頭頸部癌症病人接受放射線治療後口腔合併症之嚴重度變化

Changes in Oral Complications Severity in Head and Neck Cancer Patients after Received Radiotherapy

林雅婷(Ya-Ting Lin) ； 唐秀治(Siew-Tzuh Tang)

《源遠護理》 4卷2期 (2010/11) Pp. 34-41

https://doi.org/10.6530/YYN.2010.4(2).05

摘要

頭頸部癌症病人接受放射治療後，超過70%以上的病人有口腔合併症發生，且隨著放射治療時間逐漸拉長，病人口腔合併症嚴重度亦逐漸上升，致病人感受到中重度的症狀困擾。本文旨在回顧長期性追蹤文獻，運用歐洲癌症研究與治療組織之頭頸部位特殊性量表，探討頭頸部癌症病人接受放射治療後口腔合併症嚴重度，在不同放射治療時間點的變化。文獻整理結果為病人在放射治療後第二到三個月時，口腔合併症嚴重度最為嚴重，其中口腔疼痛與吞嚥困難嚴重度，分別在放射治療後半年至三年後緩解到治療前狀態，但在接受放射治療後三年，病人口乾、唾液黏稠與味覺改變嚴重度，卻仍高於接受放射治療前。因此頭頸部癌症病人在放射治療第一到三個月間，即面臨口腔合併症的干擾，而改善病人的不適症狀一向是醫護人員之首要任務，醫療團隊要妥善地認知，病人因放射治療導致口腔合併症的身心不適、社會壓力，進而提供病人更深層與全面性的照顧，以達到全人照顧的理想境界。

關鍵字

口腔合併症 ； 放射治療 ； 頭頸部癌症

並列摘要

More than 70% of the patients with head and neck cancer will suffer from oral complications after receiving radiotherapy. In addition, with the extension in treatment time, the severity of patients' oral complications increases as well. As a result, the patients will be tormented by moderate to severe symptoms. This paper reviews the literature on long-term follow-up, and uses the Head Neck Module Questionnaire of European Organization for Research and Treatment of Cancer (EORTC H&N35) to investigate the changes in severity of oral complications in patients with head and neck cancers at different stages in the radiotherapy treatment. The results indicate that the patients would suffer from the highest level severity of oral complications within 2-3 months after receiving radiotherapy. Among the symptoms of oral complications, oral pain and dysphagia are alleviated to the pre-treatment state after receiving radiotherapy for 6 months to 3 years, However, after receiving the treatment for three years, the severity of thirst, sticky saliva, and dysgeusia are still higher than that before receiving the treatment. Therefore, the patients with head and neck cancers immediately suffer from oral complications at the stage from Month 1 to Month 3 after receiving radiotherapy. Since improving the symptoms of patients has always been the top priority of medical staff, medical teams should properly understand physical and psychological discomfort and social pressures of patients, and further provide them with closer and more comprehensive care to achieve the purpose of holistic care.

並列關鍵字

oral complications ； radiotherapy ； head and neck cancer