晚期非小細胞肺癌病人於首療標靶藥物期間生活品質之縱貫性研究

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晚期非小细胞肺癌病人於首疗标靶药物期间生活品质之纵贯性研究

Quality of Life at First-line Target Therapy in Patients with Advanced Non-Small Cell Lung Cancer：A Longitudinal Study

林芷亘 , 硕士　　导师：陈金渊　　

繁体中文

晚期非小细胞肺癌；首疗标靶药物；生活品质；广义估计方程式； Advanced Non-Small Cell Lung Cancer ； First-Line Target Therapy ； Quality of Life ； Generalized Estimating Equation (GEE)

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摘要 │ 参考文献 (129) │ 国际计量

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Objective
Lung cancer is the leading cause of cancer death in Taiwan. Target therapy as first-line in patients with EGFR (epidermal growth factor receptor) mutated advanced NSCLC (non-small cell lung cancer) supports effective treatment option in this setting. The majority of patients taking the long-term use of target therapy suffered from adverse events and the impact of quality of life. The objective of this study aimed to evaluate the relationship of EORTC (European Organization for Research and Treatment of Cancer) QLQ-C30, QLQ-LC13 and HADS (Hospital Anxiety and Depression Scale), and quality of life in patients with NSCLC undergoing different time treatments.

Methods
In this study, a questionnaire was used to collect data. From March 2016 to March 2017, a total of 30 patients with advanced or metastatic EGFR mutations were enrolled in a teaching hospital in southern Taiwan. The patients with advanced or metastatic EGFR mutation-positive NSCLC who received gefitinib, erlotinib, or giotrif as first-line treatment, were invited to complete the EORTC QLQ-C30、QLQ-C13 and HADS on between QOL before target therapy and 1 week,1 month, 2 months, and 3 months after commencing therapy, with a total of 5 visits. The data were analyzed by SPSS 20.0 software using the Generalize estimating equation（GEE）model.

Results
With treatment progression after target therapy, the overall quality of life had significant differences (p <0.05) in the week 1 and month 3. There were significant differences (p <0.05) in the month 3 for body function, and week 1 through month 3 for emotional function. For the other scales, at month 3, improvement of insomnia, pain, dyspnea, fatigue and appetite loss, along with worsening syndromes of diarrhea, sore mouth and dysphagia were observed (p <0.05). Melancholy had a significant effect on overall quality of life after the first month of treatment (p <0.019).

Conclusion 
Based on the research results, it is suggested that the overall quality of life be used as the assessment instrument before and after treatment to enable early recognition of arising symptom aggravation. Further, before therapy, support for health education, for example, skin care, oral care, anti-diarrhea, follow up and observation of serious adverse effect is suggested. In summary, 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 close attention to the adverse effect of the target therapy on physical functioning.

参考文献 ( 129 ) 〈TOP〉

Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., . . . de Haes, J. C.(1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. Journal of the national cancer institute, 85(5), 365-376.
连结：
Akin, S., Can, G., Aydiner, A., Ozdilli, K., & Durna, Z. (2010). Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy. European journal of oncology nursing, 14(5), 400-409.
连结：
Akita, R. W., & Sliwkowski, M. X.(2003). Preclinical studies with Erlotinib (Tarceva). Semin Oncol, 30(3 Suppl 7), 15-24.
连结：
Arraras, J. I., Hernandez, B., Martinez, M., Cambra, K., Rico, M., Illarramendi, J. J., . . . Vera, R. （2016）. Quality of Life in Spanish advanced non-small-cell lung cancer patients: determinants of global QL and survival analyses. Springerplus, 5（1）, 836.
连结：
Arrieta, Ó., Angulo, L. P., Núñez-Valencia, C., Dorantes-Gallareta, Y., Macedo, E. O., Martínez-López, D., . . . Oñate-Ocaña, L. F.(2013). Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Annals of surgical oncology, 20(6), 1941-1948.
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使用DOI作为永久连结

引用含有DOI的文献

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。 如想对DOI的使用与概念有进一步了解，请参考 （ ） 。

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。如想对DOI的使用与概念有进一步了解，请参考（）。