由於國民平均壽命延長，醫療科技日新月益及醫療型態的改變，其新穎的治療方式及技術與醫療水準亦隨著進步與提升，相繼也提高了癌症治療的成效，並隨著現今健康照護政策之理念，也已由疾病治療轉為健康促進，其提升生活品質顯然也是一個重要的議題。此次研究的主要目的為瞭解頭頸部癌症病患接受放射治療後之現況及影響生活品質重要因素之探討。本研究屬橫斷性研究設計，以立意取樣方式於高雄某醫學中心選取接受放射治療後之頭頸部癌症病患為研究對象，其研究工具則是採用歐洲腫瘤研究組織EORTC所設計專門為癌症病患使用的疾病特殊性量表EORTC QLQ-C30 和EORTC QLQ-H&N35 台灣繁體中文版之問卷，以及由研究者於病歷摘錄相關資料，並利用描述性統計、t檢定、變異數分析及逐步複迴歸等方法進行資料分析，研究結果在人口學屬性中，病患以男性居多，年齡層介於40-50歲，而「年齡」與「性別」是影響生活品質的重要因素，可能與工作收入方面產生壓力及性別間之適應能力有關係，而治療後症狀多集中在口腔問題方面，譬如口乾、唾液黏稠、牙齒問題、張口困難等，嚴重影響到病患之生活品質，臨床上雖然陸續發表改善之措施，但成效有限，建議國家相關研究單位或醫療機構能針對這些症狀去進行預防和治療的研究，以減輕病患治療後不適的症狀，進而提高生活品質。
期望藉由本研究之結果，提供未來頭頸部癌症病患接受放射治療後改善生活品質之參考依據，並對於顯著影響生活品質的因素，提供改善的建議與方法，而能運用在現有癌症病患的治療中，以提升頭頸部癌症病患接受治療後的生活品質。另外期望藉由本研究之結論，提出相關建議，以作為臨床醫療工作人員及衛生主管機關，擬定相關的治療計劃及提升癌症治療品質之參考，期盼對政府及醫界均有所助益。

The purpose of this study is to evaluate the health related quality of life (QoL) of head and neck cancer (HNC) patients with cancer-free survival after treatment and to investigate the factors correlated with their health-related QoL. The European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) questionnaire and the EORTC head and neck cancer-specific questionnaire (QLQ H&N-35) were self-administered by all participating patients. Sociodemographic data were collected using a questionnaire specifically designed for the study and through the medical chart reviewed. The patients who have been treated radiotherapy in our department of radiation oncology were invited to participate Health-related quality of life was assessed 3 months or later after completion of radiotherapy. Data relating to sociodemographic factors, disease characteristics and treatment factors of HNC survivors were analyzed. A total of 141 head and neck cancer patients completed the questionnaires. After data analysis, the results are described as follows: In the results of EORTC QLQ-C30 questionnaire, the score of “global health status” is 69.34. Most of the patient could maintain good functional quality of life. “Fatigue” is the most impaired symptom score in the patient. In the results of EORTC QLQ-H&N35, the three head and neck specific symptom scores indicating the most impaired in QOL were “Weight loss”, “Nutrition supplements” and “dry mouth”. After analysis through the multiple regression model, we found sex, age, tumor subsite, radiotherapy technique and surgery were the independent factors significantly correlated with the QoL scales
This study is helpful for us to understand the QoL status and the factors affecting the QoL for patients with head and neck cancer after radiotherapy.

誌謝 i
中文摘要 ii
ABSTRACT iii
目錄 iv
圖目錄 vi
表目錄 vii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第三節 研究流程 3
第二章 文獻探討 6
第一節 頭頸部癌症介紹 6
第二節 生活品質 (Quality of Life) 14
第三章 研究方法與執行步驟 19
第一節 研究架構 19
第二節 研究方法 21
第三節 資料處理與分析 26
第四節 倫理考量 27
第四章 研究結果與分析 28
第一節 病患人口學屬性及治療情況之分析 28
第二節 病患生活品質問卷調查結果之分析 31
第三節 病患問卷尺度與各自變項相關檢定之結果 38
第四節 病患問卷各項生活品質量尺之複迴歸分析結果 51
第五章 討論 59
第一節 頭頸部癌症病患之EORTC QLQ-C30問卷結果 59
第二節 頭頸部癌症病患之EORTC QLQ-H&N35問卷結果 62
第三節 病患之人口學特性與生活品質尺度的關係 64
第四節 病患疾病狀況和醫療情形變項間與生活品質尺度的關係 65
第六章 結論與建議 68
第一節 結論 68
第二節 建議 69
第三節 研究限制 70
參考文獻 71
中文部份 71
英文部份 71
附錄一 問卷調查說明及同意書 80
附錄二 問卷調查表 83

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