Journal of Gynecologic Oncology

Korean Society of Gynecologic Oncology (대한부인종양학회)
권호 표지

A study of support-therapeutic effect and reducing side effect for high-dose vitamin C use of gynecological cancer patients with chemotherapy

항암치료 중인 부인암 환자에서 고용량 비타민 C 사용 시 항암제 보조치료효과와 부작용 감소에 대한 연구

Jeong, Myeong-Su;Jeong, Ji-Yeung;Park, Hye-Eun;Oh, Young-Lim;Kim, Won-Gyu;Lee, Chun-Jun
정명수;정지영;박혜은;오영림;김원규;이천준

  • Published : 2007.06.20
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Abstract

Objective : The high-dose vitamin C is useful in the cancer. Consequently its use should have become how many help even from gynecological cancer patient who is in chemotherapy. Methods : The study was performed prospective on 57 patients who is diagnosed initially the gynecological cancer during chemotherapy at Gospel Hospital of Kosin University between January 2005 and October 2006. The study was divided to its use 29 (cervix cancer: 17, ovarian cancer 12) and no high-dose vitamin C use 28 (cervix cancer: 11, ovarian cancer 17). The cervix cancer was treated by FP chemotherapy for all stage and the ovarian cancer was treated by CC chemotherapy for stage 1, CT or PT chemotherapy for advanced stage for 6 times respectively regarding a treatment in tumor marker change aspect and the side effect researched GOG classifications. Results : It evaluated the nausea and vomiting significantly in ovarian cancer (p＜0.05). It evaluated for liver enzyme, Hb, WBC, platelet serum creatinine, sensory, motor nervous system and tumor marker with the high-dose vitamin C group does not have the difference from the control group statistically. Conclusion : The high-dose vitamin C is a possibility of reducing nausea and vomiting in the ovarian cancer chemotherapy without other side effect. The regarding a tumor marker change it was not significantly but when it analyzed a recurrence a survival rate with more patient and follow up in long period, its use of should have become how many help in gynecological cancer treatment.

목적：많은 연구에서 비타민 C가 풍부한 신선한 과일이나 채소가 암을 예방해 준다고 알려져 있고 특히 고용량의 비타민 C는 체내에서 항산화, H2O2생성, 콜라겐 합성, 면역기능 증강기능이 있어 암 환자에 유용한 것으로 알려져 있다. 따라서 항암화학요법 중인 부인암 환자에서 고용량의 비타민 C 사용이 항암제 부작용 감소에 얼마나 도움이 되는지 알아보고자 본 연구를 하게 되었다. 연구 방법：고신의과대학 복음병원에서 2005년 1월부터 2006년 10월까지 처음 부인암으로 진단받고 항암화학요법으로 치료 중인 57예를 대상으로 전향적으로 연구하였다. 항암화학요법 전후에 혈관으로 20-30 g의 고용량의 비타민 C를 투여하였다. 비타민 C를 투여한 군은 29예이고 대조군은 28예이었고 비타민 C를 투여한 군 중 자궁경부암이 17예이고 난소암은 12예이었고, 대조군은 자궁경부암이 11예이었고 난소암은 17예이었다. 자궁경부암은 5-FU, cisplatin (FP) 항암화학요법을, 난소암은 FIGO병기가 I기초에서는 cyclophosphamide, cisplatin (CC)를 그 이상의 병기에서는 carboplatin, paclitaxel (CT) 또는 cisplatin, paclitaxel (PT) 항암화학요법을 각각 6회를 시행하고 치료에 대한 반응은 종양표지자의 변화양상으로 관찰하였고 부작용은 Gynecologic Oncology Group (GOG)의 분류를 기준으로 연구하였다. 결과：종양의 치료효과 대한 반응으로 종양표지자의 변화를 조사하였고 고용량의 비타민 C군과 대조군에서 종양표지자의 변화는 통계학적으로 유의한 차이가 없었다. 소화기계 부작용으로 오심, 구토, 설사 등을 평가하여 난소암 환자에서 항암화학요법 시 오심과 구토가 통계학적으로 유의하게 감소하는 결과를 보았다(p＜0.05). 골수부작용에 대한 평가는 혈색소, 백혈구, 혈소판 수로 하였으며, 간 기능은 간효소(AST/ALT) 수치로 평가하였으며 고용량의 비타민 C군과 대조군에서 종양표지자의 변화는 통계학적으로 유의한 차이가 없었다. 신장 독성은 혈액 크레아티닌 수치로 평가하여 고용량의 비타민 C 사용군과 대조군에서 종양표지자의 변화는 통계학적으로 유의한 차이가 없었다. 감각신경계와 운동신경계 부작용도 고용 량의 비타민 C 사용군과 대조군에서 종양표지자의 변화는 통계학적으로 유의한 차이가 없었다. 결론：부인암 중 난소암으로 항암화학요법으로 치료하는 환자에서 고용량의 비타민 C 사용군은 오심 및 구토의 소화기계 부작용을 줄일 수가 있었고 골수, 간, 신장 및 감각신경계와 운동신경계에 대해서도 안전하게 사용할 수 있었다. 치료효과에 대한 반응으로 단기간의 종양표지자의 변화는 통계학적 유의성은 없었으나 보다 많은 수의 환자에 대한 연구와 장기간의 추적관찰로 재발 및 생존율을 분석하면 고용량의 비타민 C 사용이 부인암치료에 얼마나 도움이 되는지 알 수 있을 것으로 생각된다.

Keywords

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