A Study on Quality of Life of Advanced Hepatobiliary and Pancreatic Cancer patients Administered with Traditional Korean Cancer Treatment

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서 론 1

¹⁾

. ,

최철민¹, 고병희¹, 김세현³, 최원철², 이수경²

1경희대학교 한의과대학 사상체질과, ²경희대학교 한의과대학 임상종양학과, ³경희대학교 동서의학대학원.

Original Article

A Study on Quality of Life of Advanced Hepatobiliary and Pancreatic Cancer patients Administered with Traditional Korean Cancer Treatment

Chul-Min Choi¹, Byung-Hee Koh¹, Se-Hyun Kim³, Won-Cheol Choi², Soo-Kyung Lee²

1Dept of Sasang Constitutional Mediciene,

2Dept of Clinical Oncology, College of Oriental Medicine, Kyung-Hee University,

3Graduate School of East-West Medical Science, Kyung Hee University, Seoul, Korea.

Objectives: The main goals of cancer treatment are improvement of quality of life and survival prolongation. There is a limitation to prolonging the survival time in hepatobiliary and pancreatic cancer. The purpose of this study was to evaluate the quality of life of hepatobiliary and pancreatic cancer patients who visited for traditional Korean cancer treatment.

Methods: We evaluated the quality of life of 23 hepatobiliary and pancreatic cancer patients who visited for oriental medicine treatment at East-West Neo Medical Center from June to October of 2007. FACT-G (Functional Assessment Cancer Therapy-General), used in this study, is a scale for evaluation of QOL confirmed validity and reliability, popularly used in many countries to evaluate QOL of cancer patients.

Results: The average age of enrolled patients was 57. There were 10 hepatocellular carcinoma patients, 7 pancreatic cancer patients, 6 biliary tract cancer patients. Twenty one patients were in stage and 20 patients had distant metastases. By Sasang constitution, Taeumin were 7, Soyangin were 8, and Soeumuin were 8. The baselines of FACT-G score in the first visit were from 34.33 to 85, and the mean score was 67.3. The mean score of FACT-G in hepatocellular carcinoma patients was 67.5, that of pancreatic cancer patients was 62.5, and that of biliary tract cancer patients was 71.

Conclusions: This study is valuable as an initial QOL study of hepatobiliary and pancreatic cancer patients who visited an oriental medical clinic. We believe that consistent studies will be necessary to demonstrate oriental treatment-related quality of life with hepatobiliary and pancreatic cancer.

Key Words : QOL, FACT-G, hepatobiliary cancer, pancreatic cancer, traditional Korean medicine cancer treatment

접수：2008년 6월 16일 수정：2008년 8월 13일 채택：2008년 9월 1일

교신저자 : 이수경(Soo-Kyung Lee)

서울시 강동구 상일동 149 경희대학교 동서신의학병원 암센타

Tel : +82-2-440-6229, Fax : +82-2-440-7287, E-mail : [email protected]

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2)

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3)

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EORTC (European Organization for Research and Treatment of Cancer) QLQ Series

FACT (Functional Assessment

of Cancer Therapy) .

FACT-G(general) .

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FACT-G

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연구방법

1. 연구대상

2007 6 2007 10

, ,

23

2. 연구방법 1)

2007 6 2007 10

, 23 FACT-G

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,

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3. 측정항목 1)

(1) , QSCC 2+

(Questionnaire of Sasang Constitution Classification

2+) .

(2) (stage) , ,

,

Child-Pugh

Score .

(3) performance ECOG

(Eastern Cooperative Oncology Group)

FACT-G .

(3)

4. 분석방법 및 통계처리

, . SPSS version 12 .

연구 결과

1. 진행성 간 , 담도계암과 췌장암환자의 내원당

시 의학적 상태와 삶의 질에 관한 연구

Table 1 .

23 10

7 6

. 14 (60.9%) 9

(39.1%) ,

50.8 , 64.8 ,

54.7 .

23 21 Stage

20 Stage . 23

performance ECOG Scale ECOG 1 4 , ECOG 2 13 , ECOG 3

5 , ECOG 4 1 .

23 7 ,

8 , 8 .

1) 10

10 Table

2 . 10 Hepato-

cellular Carcinoma .

Hepatocellular Carcinoma

(10)

Biliary Tract Cancer

(6)

Pancreatic Cancer

(7)

Total (23)

Sex (M/F) 8/2 1/5 5/2 14/9

Age 50.8±8.5^a 64.8±12.8 54.7±9.3 57±11.2 Stage

Ⅳ 8 8 7 21

Ⅲ 2 0 0 2

ECOG^b

0 0 0 0 0

1 2 0 2 4

2 6 4 3 13

3 2 1 2 5

4 0 1 0 1

QOL

68.5±13.3 70.9±11.9 62.5±16.9 67.3±13.9 FACT-G

a. Mean±SD, b. Eastern Cooperative Oncology Group

Table 1.

Hepatocellular Carcinoma

(10) Pathology Hepatocellular

Carcinoma 10

Stage Ⅳ 8

Ⅲ 2

ECOG^a 0 0

1 2

2 6

3 2

4 0

Operation lobectomy 2

lobectomy, Cholecystectomy 4 Hemi-hepatectomy 1

TACE^b 7

5.14±3.4^c(4)^d

RFA^e 2

1.5±0.7(1.5) Metastasized

Organ Lung 1

Lung, Bone 1

Lung, Brain 1 Lung, Adrenal gland, LN^f 1

Lung, Bone, Oral Cavity,

LN 1

Adrenal gland 1

LN 1

QOL(FACT-G)

Physical WB^g 19.6±5.58 Social/Family WB 18.1±3.78 Emotional WB 12.8±3.91 Function WB 15.5±5.15 Total 68.5±13.3

a. Eastern Cooperative Oncology Group, b. Transaterial Chemo Embolization, c. Mean±SD, d. median number of operation, e. Radio Frequency Ablation, f. Lymph Node, g. Well-being

Table 2.

(4)

Stage 8 , Stage lobectomy

2 . Stage 8

7 5 , 2 ,

adrenal gland 2 , Brain

1 ,

. Performance Scale ECOG 2 6

ECOG 1 2 , ECOG 3

2 .

10 OP 7 Lobec-

tomy Cholecystectomy 4

2 Lobectomy 1

Hemi-hepatectomy .

10 7 5.14

.

2 1 2 , 1

1 .

. 10

FACT-G

108 68.47 . (Physical Wel-

lbeing) 19.6 / (Social/

Family Wellbeing) 18.1 (Emotional Wellbeing) 12.8

(Functional Wellbeing) 15.5 .

2) 6

6 Table 3

3 3

Biliary Tree Cancer 3 . 6

Stage 6

. Performance Scale

ECOG 2 4 ECOG 3

1 , ECOG 4 1 .

Adenocarcinoma 3 , Cholangiocarcinoma

1 .

Radical Cholecystectomy 1 ,

Pylorus Preserving Pancreatico Duode-

nectomy(PPPD) 1 .

1 . 6 70.94

Biliary Tract Carcinoma

(6)

Pathology Adenocarcinoma 3

Cholangiocarcinoma 1

N/A^b 2

Stage Ⅳ 6

ECOG^f 0 0

1 0

2 4

3 1

4 1

Operation PPPD^c 1

Radical Cholecystectomy 1 Metastasized

Organ Liver 2

Liver, Lung 1 Liver, Stomach, Duodenum 1 Liver, LN^d 1

LN 1

QOL(FACT-G)

Physical WB^e 21.94±4.64 Social/Family WB 17.33±3.72 Emotional WB 15.67±3.14 Function WB 15.17±4.28 Total 70.9±11.9^a

a. Mean±SD, b. Not Assessment, c. Pylorus Preserving Pancreatico Duodenectomy, d. Lymph Node, e. Well-being, f. Eastern Cooperative Oncology Group

Table 3.

(5)

. 21.94

/ 17.33

15.67 15.17

.

3) 7

7 , 7

Stage 6

1 Thyroid Cancer Double Primary

Cancer .

Adenocarcinoma 3 , Neu-

roendocrine Carcinoma

1 . Performance Scale ECOG 1

2 ECOG 2 3 , ECOG 3

2 .

1 PPPD

, 5

, 2.2 Regimen

Cancer Progression

Median 2 .

3 .

FACT-G

62.50 .

.

15.57 /

15 14

15 .

Table 4 .

고 찰

,

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1 , 4

4)

.

5 .

HBV aflatoxin B

, 50

Pancreatic Cancer (7)

Pathology Adenocarcinoma 3

Neuroendocrine

Carcinoma 1

N/A^c 3

Stage Ⅳ 7

ECOG^e 0 0

1 2

2 3

3 2

4 0

Operation 1

Chemotherapy 2.2±1.0(2)^b

(Treated Regimen No) 4 1

2 3

1 1

Radiation Therapy 3

Metastasized Organ Liver 5

Liver, Bile duct,

Intestine 1

Thyroid 1

QOL(FACT-G)

Physical WB^d 15.57±6.11 Social/Family WB 15±4.93

Emotional WB 14±4.32 Function WB 15±6.93 Total 62.5±16.9^a

a. Mean±SD, b. median number of chemotherapy, c. Not Assessment, d.

Well-being, e. Eastern Cooperative Oncology Group

Table 4.

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, 3

10 4.

AFP

20%

5)

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20%

50 60%

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FACT-G

FACIT (Functional Assessment of Chronic Illness Therapy) 1993

. FACT-G

, 2003

15)

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16-17)

( )

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FACT-G

81.9 3

54.4 3.

.

2007 7 2007 10

,

23 .

23 10 7

6 14 (60.9%) 9 (39.1%)

. 50.8 ,

64.8 , 54.7

. 23

21 Stage 20

Stage .

23 performance ECOG

Scale ECOG 1 4 , ECOG

2 13 , ECOG 3 5 , ECOG 4

1 . 23

7 , 8 , 8

.

10 Stage 8

, Stage lobectomy

2 Stage 8 7

. 10

FACT-G

108 68.47

.

6 Stage

6 . .

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70.94 .

7 Stage

6 Liver

1 Double Primary Cancer

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FACT-G 62.50

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결 론

2007 6 2007 10 K

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1. 23 57 ,

10 , 7 ,

6 21 (91%) Stage

20 (87%) .

7 , 8 8

.

2. FACT-G

34.33 85

67.5 71 , 62.5

67.3 .

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