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中文摘要 放射治療導致的疲倦是很常有之早期及慢性的副作用

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• 計畫中文名稱 「96 年獎勵醫療機構之醫事人員從事臨床研究計畫」-cytokines 和肝癌放射治療相關疲倦之間的角色

• 計畫英文名稱 The role of cytokines in liver cancer radiotherap-related fatigue

• 系統編號 PG9608-0249 • 研究性質 基礎研究

• 計畫編號 DOH96-PA-1013-F • 研究方式 補助(研究/辦理)

• 主管機關 行政院衛生署藥政處 • 研究期間 9601 ~ 9612

• 執行機構 台北醫學院附設醫院{放射腫瘤科}

• 年度 96 年 • 研究經費 253 千元

• 研究領域 臨床醫學類

• 研究人員 邱仲峰

• 中文關鍵字 疲倦;放射治療;肝癌;;;;;

• 英文關鍵字 cytokine;fatigue;radiation;hepatoma;;;;

• 中文摘要

放射治療導致的疲倦是很常有之早期及慢性的副作用。據研究報導,多達 80﹪病人於治療中有早期發生之疲倦,而有多達 30

﹪於治療後仍有慢性疲倦副作用。至今放射治療導致疲倦的原因仍不十分清楚,許多的相關研究也提出放射治療的程度、放 射治療的長短、放射治療的癌症部位、及使用合併治療的模式等都有不同的影響。我們預計徵求 40 位肝癌病人,符合收案標 準進行每天 2Gy 劑量、每週 5 天共 50Gy 之立體定位放射治療(沒有併用其他治療),進行前驅實驗,結果顯示疲倦的程度、

疲倦的時間長短及疲倦對生活之影響和放射治療累積劑量有顯著相關。 疲倦比疼痛、性生活、癌症本身及治療模式都更嚴重 影響生活品質。而造成疲倦之原因包括有貧血、體重減輕、發燒、疼痛及感染等,以及和上述原因相關之 Cytokines、如 IL-1、

IL-2、TNF-α 及 interferon 等。Cytokines 和許多體內器官及互相反應是造成癌症病人疲倦可能原因。 綜合所知,我們假設放 射治療導致疲倦和血液中 Cytokines 之濃度有直接相關,將設計於治療前、治療中及治療後分別檢測病人血液中 Cytokines 濃 度,同時以林佳靜教授發展之台灣版簡明疲憊量表(BFI-Taiwan Form)來檢定疲倦的程度。 我們認為探索 Cytokines 和放射 治療導致的疲倦之關係是很重要。這個結果將帶給臨床上的重要依據,可以作為癌症病人疲倦治療上的方向,以 Cytokines 為 治療之標的。 既然疲倦是放射治療最重要的副作用之一,許多病人都需要尋求相關的知識,因此本計劃是基礎加上臨床上之 研究來證實相關知識,對醫療工作人員及家人來照顧疲倦病人就非常重要。

• 英文摘要 Radiation therapy induced fatigue is a common early and chronic side effect, reported in up to 80% and 30% of patients during

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radiation therapy and at follow-up visit, respectively. The etiology of radiation therapy induced fatigue are still not understood, and in many studies the degree and time course of fatigue was shown to depend on site of tumor and treatment modalities. Our project is planed to collect 40 hepatoma patients undergoing stereotactic radiotherapy( 2 Gy/ day, 5 fractions/ week, total of 50 Gy) to correlate their fatigue intensity, fatigue duration and fatigue interference during treatment course. Fatigue is the major affect of quality of life more than pain, sexual dysfunction and other cancer or treatment related symptoms. Factor contributing to fatigue including anemia, weight loss, fever, pain, medication and infection; and their natural nataghists , such as IL-1, Il-2, TNF-α and interferon. Cytokines have pleiotropic effects on multiple organ systems and may be responsible for many of the components of fatigue in cancer patients. As our knowledge, we suppose that radiotherapy-induced fatigue may correlate the changes of level of cytokines, besides duration of treatment or time-dose factor in radiotherapy is also an important factor. We will design a protocol to check cytokines levels before, during and after radiotherapy of cancer patients, and Brief Fatigue Inventory- Taiwan Form(BFI) will be tested as a score of fatigue in cancer patients receiving radiotherapy. In summary, as inchoate understanding of the role of cytokines in radiotherapy Related fatigue is emerging. This knowledge has potential for clinical using, it is possible that fatigue in cancer patients can be ameliorated by soluble receptors, receptor antagonists, or other cytokine inhibitors. Since fatigue is one of the most common long-term radiotherapy side effects, numerous patients continue to seek information. Thus , support and guidance provided by healthcare givers are essential.

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