頭頸癌病人接受化學放射治療期間疲憊給予運動及按摩之成效探討

頭頸癌是全球男性前10大癌症之一，治療以化放療的合併治療為主。化學治療期間，疲憊是最普遍及最困擾的問題，而放射治療期間疲憊的程度可能會增加，會造成經濟及社會的負擔，影響病人的順從性及生活品質。疲憊可給予藥物及非藥物治療，非藥物治療如運動可以改善癌症病人在治療期間心理及生理的不適，且對肢體力量有大範圍的效果。有運動的病人疲憊、憂鬱分數是比較低，但對睡眠障礙及疼痛是沒有顯著意義。而按摩對癌症病人也有許多正面的影響，可以經由增進放鬆、睡眠及免疫反應去改善他們的疲憊、疼痛、焦慮及噁心。經由文獻查講發現並未有相關研究針對運動加上按摩的共同效應，或針對頭頸部癌症病人因化學及放射治療所產生的疲憊之成效探討，故引發研究的動機。本研究採用類實驗研究方式，探討頭頸癌患者化學併/或放射治療期間給予運動及按摩之成效，結果發現頭頸癌病人於化學治療併/或放射治療期間呈度輕度疲憊 ，按摩組疲憊程度有下降趨勢，但未達統計顯著意義(p=0.080)。睡眠品質之改善，按摩組睡眠品質有上升趨勢，但未達統計顯著意義(p =0.100)。焦慮程度之改善，3組焦慮程度有下降，但未達統計顯著意義。憂鬱程度之改善，3組的憂鬱程度有下降但未達統計顯著意義。

Head and neck cancer is among the top 10 cancers in males, and its treatment is based primarily on concurrent chemoradiotherapy. During chemotherapy, fatigue is the most common and disturbing problem, and radiotherapy increases the fatigue severity, which influences the patient’s compliance, life quality and causes economical and society burden.Fatigue can be treated with or without drugs. Nondrug remedy like exercise eases the mental and physical discomfort of patients and has vast effect on limb power during treatments. Patients who exercise perform better in fatigue and depression scoring, but have no significant advantage in sleep disorder and pain. Massage also has several positive effect on patients with cancer; it relieves their fatigue, pain, anxiety and sickness by improving relaxation, sleep and immune reaction.After bibliographic retrievals, we found no relevant research focuses on the effect of concurrent exercise and massage, or its effect on easing the fatigue of patient receiving concurrent chemoradiotherapy for head and neck cancer, which triggered our motivation for the research.This research adopted quasi-experimental method and discussed the effect of exercise and massage on patients with head and neck cancer during concurrent chemoradiotherapy.The results showed that patients became lightly fatigued after receiving concurrent chemoradiotherapy, and massage group having lower fatigue level but not reaching statistical significance (p=0.080). Massage group also had better sleep quality but not reaching statistical significance (p=0.100). All three groups had lower anxiety and depression level but didn’t reach statistical significance.