研究目的：放射治療為頭頸癌病患除了外科手術、化學治療外的主要治療方式，但有些病患因中 斷放射治療療程而影響了治療效果。本研究為回顧性探討本科頭頸癌病患放射治療中斷因素，以 提供護理人員改善放射治療護理品質之參考。 材料與方法：本科自 2013 年 1 月 1 日起至 2013 年 6 月 30 日止，針對此期間回顧頭頸癌初診患 者放射治療療程，進行病患個人屬性、臨床狀況與護理介入措施與放射治療完成療程相關性之分 析，以接受計畫劑量 90% 定義為完成放射治療療程。利用 Chi-square test 評估病患不同因子完 成放射治療的比例，並以 Logistic regression 評估影響完成放射治療療程的獨立因子。 結果：共有 203 位頭頸癌病患於本科接受放射治療，174 人（85.7%）完成放射治療，在 Chi-square test 中，病患個人屬性中無遠端轉移（p= 0.024）及無慢性病（p= 0.044）者有較佳 之治療完成率。在介入措施方面病患接受營養照會（p ＜ 0.001）和會談衛教（p ＜ 0.001）, 及 自費使用影像導引放射治療（p= 0.004）者亦有較佳之治療完成率。在 Logistic regression 中， 病患日常生活狀態（Eastern Cooperative Oncology Group ﹐ ECOG）優於等於 1（p= 0.049）、 無遠端轉移（p= 0.032）、曾接受會談衛教（p= 0.004）及營養師照會（p= 0.004）為與完成放 射治療有關之獨立因子，其中又以營養照會及會談衛教為最顯著之獨立因子，其機率比值分別為 8.902 與 8.012。接受營養照會、衛教會談和自費使用影像導引放射治療三者皆互相關聯，且其治 療完成率較高。病患中斷治療最常見的原因是無法忍受及害怕副作用，佔 48.3%（14/29），其次 為病情嚴重身體虛弱，佔 34.5%（10/29）。 結論：由本研究顯示結果，頭頸癌病患接受營養照會及會談衛教為治療完成率上為重要之影響因 子。因此藉由介入措施- 營養照會與專業放射腫瘤科護理師會談衛教，可改善病患治療的順從性 進而提高治療完成率。

Purpose : Radiation therapy is the major treatment modality in head and neck cancer other than surgical intervention, Some patients did not complete the radiation therapy course that in turn compromise the treatment response. In this study, we retrospectively reviewed the clinical and interventional factors that affect the completion of radiation therapy, and help to improve the quality of nursing care in radiation therapy. Materials & Methods : From January 1 to June 30 in 2013, total 203 patients with head and neck cancer were referred to our radiation therapy department were reviewed. The completion of radiation therapy is defined as 90% of planned radiation dose was delivered. The association between the completion of radiation therapy and their personal characteristics, clinical status and nursing interventions were analyzed. Chi-square test was used for evaluate the proportion of complete treatment in different factors and Logistic regression was applied to define independent factors for completion of radiation therapy. Results : There were 203 head and neck cancer patients received radiation therapy enrolled in this study. Total 174 patients (85.7%) had completed the radiation therapy course. In Chi-square test, the patients who were without distant metastases (p= 0.024) and without chronic systematic disease (p= 0.044) had higher completion rate. For interventional factors, patients who accepted patient instructions (p< 0.001), nutritional consultation (P< 0.001) and image-guided radiation therapy by self-paid (p= 0.004) were also had a better completion rate for radiation therapy course. In Logistic regression, Eastern Cooperative Oncology Group (ECOG) performance status less or equal to 1 (p= 0.049), without distant metastases (p= 0.032), patients who had conselling of patient instructions (p= 0.004) and nutritional consultation (P= 0.004) were the independent factors for completion of radiation therapy course. Nutritional consultation and patient instructions were the most significant independent factors for completion of radiation therapy, and the odd ratio were 8.902 and 8.012, respectively. Nutritional consultation, patient instructions and image-guided radiation therapy by self-paid are interrelated with a higher completion rate of radiation therapy course. The most common reasons for interruption of radiation therapy were intolerante to and anxious of the treatment complications in 48.3% (14/29) patients, following by sickness and weakness in 34.5% (10/29) patients.