頭頸部腫瘤患者之體質證型在放射治療前後對體重變化的影響：前瞻性觀察型研究

Influence of Weight Loss on Different Traditional Chinese Medicine Constitutional Types of Patients with Head and Neck Cancer Who Underwent Radiotherapy: An Observational Study

目的：探討中醫體質陰虛，陽虛及痰瘀對頭頸部腫瘤患者在接受放射治療前後體重變化的影響。研究對象及方法：從2013 年2 月1 日至2013 年9 月30 日止，診斷為頭頸部腫瘤，且為第一次接受放射線或同步化學治療，年齡為18 到70 歲患者為收納研究族群，每位患者均以中醫體質量表針對體質進行分類，並對不同體質的患者進行體重變化的比較。放射治療期間，每周紀錄患者之體重，由治療前後之差別評估放射治療對於體重的影響。結果：共收案31 位符合收案標準之頭頸部腫瘤患者。分析後發現接受放射治療前具有痰瘀體質患者在治療結束後體重下降幅度相較於無痰瘀體質患者較大，且有統計學上的意義（P= 0.046）。另外，陰虛體質患者相較於無陰虛體質患者在治療前體重明顯較低（P= 0.008），且隨著治療的過程，具有陰虛體質證型之患者比例也由17.2% 大幅上升至64.3%，但治療前後之體重變化則無明顯差異（P= 0.554）。結論：痰瘀體質頭頸部腫瘤患者在接受放射治療時體重下降幅度明顯較大。據此，可以提供臨床工作者提早對此族群給予預防性營養評估及治療，有利於腫瘤治療進行。Objective: The aim of this study was to investigate the relationship of the traditional Chinese medicine constitutional types “yin-deficiency”, “yang-deficiency” , and “stasis” on changes in body weight of patients with head and neck cancer who were undergoing radiotherapy. Material and Methods: The study enrolled patients within 18 to 70 years old from 2013/02/01 to 2013/09/30 who were diagnosed with head and neck cancer and were going to receive radiotherapy. The patients were asked to complete a questionnaire on body constitution at the onset of radiotherapy, and the body weight of each patient was recorded weekly. The body weight before radiotherapy and body weight change after radiotherapy was compared through different constitutional types. Results: There were 31 patients who were included in the study. Patients with “stasis” constitution at the initiation of radiotherapy had significant weight loss (mean=9.77, P=0.046) at the end of radiotherapy. Patients with “yin-deficiency” constitution before radiotherapy were lighter than patients without it (P=0.008). And the ratio of “yin-deficiency” constitution after radiotherapy elevated from 17.2% to 64.3%, but there was no significant difference on body weight loss (P=0.554). Conclusion: Head and neck cancer patients undergoing radiotherapy who had a “stasis” constitution lost more body weight than patients with other constitutions by the end of the radiotherapy regimen. To avoid this adverse effect, we should administer preventative treatment early during the course of radiotherapy.