Ming Huang) ； 陳昭旭(Jau-Shiuh Chen) ； 黃文濤(Wen-Tao Huang) ； 許峰銘(Feng-Ming Hsu) ； 陸思慧(Szu-Huai Lu) ； 張寶枝(Pao-Chih Chang) ； 成佳憲(Jason Chia-Hsien Cheng) ； 王駿瑋(Chun-Wei Wang)

《中華放射線技術學雜誌》 32卷2期 (2008/12) Pp. 164-172

摘要

本研究主要是探討頭頸部癌症病患接受放射治療後，其急性皮膚反應之嚴重程度與各項臨床因子之關係。研究以立意取樣法(judgment sampling)收集2004年1月至同年12月在本院接受頭頸部放射治療之病患共105位，設計混合式問卷表以紀錄治療中所發生的皮膚反應，調查病患個人體質差異、病人照護方法、各種治療因子與皮膚反應之相關性，並利用統計軟體SPSS（15.0版）進行所需的統計分析。結果顯示性別、年齡、治療劑量、清潔方式等，與造成皮膚反應嚴重程度並無統計學上之意義。病人出汗程度愈多、過敏體質、皮膚膚質屬性、治療部位的衣物穿戴方式、以及體重減輕5公斤以上的病患，此5項因素與皮膚反應的嚴重程度具有統計學上顯著意義。前述5項因素以邏輯式回歸分析排除干擾效果變項後，只有過敏體質與出汗程度兩項因素在多變項邏輯式回歸分析(multiple logistic regression analysis)中其p值小於0.05，具有統計學上顯著相關。本研究發現如爲出汗較多者或過敏體質者，較易產生較爲嚴重的皮膚濕性脫屑，故建議病人應保持皮膚乾燥或減少出汗機會。若爲過敏體質者，則建議在接受放射治療期間可至皮膚部門進行皮膚治療，以減少因放射治療造成濕性脫屑而延宕治療。

關鍵字

放射治療 ； 頭頸部癌症 ； 皮膚反應

並列摘要

This study evaluated the relationship between clinical characteristics or treatment factors and the severity of acute skin reactions for patients of head and neck cancer receiving radiation therapy. From January 2004 to December 2004, 105 patients underwent radiation therapy for head and neck cancer were enrolled prospectively by judgment sampling. The grading of acute skin reaction was recorded. The clinical characteristics or treatment factors were collected by patient survey and chart review. Data were analyzed using statistical software SPSS version 15.0. The results showed that gender, age, total radiation dose, skin care method were not associated with the severity of acute skin reaction statistically. The amount of sweating, allergy to topical agents, skin characteristics, wearing, and body weight loss more than 5 kg during treatment were significantly associated with more severe acute skin reactions in univariate analysis. Among these factors, the amount of sweating and allergy to topical agents were the only two significant factors associated with more severe acute skin reactions in multivariate analysis. Patients with greater amount of sweating and history of allergy to topical agents were susceptible to more severe acute skin reaction during radiation therapy for head and neck cancer. Thus, the irradiated skin should be kept dry during treatment period. Patients with history of skin allergy should seek for professional assistance from dermatologist. These efforts might reduce the severity of skin reaction and risk of treatment interruptions. Patients should also maintain their body weight with nutrition support to facilitate the recovery of skin reactions.

並列關鍵字

Radiotherapy ； head and neck cancer ； skin reaction