|
| |
在開始治療之前，我們應該選評估病人的日常體能狀態 (performance
status,PS)。一般有兩種方法，一是美國東岸癌症臨床研究合作組織 (Eastern
Cooperative Oncology Group ,
ECOG)，二是 Karnofosky。通常，由於前者ECOG比較簡單，所以臨床上也比較常用。從
0分到 4分。基本上，肺癌患者要進行單一化學治療時，其日常體能狀態
(PS) 最好在 2分以內。與含鉑類之化學療法併用，作為治療局部/晚期或轉移性非小細胞肺癌之第一線化療用藥，且最好限制於ECOG
performance status 為 0~1分之病患。然而，肺癌患者要進行標靶治療
，其PS就沒有限制了 。
|
Karnofsky*
|
Scales
|
Zubrod-ECOG-WHO**
|
|
Normal, no complaints
(常沒有任何抱怨，確定沒有疾病) |
100 |
0 |
Normal activity fully ambulatory
(無症狀) |
|
Able to carry on normal activities, Minor signs or symptoms
of disease
(可以正常活動，有一些疾病症狀) |
90 |
1 |
Symptoms, but nearly fully ambulatory
|
|
|
(有症狀，完全步行，但對生活無影響) |
|
Normal activity with effort
(可以稍微正常活動，已經有一些疾病的症狀) |
80 |
|
Cares for self. Unable to carry on normal activity or to do active work
(需要自己照顧，無法從事正常活動) |
70 |
2 |
Some bed time, but needs to be in bed less than 50% of normal daytime
|
|
Requires occasional assistance, but able to care for most of his needs
(有時需要別人幫助，能照顧患者大部分的需要) |
60 |
(躺在床上的時間<50%)
≦2分才能接受針劑化學治療 |
|
Requires considerable assistance, and frequent medical care(需要考慮別人幫助，經常給予醫療照顧)
|
50 |
3 |
Needs to be in bed more than 50% of normal daytime
|
|
Disabled. Requires special care and assistance
(傷殘，需要特別照顧及幫助) |
40 |
(躺在床上的時間>50%) |
|
Severely disabled. Hospitalization indicated though death not imminent
(嚴重傷殘，尚未有死亡的危險) |
30 |
4 |
Unable to get out of bed |
|
Very sick. Hospitalization Necessary. Active supportive Treatment
necessary
(痛情嚴重，尚未有死亡的危險) |
20 |
(長期完全臥床) |
|
Moribund (病況緊急，很快有死亡的危險) |
10 |
|
Dead
|
0 |
5 |
Dead
|
* From D.A.
Karnofsky, J.H. Burchenal: The clinical evaluation of chemotherapeutic agents.
In: Evaluation of chemotherapeutic Agents, ed. by Mcleod, Columbia University
Press, New York , 1949, 191-205.
** From A.B. Miller, B. Hoogstraten, M. Staquet, A. Winkler: Reporting
Results of Cancer Treatment, Cancer 1981, 147: 207.
|
肺癌(Lung
Cancer)醫療暨衛教網頁
(From
何明霖醫師)