晚期肺癌病人接受首次免疫療法前衰弱狀況之初探

背景：大多數晚期肺癌病人在接受免疫療法前，往往都先歷經過其他的治療。相較於接受第一線治療之晚期肺癌病人，這些病人更易出現易受傷害的傾向及衰弱的狀況。目的：本研究在探討晚期肺癌病人接受首次免疫療法前之衰弱狀況。方法：收集將接受免疫療法52位晚期肺癌病人以Fried標準判定其衰弱狀況。使用工具包括：病人基本資料、巴氏量表、美國流行病學研究中心憂鬱量表、國際身體活動量表及手握力與4.6公尺行走速度。結果：發現衰弱者占17.3%，衰弱分組會受到共病症（p = .023）、身體質量指數（p = .004）、日常體能狀態（p ＜ .001）、日常生活活動功能（p ＜ .001）及生理檢驗數值白蛋白（p = .042）、C反應蛋白（p = .048）的影響。結論／實務應用：本研究晚期肺癌病人以體重減輕與低身體活動量為衰弱的主要症狀。因此，醫療人員在病人接受免疫療法前，應評估病人的營養與身體活動功能狀況。盼藉由此研究可提供臨床照護人員思考如何在接受免疫療法之前，提供病人衰弱相關照護。

關鍵字

晚期肺癌；免疫療法；衰弱

並列摘要

Background: Most advanced lung cancer patients have already received many types of treatment before starting immunotherapy. Compared with advanced lung cancer patients under first-line treatment, those receiving immunotherapy are vulnerable to many health problems and increased frailty. Purpose: This study was designed to investigate frailty in advanced lung cancer patients before starting immunotherapy. Methods: A total of 52 pre-immunotherapy patients completed the survey. Frailty status was determined using the Fried standard and survey questionnaires included the Barthel Index, Center for Epidemiologic Studies Depression Scale, the Chinese version of scales of international physical activities questionnaire (short version). In addition, the handgrip and 4.6-meter walk speed of the participants were measured. Result: The ratio of frailty was 17.3%, with comorbidities ( p = .023), body mass index ( p = .004), Eastern Cooperative Oncology Group Status (p ＜ .001), activities of daily living status (p ＜ .001), albumin (p = .042), and C-reactive protein (p = .048) all associated with frailty. Conclusions/Implications for Practice: In this study, weight loss and low physical activity were the main symptoms of frailty in patients with advanced lung cancer. Therefore, healthcare workers should assess the nutrition and physical activity status of patients before initiating immunotherapy. We suggest that clinical care workers provide frailty care to patients before administering immunotherapy.

並列關鍵字

advanced lung cancer ； immunotherapy ； frailty

參考文獻

謝昌成、蕭雅尤、林妙秋、陳碧奇（2010）．老人衰弱症．家庭醫學與基層醫療，25（11），410–417。[Hsieh, C.-C., Hsiao, Y.-Y., Lin, M.-C., & Chen, P.-C. (2010). Frailty in the elderly. Family Medicine & Primary Medical, 25(11), 410–417.] https://doi.org/10.6965/FMPMC.201011.0410

吳佩穎、侯孟次、張嘉凌、張秦松、陳全裕、楊宜青、張家銘、吳至行（2011）．南臺灣偏遠地區老年男性衰弱盛行率及相關危險因子．台灣老年醫學暨老年學雜誌，6（3），161–175。[Wu, P.-Y., Hou, M.-T., Chang, C.-L., Chang, C.-S., Chen, C.-Y., Yang, Y.-C., Chang, C.-M., & Wu, C.-H. (2011). Prevalence and associated risk factors of frailty in elderly male rural dwellers in southern Taiwan. Taiwan Geriatrics & Gerontology, 6(3), 161–175.] https://doi.org/10.29461/TGG.201108.0002

莊艷妃、宋惠娟、林麗萍（2005）．偏遠礦區老人健康狀況及健康醫療資源使用之調查研究．慈濟護理雜誌，4（1），34–41。[Chuang, Y.-F., Sung, H.-C., & Lin, L.-P. (2005). Health status and health resource utilization among older people in rural mining area. Tzu Chi Nursing Journal, 4(1), 34–41.] https://doi.org/10.6974/TCNJb.200503.0034

張欽凱、郭旭格（2006）．衰弱症候群．長期照護雜誌，10（3），203-206。[Chang, C.-K., & Kuo, H.-K. (2006). Frailty. The Journal of Long-Term Care, 10(3), 203–206.] https://doi.org/10.6317/LTC.200609_10(3).0001

柯獻欽、鄭高珍（2018）．晚期非小細胞肺癌之化學治療與標靶治療．內科學誌，29（3），143–152。[Ko, S.-C., & Cheng, K.-C. (2018). Chemotherapy and targeted therapy in patients with advanced non-small cell lung cancer. Journal of Internal Medicine of Taiwan, 29(3), 143–152.] https://doi.org/10.6314/JIMT.201806_29(3).04

國際替代計量

晚期肺癌病人接受首次免疫療法前衰弱狀況之初探

全文下載

主題瀏覽