The effects of concurrent chemoradiation therapy on respiratory function and the efficacy of inspiratory muscle training in patients with esophageal cancer

• Main Authors: Yi-Hsuan Huang, 黃怡璇
• Other Authors: Li-Ying Wang
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/16706623190423494338

碩士 === 國立臺灣大學 === 物理治療學研究所 === 104 === Background: Incidence rate of esophageal cancer remains high in Taiwan. The impacts of concurrent chemoradiation therapy (CCRT) on respiratory function, physical activity, and quality of life, and the efficacy of inspiratory muscle training (IMT) remains to be determined in patients with esophageal cancer. Purposes: The purposes of this study were to 1) evaluate the effects of CCRT and 2) investigate the effects of synchronous IMT during CCRT on respiratory function, physical activity, and quality of life in patients with newly diagnosed esophageal cancer. Methods: Phase I: a total of 33 subjects were recruited. Clinical data were collected and respiratory function (maximal respiratory pressure and pulmonary function test), physical activity, and quality of life were assessed at baseline and after CCRT was completed. Phase II: a total of 6 subjects were recruited and assigned to either control or IMT group (n=3 per group). Clinical data collection and all measurements were identical to phase I at baseline, and once per week until CCRT was completed. Diaphragmatic surface electromyography was used to exam diaphragm activity during performing maximal inspiratory pressure (MIP) and IMT tasks. Patients in IMT group received IMT with an intensity of 30%MIP, 15 times/set, 3 sets/day for 7 days/week, until CCRT was completed. Generalized Estimating Equations and Generalized Linear Model were used to detect differences of variables between and within groups. Significant level was set at 0.05. Results: Phase I: compared to baseline, respiratory function, physical activity, and quality of life all decreased after CCRT in patients with esophageal cancer (all p<0.01). Phase II: MIP, physical activity and certain aspects of quality of life showed improvement after CCRT in the IMT group. Electromyography showed that diaphragm activation efficiency and fatigability improved after training in the IMT group. Conclusions: CCRT has negative impacts on respiratory function, physical activity, and quality of life in esophageal cancer patients. Synchronous IMT during CCRT showed promising potential to improve respiratory function (e.g., diaphragm function), physical activity, and quality of life in patients with esophageal cancer.