鼻咽癌病患放射治療後生活品質之研究

Quality of Life of the Patients with Nasopharyngeal Carcinoma after Radiotherapy

許維中(Wei-Chung Hsu) ； 丁禮莉(Lai-Lei Ting) ； 陳宇嘉(Yu-Chia Chen) ； 詹淑卿(Sue-Ching Chan) ； 鍾娜娜(Na-Na Chung) ； 雷德(Lui Louis Tak) ； 王博民(Po-Ming Wang) ； 林高德(Gau-De Lin)

《放射治療與腫瘤學》 10卷3期 (2003/09) Pp. 127-136

https://doi.org/10.6316/TRO/200310(3)127

摘要

目的：本研究之目的是評估鼻咽癌病患放射治療後的生活品質。
材料與方法：自2001年3月至2002年12月，總共有兩機構的三百三十二位鼻咽癌病患被邀請參與研究。病患在放射治療結束後三個月以上，填寫EORTC QLQ C-30及EORTC QLQ-H&N35的生活品質量表，以此作為評估之依據。
結果：以簡單相關分析而言，「治療後時間間隔」與「疼痛」（r = -0.194***）形成負相關，是所有相關變項中最顯著的；其次為體重減輕（r = -0.165**）、口乾（r = -0.155**）；此外，性困擾（r = -0.138*）、唾液黏稠（r = -0.130*）、社交飲食問題（r = -0.108*）、體重增加（r = 0.107*）及張嘴問題（r = 0.105*）也達到顯著差異。本研究為了瞭解非線性簡單關係之效果，進一步將時間間隔分類為「治療後三至六個月」、「治療後六個月至十二個月」、「治療後一年至五年」及「治療後五年以上」，利用單因數變異數分析，結果發現除了「張嘴問題」、「使用止痛藥」及「體重增加」三項外，其餘全部有顯著意義。因此，本研究再進一步將生活品質各項指標依其不同時間階段的變化，予以區分為四種類型，即「遞增型」、「遞減型」、「U型」及「W波浪型」，並分析不同類型之生活品質改變的現象。
結論：本研究顯示依不同時間階段的生活品質指標變化之詳盡資料有助於我們與病患溝通病情，並可進一步設計著重於鼻咽癌病患放射治療後之支援療法及復健方面的介入性研究。

關鍵字

生活品質 ； 放射治療 ； 鼻咽癌

並列摘要

Purpose : The purpose of this study is to evaluate the quality of life of patients with nasopharyngeal carcinoma after treatment with radiotherapy.
Materials and Methods : From March 2001 to November 2002, three hundred and thirty-two nasopharyngeal cancer patients in two institutions were invited to participation. Health- related quality of life was assessed 3 months or later after the completion of the treatment by means of the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ C-30) and the EORTC head and neck cancer-specific questionnaire (QLQ H&N-35).
Results : Pain (r = -0.194***), weight loss (r = -0.165**), dry mouth (r = -0.155**), sexuality (r =
-0.138*), sticky saliva (r = -0.130*), social eating (r = -0.108*), gain weight (r = 0.107*) and problem of open mouth (r = 0.105*) revealed significance with changes over time by simple correlation analysis. In order to understand the effects of non-linear simple correlation, the periods between completion of radiotherapy and patients filling in the questionnaire were divided to 4 groups: 3-6 months, 6-12 months, 1-5 years and more than 5 years. All items but three (problem of open mouth, administration of painkiller and gain weight) showed statistical significance by one-way ANOVA analysis. Hence, all items and symptoms changing over time were divided into four types: increasing, decreasing, U type, and W wave type.
Conclusions : Our study suggest that detailed information about the changes over time may help us in communication with patients and in design of intervention studies focusing on improvement of the supportive care and rehabilitation of patients with nasopharyngeal carcinoma after radiotherapy.

並列關鍵字

Quality of life ； Radiotherapy ； Nasopharyngeal carcinoma ； EORTC