乳癌病患接受強度調控放射治療與護理照護介入之皮膚反應分析

Nursing Instruction to reducing Skin Toxicity for Breast Cancer Patients who undergo Intensity-Modulated Radiotherapy

"背景:使用「強度調控放射治療」可以減輕放射治療所帶來的「皮膚副作用」,若能搭配完整衛教,增加自我照護強度,更可減輕副作用。

目的:探討「乳癌」病人接受強度調控放射治療過程,給予多階段自我照護衛教之 相關成效。

材料及方法:本研究包含 65 位接受「強度調控放射治療」乳癌患者。回顧分析病人相關資料,患者皆接受多階段護理衛教。以 CTCAE 及 RTOG 分級並記錄其 急性皮膚副作用,進而統計分析影響皮膚副作用之因素。

結果:收集自 2014 年 2 月至 2016 年 3 月共 65 位病人。完成 4 次護理衛教與評值。 急性副作用方面,RTOG 分級 0 級 1 位(1.5%);第 1 級 54 位(83.1%);第二級 10 位(15.4%)。CTCAE Grade1:55 位(84.6%),Grade2:10 位(15.4%)。不論是 RTOG 或是 CTCAE,都沒有病人超過第三級以上的皮膚 急性副作用。

結論:本研究發現大多數病患(85%)都只有發生 0-1 級的皮膚急性副作用。多階段給予病人自我照護護理衛教,及適時評值可整體減輕乳癌患者放射治療過程 中的急性皮膚副作用。

 

The use of intensity-modulated radiation therapy reduces the skin side effects due to radiation therapy. When combined with a complete health educa-tion, the intensity of self-care is increased and side effects are decreased.

Purpose: This study determines the effect of multi-stage self-care health education for patients with breast cancer who are subject to intensity-modulated radiation therapy.

65 patients with breast cancer who receive radiotherapy were enrolled. The data for the patients who received multi-stage nursing health education was used to grade and record acute skin side effects in patients using CTCAE and RTOG and for a statistical analysis of the factors affecting skin side effects.

Data from a total of 65 patients from February 2014 to March 2016 was collected. The patients completed 4 nursing health education and assessments. In terms of acute side effects, 1 patient (1.5%) suffered from RTOG grade 0, 54 patients (83.1%) suffered from RTOG grade 1 and 10 patients (15.4%) suffered from RTOG grade 2. 55 patients (84.6%) suffered from CTCAE Grade 1 and 10 patients (15.4%) suffered from CTCAE Grade 2. No patients suffered from Grade 3 RTOG or CTCAE.

This study determines that most patients (85%) experience Grade 0-1 acute skin side effects. Multi-stage self-care nursing health education for patients and timely assessments reduce the overall incidence of acute skin side effects in patients with breast cancer during radiotherapy.