| Research objectives:To investigate the survival benefit of traditional Chinese medicine combined with TACE plus target immunotherapy on patients with advanced liver cancer,and to conduct subspecies research based on TCM syndrome type,short-term efficacy of tumor body,invasion of portal vein tumor thrombus,liver function classification,physical condition and other factors.To summarize the influencing factors related to the improvement of survival in advanced liver cancer with TACE combined therapy.Research methods:This clinical retrospective study was collected from patients who were hospitalized in the Department of Hepatology,Hubei Provincial Hospital of Traditional Chinese Medicine from January2018 to December 2021.A total of 139 TACE cases were collected in strict accordance with the inclusion and exclusion criteria through query and review of the case system.Combination therapy for patients with advanced liver cancer.3 cases were excluded,9 cases were dropped out,and a total of 127 patients who met the requirements were included.The average survival time,median survival time and survival rate of the total cases were observed.According to the different treatment methods,they were divided into traditional Chinese medicine combined with TACE group,target immunotherapy combined with TACE group,traditional Chinese medicine combined with TACE plus target immunotherapy group（hereinafter referred to as traditional Chinese medicine group,target immunotherapy group,traditional Chinese medicine + target immunotherapy group）.comparison of survival benefits.Different TCM syndrome types,short-term curative effect of tumor,invasion of portal vein tumor thrombus,liver function grading,physical condition and other factors were studied in subspecies.The collected data was established by excel software,and SPSS22.0software was used for statistical analysis of the data.P<0.05 indicated that the difference was statistically significant,and the relationship between it and the median survival time and survival rate was statistically analyzed.Results:1.General situation: There are a total of 127 cases in this retrospective experiment,of which the total number of females is31 and the total number of males is 96.The age range was 39 to 81 years old,with a mean age of 59 years.There were 52 patients aged<60 and 85 patients aged ≥60.There were 86 patients with HBV-DNA positive and 11 patients with HCV-RNA positive.There were 29 patients with portal vein tumor thrombus,and 98 patients without portal vein tumor thrombus.There were 17,19,and 97 patients with an ECOG score of 0,1,and 2,respectively.There were 41 patients with liver function class A and 86 patients with liver function class B.From the distribution of TCM syndrome types,Zheng deficiency and blood stasis syndrome and spleen deficiency and dampness resistance syndrome account for the vast majority,accounting for 57 and 46 cases respectively.3 cases,12 cases of liver-kidney yin deficiency syndrome.2.Evaluation of short-term efficacy of tumor: Among the 113 evaluable patients,there were 26 patients with tumor remission（CR+PR）,the tumor remission rate was 20.47%,and the number of cases whose disease was controlled（SD+PR+CR）For 82 cases,the tumor control rate was 72.56%.3.Overall survival analysis: Survival analysis of all cases included in the study group showed that the median survival time of TACE combined treatment for advanced liver cancer was 14 months,and the Cl（95%）was 11.949-16.051.Statistical analysis with life table method showed that the half-year survival rate was 88%,the1-year survival rate was 76%,the 2-year survival rate was 49%,and the 3-year survival rate was 4%.4.Survival analysis among the three groups: Chinese medicine group,target immunity group and Chinese medicine + target immunity group,the median survival time of the three groups were 12 months,15 months,and 19 months respectively（P values between groups were0.034,0.001,0.043）,p < 0.05,with statistical significance.5.Comparison of survival rates between the traditional Chinese medicine group and the target immunity group: The traditional Chinese medicine group and the target immunity group were statistically analyzed by the life table method.The half-year,1-year,2-year and 3-year survival rates of the Chinese medicine group were 78%,32 %,6%,and 0%,and the half-year,1-year,2-year,and 3-year survival rates in the target-immune group were 82%,63%,12%,and 3%,respectively.6.Comparison of survival rates between the target immunity group and the Chinese medicine + target immunity group: The target immunity group and the Chinese medicine + target immunity group were statistically analyzed by the life table method.The rates were 82%,63%,12%,and 3%,respectively.The half-year,1-year,2-year,and3-year survival rates of the TCM+target immunity group were 87%,66%,36%,and 7%,respectively.7.Internal comparison of target immunity group: The target immunity group was subdivided into targeted group,immune group,and targeted + immune group.The median survival time of the target group was 14 months,and the median survival time of the immune group was 16 months.The median survival time in the targeting +immunization group was 14 months（P values ??between groups were0.776,0.540,and 0.708,respectively）,p>0.05,and there was no statistical significance.8.Survival analysis of short-term efficacy evaluation of tumor:the median survival time of CR+PR group was 27 months,the median survival time of SD group was 14 months,and the median survival time of PD group was 6 months（P values ??between the groups were respectively）.is 0.000,0.001,0.000),p < 0.05,with statistical significance.9.Survival analysis of different TCM syndrome types: Comparing the most common TCM syndrome types,Zheng-deficiency and blood-stasis syndrome and spleen-deficiency-damp-resistance syndrome,the median survival period of Zheng-deficiency and blood-stasis syndrome was 12 months,and the median survival time of spleen-deficiency and damp-stagnation syndrome was 12 months.The survival time was 14 months（P=0.769）,p>0.05,not statistically significant.Once again analyzed by the life table method,the half-year,1-year,2-year and 3-year survival rates of Zheng deficiency and blood stasis syndrome were 77%,47%,9% and3%,respectively,while the half-year,1-year survival rates of spleen deficiency and dampness excess syndrome were,2-year and3-year survival rates were 80%,56%,11% and 0%,respectively.10.Survival analysis with portal vein tumor thrombus: the median survival time of patients with portal vein tumor thrombus was 14 months,and the median survival time of patients without portal vein tumor thrombus was 14 months（P=0.113）,p>0.05,Not statistically significant.11.ECOG score survival analysis: the median survival time of patients with ECOG score 0 was 17 months,the median survival time of patients with ECOG score 1 was 16 months,and the median survival time of patients with ECOG score 2 was 13 months（group）.Comparison between the two,the P values were 0.719,0.508,0.643),p>0.05,and there was no statistical significance.12.Survival analysis of liver function classification: the median survival time of patients with liver function class A was21 months,and the median survival time of patients with liver function class B was 13 months（P=0.001）,p<0.05,with statistical significance significance.Conclusion:1.Traditional Chinese medicine combined with TACE plus target immunotherapy,compared with target immunotherapy combined with TACE,can greatly improve the survival period of patients and increase the survival benefit of patients.2.Traditional Chinese medicine combined with TACE plus target immunotherapy can improve the survival of patients with advanced liver cancer,but its survival benefit may be related to liver function classification.3.In the aspect of TCM dialectics,there was no significant difference in the median survival time between Zheng-deficiency and blood-stasis syndrome and spleen-deficiency and damp-stagnation syndrome.4.The combination of multiple treatments can bring more survival benefits to patients.In clinical practice,depending on the conditions of different patients,multiple treatment plans can be combined to strengthen the control of patients’ tumors when the patient can tolerate it.Combined with traditional Chinese medicine Treatment to reduce toxicity and enhance efficacy,inhibit tumor growth,so that patients can have better survival treatment and survival benefits. |
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