Study On The Prognostic Factors Of Stage Ⅳ Gastric Cancer And The Efficacy And Safety Of Traditional Chinese Medicine In Treating Patients Of Stage Ⅳ Gastric Cancer

Gastric cancer is one of the most common malignant tumor of digestive tract,the incidence and mortality rates are the highest in all malignant tumors in our country,threatening people’s health and life safety,and it’s becoming a major public health problem in the medical personnel urgent.Early gastric cancer is not easy to be found and diagnosed,more than half of the patients have been in the stage of disease progression,losing the opportunity of radical resection.Gastric cancer is complicated,and the treatment plan is not uniform,the overall prognosis is generally poor.Therefore,to investigate the prognostic factors of survival for stage IV gastric cancer patients,especially to explore can better improve the clinical symptoms,improve the quality of life and prolong the survival time of the means,has very important practical significance.ObjectiveObjective to explore the factors related to the prognosis of patients with gastric cancer in Shanghai Changzheng Hospital and Shanghai Armed Police Hospital;to compare therapeutic effects of traditional Chinese medicine and Western medicine combined with radiotherapy and chemotherapy in treatment of stage IV gastric cancer,to evaluate the effect of traditional Chinese medicine in the treatment of stage IV gastric cance,in order to provide the reference and support for the future clinical practice,the relevant data of the patients with advanced gastric cancer were collected by standardized treatment and individualized intervention.Materials and MethodsUp to December 31,2016,a total of 273 patients with stage IV gastric cancer were collected by retrospective investigation.Use Microsoft Excel 2007 to establish the database,the use of double control input case data,after the sampling inspection,sampling rate of not less than 20%.Indicators and factors include:(1)The general condition of the patient: gender,age,smoking history,drinking history,family history of cancer,disease history,newly diagnosed Karnofsky score(KPS),newly diagnosed hemoglobin values and anemia,untreated serum albumin values and hypoproteinemia;(2)tumor factors: primary tumor distribution,Borrmann type,pathological type,histological differentiation,metastasis,abdominal and pelvic effusion,digestive tract obstruction,gastrointestinal bleeding,complications etc;(3)Treatment: Traditional Chinese medicine,chemotherapy,chemotherapy combined with traditional Chinese medicine treatment,chemotherapy combined with radiation therapy;(4)Time: the time of pathological diagnosis,time of death,the last follow-up time,and the actual survival time.Use SPSS17.0 software for statistical analysis:using the t test,χ2 test,non-parametric tests,Kaplan-Meier method to calculate the Log-rank analysis of survival;life table survival analysis;COX proportional hazard model for multivariate analysis of stage IV gastric cancer independent prognostic factors.Results1.It showed that the median survival time(mOS)of overall patients were 11.3 months,1,2,3,5 year survival rates were47.6%,8.8%,2.6%,1.1%.2.COX regression proportional hazards model shows: gender,treatment,age of onset,degree of tumor cell differentiation,number of metastatic foci,KPS score,the number of newly diagnosed hypoproteinemia and the number of complications,are the independent prognostic factors in patients with stage IV gastric cancer.3.Comparative result between traditional Chinese medicine and radiotherapy combined with chemotherapy:(1)Survival and survival rates: the median OS of the two groups were 15.1 months and 10.1 months,1,2,3,5 year survival rates were62.5%,12.5%,3.1%,3.1% and 35.0%,8.3%,3.3%,0,their difference was statistically significant(P=0.046<0.05);(2)Quality of life: three months after treatment,the KPS score was(79.06±12.79)and(71.50±16.14),their difference was statistically significant(P=0.024<0.05);(3)Adverse reactions: two groups of leucopenia,anemia,nausea and vomiting,diarrhea,hand foot syndrome,liver and kidney toxicity,neurotoxicity,mucositis were statistically significant(P<0.05).Conclusion1.Gender,age,disease treatment,tumor cell differentiation,metastasis,the number of newly diagnosed KPS score,the number of diagnosed hypoproteinemia and complications are the independent prognostic factors in patients with stage IV gastric cancer.2.Compared with the western medicine combined with radiotherapy and chemotherapy group,the traditional Chinese medicine therapy of resolving phlegm and resolving stasis has advantages in survival time,quality of life and adverse reactions,It is suggested that standardized TCM therapy is an effective and feasible method for patients with stage IV gastric cancer.