- 期刊
比較傳統換藥與親水性敷料於頭頸癌放射線皮膚損傷成效之回溯性研究
A Comparison between Conventional Gauze Dressing and Hydrocolloid Dressing Material on the Care of Radiation Dermatitis among Head and Neck Cancer Patients: A Single Institution Retrospective Analysis
摘要
目的：頭頸癌接受放射線治療後嚴重的皮膚損傷會中斷癌症治療，若要完成治療，最好能將皮膚反應維持至第二級以下，本研究目的在比較傳統換藥與親水性敷料於頭頸癌放射線皮膚損傷成效。方法：以病歷回溯2012年1月至2015年12月南部某區域教學醫院放射腫瘤科頭頸癌放射線皮膚損傷，有接受傳統換藥與親水性敷料照護的病患，評估其皮膚反應及疼痛，以描述性及推論性研究進行統計分析。結果：依換藥方式分為傳統換藥組和親水性敷料組各12人，以年齡、BMI、癌別、癌症期別、癌症治療、放射線治療分次劑量和累積劑量、最初RTOG、最初及最終疼痛VAS為變項，兩組無顯著差異(p＞0.05)。以RTOG已降至第二級以下做為研究終點，使用線性迴歸及邏輯式迴歸分析換藥方式與RD的成效之相關性，結果顯示RTOG降至第二級以下的換藥總天數親水性敷料組比傳統換藥組少16.5天(p=0.004)，第9天疼痛VAS親水性敷料組比傳統換藥組少2.34分(p=0.09)。結論：研究發現親水性敷料能有效加速傷口癒合，有減輕疼痛的趨勢，提升中重度放射性皮膚炎照護品質。
並列摘要
Objective: Severe radiation dermatitis (grade 3 to 4) is a common cause of treatment interruption among head and neck cancer patients and thus keeping radiation dermatitis at grade 2 or below may enable the patient to complete the radiation treatment course. Methods: Medical records of head and neck cancer patients who had radiation dermatitis grade 3 to 4 and underwent conventional gauze or hydrocolloid dressing at a regional hospital in southern Taiwan were retrospectively reviewed from January 2012 to December 2015. Wound healing time and pain relief were compared. Results: Twelve patients in each dressing material group were identified. Patient demographics such as age, BMI, cancer type, staging, treatment modality, initial RTOG graded radiation dermatitis, cumulated radiation dose causing severe radiation dermatitis, initial and final pain visual analog scale (VAS) did not differ significantly. Time to grade 2 or 1 dermatitis was the endpoint and decrease in pain scores (VAS) were assessed. Analytical statistics included linear and logistic regressions. Among the two treatment groups, the difference time to recover to RTOG grade 2 or 1 dermatitis was 16.5 days, favoring the hydrocolloid material group (p=0.004). There was a trend towards improved pain score at ninth day (2.34 points drop) for the hydrocolloid group (p=0.09). Conclusions: Hydrocolloid material group has shorter time to radiation dermatitis wound healing. A trend towards better pain relief was also noted. Quality of care in dose limiting dermatitis may be improved.