探討不同治療方式對早期子宮頸癌病患生活品質之影響

An investigate of treatments impact on quality of life in cervical cancer patients

李書帆(Su-Fung Li)

指導教授 ： 李亞欣

中山醫學大學/健康管理學院/醫療產業科技管理學系碩士班/碩士(2013年)

https://doi.org/10.6834/CSMU.2013.00193

摘要

研究目的:子宮頸癌治療方式於2000年美國癌症協會（American national cancer institute；NIC）提出同步化學放射線治療後，此新治療方式目前已廣泛的被採用，而該治療方式與僅進行放射治療比較，CCRT治療能增加百分之三十到五十的存活率，在存活率大幅增加後病患生活品質的議題也成為重要的研究項目。針對子宮頸癌第一期與第二期的病患，治療方式有較多選擇及爭議性，故本研究希望藉由問卷訪問方式，了解早期子宮頸癌病患於接受不同治療方式後對生活品質之影響。

研究方法:本研究採歐洲癌症研究及治療中心(European Organization for Research and Treatment Center)發展之問卷EORTC QLQ-C30及EORTC QLQ-Cx24於4家醫療院所婦產科門診進行問卷調查。研究對象為治療後早期子宮頸癌病患，訪問期間為2013年1月至2013年5月，共回收99份有效問卷，分析方法除描述性統計外，利用雙變項分析了解不同治療方式下生活品質;利用複迴歸分析了解各項人口統計變數與疾病情況影響生活品質之情形。

研究結果:接受CCRT治療及手術後CCRT治療病患生活品質普遍較手術治療病患生活品質差。接受CCRT治療及手術後CCRT治療患者症狀以呼吸困難、失眠、嘔吐與噁心、潮熱影響生活品質最劇，手術治療及手術後CCRT治療的病患會有較嚴重的淋巴水腫情況產生。病人生活品質部份以有宗教信仰、切除子宮、家庭月收入較高、無個人病史、可正常活動、70歲以下的患者有較佳的生活品質。

結論:在總體生活品質而言以接受手術治療患者較接受CCRT治療及手術後CCRT治療患者佳。

關鍵字

早期子宮頸癌

並列摘要

Objective:Concurrent Chemoradiation (CCRT), after being proposed by the American National Cancer Institute (NIC) in 2000, has now become a widely-applied new treatment for cervical cancer. CCRT therapy compared with radiation therapy only, CCRT therapy can increase survival rate thirty to fifty percent, a substantial increase in the survival rate of patients after the issue of the quality of life has also become an important research projects. Considering that there has been controversy on the treatment options of cervical cancer stage I and stage II patients, this study aims to understand the post-treatment influence of different treatments on the lifestyle of early-stage cervical cancer patients through the questionnaire interview method.

Method:This study used two questionnaires EORTC QLQ-C30 and EORTC QLQ-Cx24, which was developed by the European Organization for Research and Treatment Center, to interview early stage cervical cancer patients after treatment at the outpatient service of Department of Obstetrics and Gynaecology in four hospitals. The interview period was from January 2013 to May 2013, and a total of 99 valid questionnaires were collected.

Results:The comprehensive analysis found that the life quality of patients receiving CCRT treatment and surgical treatment followed by CCRT is poorer than the life quality of patients receiving surgical treatment. Among the symptoms of patients who receive CCRT and surgical treatment followed by CCRT, dyspnea, insomnia, vomiting and nausea, and menopausal symptoms have been found to have the most severe impact on their quality of life. Surgical treatment and surgical treatment followed by CCRT of patients would have more serious situation arising lymphedema. Partly in the quality of life of patients with religious beliefs, hysterectomy, family income is higher, no personal history, the normal activities of patients under 70 years of age have a better quality of life.

Conclusion: In terms of overall life quality of patients receiving CCRT treatment and surgical treatment followed by CCRT is poorer than the life quality of patients receiving surgical treatment.

並列關鍵字

CCRT ； EORTC QLQ-C30 ； EORTC QLQ-Cx24

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