健脾解毒通络方联合替加氟维持治疗晚期胃癌的临床观察
发布时间：2019-03-31 12:03
【摘要】：目的通过观察接受健脾解毒通络方联合替加氟维持治疗的晚期胃癌患者,回顾性分析该方案对晚期胃癌患者PFS、OS、生存质量及毒性反应的影响;并通过单因素分析,探索与晚期胃癌预后相关的临床病理因素,近而为晚期胃癌的维持治疗提供一定的临床研究证据。方法搜集2010年1月至2015年1月就诊于安徽省立医院中医肿瘤科门诊或病房、有明确病理诊断、临床分期为Ⅲ~Ⅳ期、已接受一线化疗且达到疾病控制后采用健脾解毒通络方联合替加氟治疗的30例晚期胃癌患者。观察其接受该方案维持治疗后的PFS、OS、生存质量及毒性反应。通过建立生存曲线,分析与晚期胃癌预后相关的单因素,进一步通过多因素分析,最终确定影响预后的独立因素。结果PFS方面,30例患者的平均PFS为29.689±5.684个月,中位PFS是15.000±4.674个月。OS方面,30例的平均OS为33.230±4.916个月,中位OS是27.000±5.439个月,截止到观察期,30例患者中仍存活11人。在存活人群中,OS超过5年(76月、75月、72月)且继续存活的有3人;达到4年(48月)的1人;达到2年(24月)的1人;超过1年(16月、17月、19月)的有3个;另有3人未满1年(4月、6月、8月),仍需继续观察;已死亡的19例患者中OS最长达56个月,最短6个月,其中生存期超过1年的有15人,占比78.94%;生存期超过2年的有7例,占比36.84%;生存期达3年的有2人,占比10.52%。生存期超5年的3人,占比10%。预后相关因素方面,本研究从性别、年龄、KPS评分、有无手术治疗、病理类型、组织分级、淋巴结转移、脏器转移等单因素对PFS和OS的影响进行分析,结果显示,影响PFS的单因素是有无手术治疗、淋巴结转移的位置和脏器转移情况(P=0.014、P=0.005、P=0.005)。而淋巴结转移的位置和脏器转移情况(P=0.005、P=0.005)是影响OS的两个单因素。进一步行多因素COX回归模型分析显示,只有脏器转移情况是决定PFS、OS长短的独立因素(P=0.002、P=0.005)。生活质量改善方面,经过中医的辨证施治,以及合理的遣方处药,全部患者在服药期间生活状态改善明显。毒副反应方面,30例患者对替加氟的耐受良好,偶见Ⅰ-Ⅱ度的血液毒性及Ⅰ度的消化道反应,未出现因药物毒性反应而停药,化疗相关性死亡0人。结论健脾解毒通络方联合替加氟维持治疗可以提高晚期胃癌患者近期疗效,改善生存质量,延长疾病无进展生存时间,总生存期也有延长趋势,且毒副作用低,耐受性好。通过多因素回归分析模型探讨影响预后的相关因素,结果显示脏器转移情况是影响预后的独立因素。此维持治疗方案对晚期胃癌患者安全、有效且易于接受,值得进行进一步研究并推广应用。
[Abstract]:Objective to observe the effects of Jianpi jiedu Tongluo recipe combined with tegafur on the quality of life (QOL) and toxicity of PFS,OS, in patients with advanced gastric cancer. Through univariate analysis, to explore the clinicopathological factors related to the prognosis of advanced gastric cancer, and to provide some clinical research evidence for the maintenance and treatment of advanced gastric cancer. Methods from January 2010 to January 2015, the clinic and ward of traditional Chinese medicine oncology department of Anhui Provincial Hospital were collected. Thirty patients with advanced gastric cancer were treated with Jianpi jiedu Tongluo recipe combined with tegafur after receiving first-line chemotherapy and achieving disease control. The quality of life (QOL) and toxicity of PFS,OS, treated with this regimen were observed. The survival curve was established to analyze the univariate factors related to the prognosis of advanced gastric cancer, and the independent factors affecting the prognosis were finally determined by multivariate analysis. Results in PFS, the mean PFS of 30 patients was 29.689 卤5.684 months, the median PFS was 15.000 卤4.674 months, the mean OS of 30 patients was 33.230 卤4.916 months and the median OS was 27.000 卤5.439 months. Eleven of the 30 patients were still alive. Among the survivors, 3 survived for more than 5 years (76, 75, 72 months), 1 for 4 years (48 months), 1 for 2 years (24 months), 3 for more than 1 year (16 months, 17 months, 19 months), 3 for more than 1 year (16 months, 17 months, 19 months), 1 person for 4 years (48 months), 2 years (24 months) and over 1 year (16 months, 17 months, 19 months). Of the 19 patients who had died, the longest OS was 56 months and the shortest was 6 months, of which 15 (78.94%) survived more than one year, among which 15 (78.94%) lived longer than one year. The number of patients who had died was 56 months and the shortest was 6 months, while the other 3 patients had less than one year (April, June, August), which still needed to be observed. The survival time was more than 2 years in 7 cases (36.84%) and 3 years in 2 cases (10.52%). The survival time was more than 5 years, accounting for 10%. In terms of prognostic factors, the effects of sex, age, KPS score, surgical treatment, pathological type, histological grade, lymph node metastasis and organ metastasis on PFS and OS were analyzed. The single factor influencing PFS was surgical treatment, location of lymph node metastasis and organ metastasis (P = 0.014, P = 0.005, P = 0.005). The location of lymph node metastasis and organ metastasis (P = 0.005, P = 0.005) were the two single factors affecting OS. Further multivariate COX regression analysis showed that only organ metastasis was an independent factor in determining the length of PFS,OS (P < 0. 002, P < 0. 005). In the aspect of improving the quality of life, the improvement of life condition of all patients was obvious after the treatment of syndrome differentiation of traditional Chinese medicine and the rational treatment of prescription. In terms of toxicity and side effects, 30 patients had good tolerance to tegafur. I-II degree of blood toxicity and 鈪，
本文编号：2450884
[Abstract]:Objective to observe the effects of Jianpi jiedu Tongluo recipe combined with tegafur on the quality of life (QOL) and toxicity of PFS,OS, in patients with advanced gastric cancer. Through univariate analysis, to explore the clinicopathological factors related to the prognosis of advanced gastric cancer, and to provide some clinical research evidence for the maintenance and treatment of advanced gastric cancer. Methods from January 2010 to January 2015, the clinic and ward of traditional Chinese medicine oncology department of Anhui Provincial Hospital were collected. Thirty patients with advanced gastric cancer were treated with Jianpi jiedu Tongluo recipe combined with tegafur after receiving first-line chemotherapy and achieving disease control. The quality of life (QOL) and toxicity of PFS,OS, treated with this regimen were observed. The survival curve was established to analyze the univariate factors related to the prognosis of advanced gastric cancer, and the independent factors affecting the prognosis were finally determined by multivariate analysis. Results in PFS, the mean PFS of 30 patients was 29.689 卤5.684 months, the median PFS was 15.000 卤4.674 months, the mean OS of 30 patients was 33.230 卤4.916 months and the median OS was 27.000 卤5.439 months. Eleven of the 30 patients were still alive. Among the survivors, 3 survived for more than 5 years (76, 75, 72 months), 1 for 4 years (48 months), 1 for 2 years (24 months), 3 for more than 1 year (16 months, 17 months, 19 months), 3 for more than 1 year (16 months, 17 months, 19 months), 1 person for 4 years (48 months), 2 years (24 months) and over 1 year (16 months, 17 months, 19 months). Of the 19 patients who had died, the longest OS was 56 months and the shortest was 6 months, of which 15 (78.94%) survived more than one year, among which 15 (78.94%) lived longer than one year. The number of patients who had died was 56 months and the shortest was 6 months, while the other 3 patients had less than one year (April, June, August), which still needed to be observed. The survival time was more than 2 years in 7 cases (36.84%) and 3 years in 2 cases (10.52%). The survival time was more than 5 years, accounting for 10%. In terms of prognostic factors, the effects of sex, age, KPS score, surgical treatment, pathological type, histological grade, lymph node metastasis and organ metastasis on PFS and OS were analyzed. The single factor influencing PFS was surgical treatment, location of lymph node metastasis and organ metastasis (P = 0.014, P = 0.005, P = 0.005). The location of lymph node metastasis and organ metastasis (P = 0.005, P = 0.005) were the two single factors affecting OS. Further multivariate COX regression analysis showed that only organ metastasis was an independent factor in determining the length of PFS,OS (P < 0. 002, P < 0. 005). In the aspect of improving the quality of life, the improvement of life condition of all patients was obvious after the treatment of syndrome differentiation of traditional Chinese medicine and the rational treatment of prescription. In terms of toxicity and side effects, 30 patients had good tolerance to tegafur. I-II degree of blood toxicity and 鈪，
本文编号：2450884
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