항암화학요법 실시 중인 위암 환자를 위한 운동 중재 연구 :신체조성, 마이오카인, 항암화학요법 부작용 및 치료율

Abstract

In this study, 20 patients who had to undergo chemotherapy after gastric cancer surgery at S city university hospital were divided into 10 exercise group and 10 non-exercise group. The following conclusions were obtained by comparing and analyzing treatment side effects and treatment rates.

1. As a result of comparison and analysis of body composition according to whether or not exercise program was performed, muscle mass in the exercise group increased by 4.34%, lean mass by 4.26%, skeletal muscle mass by 4.39%, and basal metabolic rate by 3.18% after chemotherapy (p< .05). Body fat mass decreased by 3.52%, but there was no significant difference. SMI decreased by 0.18%, but there was no significant difference. After chemotherapy, the muscle mass of the non-exercise group significantly decreased by 2.27%, the lean mass by 2.14%, the skeletal muscle mass by 3.28%, the body fat mass by 11.45%, and the basal metabolic rate by 11.45% (p<.05). SMI decreased by 13.01%.

2. As a result of myokine comparison and analysis according to whether or not the exercise program was implemented, the SPARC in the exercise group decreased from 34.198±3.20ng/ml before chemotherapy to 33.073±.999ng/ml after chemotherapy, but there was no significant difference. did not appear The non-exercise group increased from 28.470±3.993ng/ml before chemotherapy to 30.017±2.575ng/ml after chemotherapy, but there was no significant difference.

3. As a result of comparison and analysis of side effects of chemotherapy according to exercise program execution, in Anorexia/Nausea (anorexia/nausea), in the exercise group, grade 1 was 10%, in the non-exercise group, grade 1 was 37.5%, grade 2 was 12.5%, In oral mucositis, grade 1 was 10% in the exercise group, grade 1 was 25% in the non-exercise group, grade 1 was 12.5% ​​in the non-exercise group in Vomiting (vomiting), and grade 1 was grade 1 in the exercise group in diarrhea (diarrhea). 20%, grade 1 12.5% ​​for non-exercise group, grade 1 12.5% ​​for non-exercise group for constipation, 12.5% ​​for non-motor group for alopecia (hair loss), 12.5% ​​for non-motor group, Neuropathy-Sensory (sensory neuropathy) exercise In the group, grade 1 was 50%, grade 2 was 10%, non-exercise group was grade 1 25%, grade 2 was 12.5%, and in Fatigue (fatigue), grade 1 was 20% in exercise group, and grade 1 was 25% in non-exercise group. %, grade 2 was 12.5%, and in the pain group, grade 1 was 20%.

4. As a result of comparison and analysis of chemotherapy treatment rates according to exercise program execution, in the chemotherapy completion rate, 100% of the exercise group was completed, and 20% of the non-exercise group did not. In the anticancer drug weight loss rate, 60% of the exercise group and 62% of the non-exercise group lost weight.

Based on the above results, it was confirmed that the implementation of the exercise program during anticancer chemotherapy has a positive effect on the body composition of gastric cancer patients, myokine, and the treatment rate of anticancer chemotherapy. This suggests that exercise is a positive part of the treatment of patients with gastric cancer, and arbitration studies by large-scale studies will be required in the future.|본 연구는 S시 K대학병원에서 위암 수술 후 항암화학요법을 시행해야 하는 환자 20명을 대상으로 운동군 10명, 비운동군 10명으로 나누어 운동프로그램 실시 여부에 따른 신체조성, 마이오카인, 항암화학요법 부작용 및 치료율을 비교·분석하여 다음과 같은 결론을 얻었다.

1. 운동프로그램 실시 여부에 따른 신체조성 비교·분석 결과 항암화학요법 후 운동군의 근육량은 4.34%, 제지방량은 4.26%, 골격근량은 4.39%, 기초대사량은 3.18% 유의하게 증가하였다(p<.05). 체지방량은 3.52% 감소하였으나 유의한 차이는 나타나지 않았다. SMI는 0.18% 감소하였으나 유의한 차이는 나타나지 않았다. 항암화학요법 후 비운동군의 근육량은 2.27%, 제지방량은 2.14%, 골격근량은 3.28%, 체지방량은 11.45%, 기초대사량은 11.45% 유의하게 감소하였다(p<.05). SMI는 13.01% 감소하였다.

2. 운동프로그램 실시 여부에 따른 마이오카인 비교·분석 결과 운동군의 SPARC는 항암화학요법 전 34.198±3.20ng/ml에서 항암화학요법이 끝난 후 33.073±.999ng/ml으로 감소하였으나 유의한 차이는 나타나지 않았다. 비운동군은 항암화학요법 전 28.470±3.993ng/ml에서 항암화학요법이 끝난 후 30.017±2.575ng/ml으로 증가하였으나 유의한 차이는 나타나지 않았다.

3. 운동프로그램 실시 여부에 따른 항암화학요법 부작용 비교·분석 결과 Anorexia/Nausea(식욕 부진증/구역)에서 운동군은 grade 1이 10%, 비운동군은 grade 1이 37.5%, grade 2가 12.5%, Oral mucositis(구강점막염)에서 운동군은 grade 1이 10%, 비운동군은 grade 1이 25%, Vomiting(구토)에서 비운동군은 grade 1이 12.5%, Diarrhea(설사)에서 운동군은 grade 1이 20%, 비운동군은 grade 1이 12.5%, Constipation(변비)에서 비운동군은 grade 1이 12.5%, Alopecia(탈모)에서 비운동군은 grade 1이 12.5%, Neuropathy-Sensory(감각신경병증)에서 운동군은 grade 1이 50%, grade 2가 10%, 비운동군은 grade 1이 25%, grade 2가 12.5%, Fatigue(피로)에서 운동군은 grade 1이 20%, 비운동군은 grade 1이 25%, grade 2가 12.5%, Pain(통증)에서 운동군은 grade 1이 20%로 나타났다.

4. 운동프로그램 실시 여부에 따른 항암화학요법 치료율 비교·분석 결과 항암화학요법 완료율에서 운동군은 100% 완료하였으며, 비운동군은 20%가 완료하지 못하였다. 항암제 감량율에서 운동군 60%, 비운동군 62%가 감량하였다.

이상과 같은 결과를 바탕으로 항암화학요법 중 운동프로그램의 실시가 위암 환자들의 신체조성, 마이오카인, 항암화학요법 치료율에 긍정적인 영향을 주는 것이 확인되었다. 이를 통해 운동이 위암 환자의 치료에 대한 긍정적인 부분을 시사하였으며, 향후 대규모 연구를 통한 중재연구가 필요할 것으로 사료된다.