I. はじめに ) Body Mass Index 2012 BMI stage 1 Isometric Knee 2) Extension Force; IKEF 6 6-Minute 3) Walk Distance; 6MWD Quality

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30 6 867 872 2015 原著 Characteristics of Fatigue of Gastrointestinal Cancer Patients in the Perioperative Period 1,2) 1) 1,3) 2) EISUKE KOGURE, RPT 1,2), TSUYOSHI HARA, RPT, PhD 1), TAKAYA ISHII, RPT 1,3), MASAHARU MAEDA, MD 2) 1) Division of Rehabilitation, International University of Health and Welfare, Mita Hospital: Mita 1-4-3, Minato-ku, Tokyo 108-8329, Japan. TEL+81 3-3451-8121 E-mail: eisuke0590@yahoo.co.jp 2) Department of Rehabilitation, International University of Health and Welfare Graduate School 3) Department of Physical Therapy, International University of Health and Welfare Graduate School Rigakuryoho Kagaku 30(6): 867 872, 2015. Submitted May 29, 2015. Accepted Jul. 27, 2015. ABSTRACT: [Purpose] This study investigated the characteristics of fatigue of gastrointestinal cancer patients in the perioperative period. [Subjects and Methods] Thirty-three gastrointestinal cancer patients were assessed using the cancer fatigue scale (CFS) and their characteristics of fatigue were investigated using factor analysis of CFS subscales. [Results] Three factors were identified and their loadings were respectively 24.5, 17.9, and 17.3%. They were different from the original CFS factors of physical, mental, and cognitive fatigue, and were interpreted as physical durability, mental, and initial action fatigue. [Conclusion] In gastrointestinal cancer patients, physical durability and initial action fatigue are commingled, and there is a possibility that unique characteristics of fatigue, including various factors, exist. Key words: gastrointestinal cancer patients, fatigue, perioperative period 要旨 : 33 Cancer Fatigue Scale CFS 3 24.5 17.9 17.3 CFS 3 キーワード : 1) : 1-4-3 108-8329 TEL 03-3451-8121 2) 3) 2015 5 29 2015 7 27

868 30 6 I. はじめに 5 1 2006 2007 2 1) Body Mass Index 2012 BMI stage 1 Isometric Knee 2) Extension Force; IKEF 6 6-Minute 3) Walk Distance; 6MWD Quality of Life QOL IKEF HUR 5530 5 QOL 1 kgf Nm/ kg 4) 6MWD 50 m 30 5,6) 50 80 7,8) SDM-1 m QOL Cancer Fatigue Scale 9,10) CFS 15) CFS 11) 3 12) 13) CFS 15 1 5 5 0 60 1 19 19 45 14) 16) QOL Hospitality Anxiety and Depression scale HAD HAD 7 7 14 0 7 8 10 11 QOL 17,18) Alb CRP II. 対象と方法 2 1 Wilcoxon CFS 33 1 2 11 1 1 4 0.5 1 1 S 8

869 表 1 CFS 1 1 2 3 4 5 2 1 2 3 4 5 3 1 2 3 4 5 4 1 2 3 4 5 5 1 2 3 4 5 6 1 2 3 4 5 7 1 2 3 4 5 8 1 2 3 4 5 9 1 2 3 4 5 10 1 2 3 4 5 11 1 2 3 4 5 12 1 2 3 4 5 13 1 2 3 4 5 14 1 2 3 4 5 15 1 2 3 4 5 IBM SPSS statistics ver.21 5 5-15-1 表 2 60.8 10.4 17 16 14.4 5.0 min 258.6 86.1 ml 133.4 308.9 31 2 stage 17 7 7 2 Mean SD. III. 結 2 3 14.4 5.0 2 256.8 86.1 133.4 308.9 ml 31 2 果 表 3 6MWD IKEF BMI 6MWD HAD Alb CRP IKEF CFS CFS HAD CFS 13 11 3 1 24.5 2 17.9 3 17.3 59.6 4 kg 58.0 12.0 55.3 11.5 * BMI kg/m 2 22.2 3.0 21.2 2.9 * IKEF N/m/kg 4.7 1.4 4.5 1.2 6 MWD m 541.5 102.2 486.1 92.7 * CFS 5.3 4.9 5.2 4.7 8.4 3.7 8.1 3.7 3.4 2.5 2.6 2.1 * 17.1 6.8 15.8 8.1 HAD 5.4 2.9 4.3 3.1 * 4.4 3.2 4.1 3.6 Alb g/dl 4.4 0.3 3.7 0.4 * CRP mg/dl 0.2 0.3 1.3 1.4 * Mean SD *p<0.05

870 30 6 表 4 1 5.3 35.4 35.4 5.0 33.5 33.5 3.7 24.5 24.5 2 3.0 19.8 55.3 2.7 18.1 51.7 2.7 17.9 42.3 3 1.5 9.9 65.2 1.2 7.9 59.6 2.6 17.3 59.6 4 1.0 6.6 71.8 5 0.9 5.8 77.6 6 0.7 4.5 82.2 7 0.5 3.4 85.6 8 0.5 3.2 88.7 9 0.4 2.6 91.3 10 0.3 2.2 93.5 11 0.2 1.6 95.2 12 0.2 1.6 96.8 13 0.2 1.4 98.1 14 0.1 1.0 99.1 15 0.1 0.9 100.0 表 5 1 2 3 * 2 0.882 0.000 0.194 * 6 0.815 0.022 0.187 * 3 0.778 0.097 0.239 * 1 0.760 0.334 0.063 * 15 0.547 0.111 0.492 4 0.533 0.040 0.400 14 0.021 0.902 0.056 8 0.003 0.890 0.003 11 0.097 0.705 0.077 2 CFS 3 5 5 0.064 0.614 0.023 * 12 0.238 0.035 0.725 IV. 考 察 7 0.129 0.050 0.673 * 9 0.535 0.068 0.660 10 0.132 0.100 0.584 13 0.261 0.216 0.539 *:, : 0.5 1 BMI 19) 20) 1 CRP Alb 6MWD IKEF 6MWD 21)

871 HAD 22) HAD 22) 22) 3 CFS 2 CFS CFS 1 2 CFS 3 CFS 13 11 1/3 23) 19.0 24.2 24) 15.8 20.0 25) CFS 20.3 25) CFS 17.1 CFS 16,24 26) CFS stage 27) 6MWD 3 59.6 引用文献 1) http//www.mhlw.go.jp/stf/ seisakunitsuite/bunya/kenkou_iryou/kenkou/gan/index.html 2015 5 5. 2) 2014 42(12): 1125 1132. 3) 2010 pp23 37. 4) NCCN http//www.jccnb.net/guideline 2015 5 5 5) Degner LF, Sloan J: Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer. J Pain Symptom Manage, 1995, 10(6): 423 431. 6) Bower JE, Ganz PA, Desmond KA, et al.: Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol, 2000, 18(4): 743 753. 7) Stone P, Hardy J, Broadley K, et al.: Fatigue in advanced cancer: A prospective controlled cross-sectional study. Br Cancer, 1999, 79(9 10): 1479 1486. 8) Kutner JS, Kassner CT, Nowels DE: Symptom burden at the end of life: hospice providers perceptions. J Pain Symptom Manage, 2001, 21(6): 473 480. 9) Courneya KS, Mackey JR, Bell GJ, et al.: Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol, 2003, 21(9): 1660 1668. 10) Cramp F, Daniel J: Exercise for the management of cancerrelated fatigue in adults. Cochrane databace Syst Rev, 2008, 16(2): 1 28 11) Richardson A: Fatigue in cancer patients: a review of the literature. Eur J Cancer, 1995, 4(1): 20 32. 12) Escalante CP, Grover T, Johnson BA, et al.: A fatigue clinic in a comprehensive cancer center: design and experiences. Cancer, 2001, 92(6): 1708 1713.

872 30 6 13) Winningham ML, Nail LM, Burke MB, et al.: Fatigue and the cancer experience: the state of the knowledge. Oncol Nurs Forum, 1994, 21(1): 23 36. 14) Matsuda T, Marugame T, Kamo K, et al.: The Japan cancer surveillance research group. Cancer incidence and incidencerates in Japan in 2005: based on data from 12 population based cancer registries in the monitoring of cancer incidence in Japan (MCIJ) project. J Clin Oncol, 2011, 41(1): 139 147. 15) Okuyama T, Akechi T, Kugaya A, et al.: Development and validation of the cancer fatigue scale: a brief, three dimensional, self-rating scale for assessment of fatigue in cancer patients. J Pain Symptom Manage, 2000, 19(1): 5 14. 16) Okuyama T, Akechi T, Kugaya A, et al.: Fatigue in ambulatory patients with advanced lung cancer: prevalence, correlated factors, and screening. J Pain Symptom Manage, 2001, 22(1): 554 564. 17) hospital anxiety and depression scale HAD 1996 93(12): 884 892. 18) hospital anxiety and depression scale 1998 38(5): 310 315 19) Fairey AS, Courneya KS, Field CJ, et al.: Physical exercise and immune system function in cancer survivers. Cancer, 2002, 94(2): 539 551 20) Lin E, Lowry SF, Calvano SE, et al.: Schwartz s principles ofsurgery. McGraw-Hill, New York, 2005 pp3 41 21) Quality of Life 2013 40(3): 184 192 22) 2007 6(1): 59 63 23) QOL 2010 25(5): 711 715 24) QOL 2012 27(4): 469 474 25) 2003 24: 17 22 26) 2008 1(1): 18 25 27) 2012 27(6): 705 709