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Association of Quality of Life in Patients with advanced Non-small Cell
Lung Cancer and Anti-cancer Treatment Modalities:
A longitudinal Study
Quality of life,non-small cell lung cancer,advanced lung cancer,
|Publication Year :||2019|
癌症是目前全球第二大死因，其中又肺癌的死亡率與發生率皆為癌症死因的首位。肺癌病人中約有 85%為非小細胞肺癌病人，非小細胞肺癌相較於小細胞肺癌的病程發展較為緩慢，預後較佳且存活率較高，由於肺癌早期症狀不明顯，加上篩檢診斷較為困難，較容易被忽略，多數病人被診斷時都已經是晚期的階段，五年的存活率只有 6~18%，考量病患多數為年老伴隨共病與晚期肺癌無法痊癒的因素，因此治療的目標不僅止有集中在控制疾病上，更應該針對與顧及病患生活品質的維護甚至提升。
此研究為縱貫型研究，使用便利取樣的抽樣方式，研究對象為從台大醫院腫瘤醫學部門診收取 20 歲以上的 130 名受訪者，研究收案期間為 2017 年 12 月至 2019 年 4 月，並且將病患根據治療方式分成三組分別比較不同治療方式前後的生活品質差異。
本研究中總共收集到 104 位受訪者，依照治療方式將病人分為三個組別，可以發現在整體病患的總體生活品質與功能及症狀構面都有變好的趨勢，但只有免疫治療的整體生活品質治療前後的改變相對於化學與放射治療提高 7.23 分且達到統計上顯著，標靶治療則是在噁心與嘔吐上相較於化學與放射治療改變程度較差，但在腹瀉改變程度則是相對較好。
In more recent years, lung cancer is the major cause of oncologic-related death worldwide. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer (85%). Because of delayed diagnosis, most NSCLC patients are diagnosed at an advanced-stage and predominantly
receive palliative treatment. Treatment includes chemotherapy, radiotherapy, targeted therapy and immunotherapy. In view of incurable nature of advanced NSCLC, the goals of therapy should not only focus on attempts at controlling the disease, but it should also be directed at optimizing the patient’s quality of life (QoL). In the light of these various therapeutic options, it is clear that old version questionnaire cannot cover many important QoL issues or potential side-effects, so the objective of research is to evaluate the QoL of advanced-stage NSCLC patients receiving palliative anti-cancer modalities by using the latest questionnaire.
This research design was a longitudinal design and utilizing convenience sampling. The participants for this study were recruited from the patients with advanced NSCLC and receiving anti-cancer treatment at National Taiwan University Hospital. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and EORTC QLQ-LC29 were used to investigate changes in QoL. The data was analyzed by SAS 9.4. The continuous data were analyzed by t-test and the categorical data were analyzed by Chi-squared test. ANCOVA and Multiple regression was applied to analytic statistics., P<0.05 was defined as statistically significant.
One hundred and four participants were included in the study. The median age of the participants was 63.6 years, and 55.8% were male. Compared three therapy mean difference after 4 to 6 weeks anti-cancer treatment. For the Global health status using immunotherapy improvement of quality of life, and for the Symptoms scales using targeted therapy improvement of diarrhea, but worsening of nausea and vomiting were observed (P <0.05).
Longitudinal QoL assessments are important in advanced lung cancer patients because the data they provide could, for example, evaluate the benefit and risk on QoL under different anti-cancer modalities for doctor to do decision making. During the treatment period, not only is it necessary trying to improve the quality of life for the functional scales and symptomatic scales, but also should pay attention to the adverse effect of the target therapy on physical functioning.
|Appears in Collections:||流行病學與預防醫學研究所|
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