| BackgroudProstate cancer is one of common malignant tumors, elderly men in Europe, newly diagnosed each year as many as2,600,000of men with prostate cancer, tumor in11%, accounting for9%deaths in the European Union. In America incidence of prostate cancer in male malignant tumor in the first place, the mortality rate ranks second. In China the incidence of prostate cancer is lower than that in the western countries, the incidence rate of malignant tumor of urinary and reproductive system in third, and showed a rising trend. Since the onset of early clinical symptoms of prostate cancer,50-80%more patients often has to late, lost the opportunity of radical operation. The endocrine therapy is the main treatment for advanced prostate cancer, but after a median time of14～30months after treatment, almost all patients with lesions develop gradually for castration resistant prostate cancer, the clinical therapy for advanced prostate cancer presents a conundrum. Patients with advanced prostate cancer will eventually develop resistance, leading to tumor progression, patients with disease progression, a variety of treatment methods and the current include chemotherapy, radiotherapy, isotope therapy, the clinical efficacy is still not satisfactory. After years of exploration,2008in our hospital specialist Lv Liguo on142cases of advanced prostate cancer patients in the standard endocrine therapy combined with traditional Chinese medicine Fuzheng Yiliu decoction treatment, symptoms and improve the effective rate was81%, the incidence of hot flashes in22.4%, the incidence of osteoporosis is13.8%, breast swelling rate11.7%. In2010our hospital specialist in ancient Chiming prophase syndrome based on the investigation, on androgen independent prostate cancer patients take FuZhengYiLiu therapy, showed FuZhengYiLiu therapy in improving the clinical symptoms of androgen independent prostate cancer rate was78.94%. Hospital statistics in2005to2011in the Department of Urology of Guangdong Province Traditional Chinese Medical Hospital in209patients with advanced prostate cancer follow-up data display, the quality of life in patients with considerable improvement, into hormone independent prostate cancer and hormone refractory prostate cancer patients significantly extend the time of patients with PSA level, objective measures of synchronous better, the individual patient to clinical cure. Previous studies in our institute also found that, in the effect of PSA and bone metastasis index, Fuzheng anti endocrine and isotope therapy tumor intervention measures in prostate cancer bone metastasis in the course of treatment and modern medicine may have a synergistic effect, to achieve the "Quxie" purposes. Traditional Chinese medicine Fuzheng Yiliu therapy for advanced prostate cancer gradually shown its clinical advantages, the theory of traditional Chinese medicine emphasizes the overall view, the etiology and pathogenesis in patients with advanced prostate cancer and syndrome differentiation treatment, can improve the tolerance and compliance of patients, improve the quality of life, improve the clinical efficacy, and can reduce the side effects of hormones and complications. How much is but the application of traditional Chinese medicine Fuzheng Yiliu therapy in the treatment of advanced prostate cancer survival? What is the prognosis? It is reported, based on the relevant research establishment.ObjectiveTo investigate the clinical effect of FuZhengYiLiu therapy in the treatment of advanced prostate cancer, from607Cases of prostate cancer database screened213cases of advanced prostate cancer were eligible patients were retrospectively analyzed, preliminary exploration of FuZhengYiLiu therapy effect on survival time of advanced prostate cancer, and to explore the correlation between survival and patient age, body mass index, underlying diseases, disease stage, pathological staging, liver and kidney function, electrolytes, nutritional status, explore the factors of traditional Chinese medicine Fuzheng anti therapeutic effect and prognosis of law, to guide the clinical practice, and to provide the basis for further clinical study.MethodsEstablishment of prostate cancer database, retrospective analysis of Guangdong Province Traditional Chinese Medical Hospital from December17,2002to May15,2013213cases of patients with advanced prostate cancer, and the database were followed, and the survival time were recorded, the follow-up of patients with BMI index, index, Gleason score, clinical stage, disease stage of development for data analysis, using SPSS18statistical software, analysis of prognostic factors a duality regression, using single factor Cox regression analysis of prognostic factors, selection of relevant factors were significant in the multivariate Cox regression analysis. Survival analysis using the life table method and Kaplan-Meier method, to formulate relevant survival curve, to two or more groups of survival were compared, using Long rank test method. P<0.05is the difference has statistics significance.Result1. Application of traditional Chinese medicine Fuzheng anti tumor therapy in patients with advanced prostate cancer, the median survival time was56.81months, and5year survival rate was44%, the standard error is3%, and5year survival rate of patients with95%confidence interval was44%±1.96X3%, namely (38.12%,49.88%). The median survival time of AIPC was27months, the median survival time was22months in HRPC.2. The study found that prostate cancer syndromes distribution is the main influencing factors of qi deficiency, blood deficiency, yin deficiency, Yang deficiency, qi stagnation, blood stasis, phlegm, heat, toxin, associated with lung, spleen, kidney three organs; Qi deficiency blood stasis which accounted for92.9%, accounted for80.7%, kidney accounted for70.4%, Yang Xu accounted for60.5%, phlegm accounted for36.6%, spleen accounted for35.2%, damp heat accounted for28.6%.3. Treatment for213cases of patients with advanced prostate cancer were analyzed, all patients underwent traditional Chinese medicine Fuzheng Yiliu therapy, IHT therapy in120cases, MAB treatment47cases, radiotherapy in35cases, chemotherapy in11cases. The castration is discussed, the median survival time of operation of ovariectomized group was49months, median survival time in drug therapy group was72months, the results of Log rank test on survival rate in two groups:X2=8.453, P=0.004, efficacy of the drug group is better than control group operation.The endocrine therapy of median survival time of IHT group was50months, the median survival time of group MAB was56months, the results of Log rank test on survival rate in two groups:X2=0.668,P.414>0.05, with no significant difference and the effect of MAB IHT group. The endocrine therapy drug choice are discussed, the median survival time of bicalutamide group was56months, the median survival time of flutamide group was58months, the results of Log rank test on survival rate in two groups:X2=0.779, P=0.378>0.05, efficacy and fluorine bicalutamide group has no difference in efficacy.4. The median survival time of hypertension group was45months, the median survival time of non hypertension group was65months, the results of Log rank test on survival rate in two groups:X2=3.111, P=0.078>0.05, no statistical significance can think, survival rate of the two groups had no difference, no significant difference between the survival group and non hypertension group and hypertension.5. Relationship between patients with advanced prostate cancer related index and survival, serum chlorine test index, serum potassium, serum albumin, unconjugated bilirubin, serum globulin, alkaline phosphatase, urine specific gravity, platelet count, white blood cell count, serum creatinine, aspartate aminotransferase, red blood cell count, blood urea nitrogen, total bilirubin, serum sodium, hemoglobin, serum total protein, serum alanine aminotransferase, the correlation between total bilirubin19influence index and prostate cancer survival, as a significant test of regression equation of the constant term included analysis of variance. Regression regression, SS regression and=21137.174, the19degrees of freedom, MS regression=1112.483;Residual SS residual, residual=182263.695, the164degrees of freedom, MS residual error=1111.364. F=MS/MS=1.001regression residuals. Visible by F significance test, F=1.001, p=0.463>0.05were not significant, through the correlation analysis of variance found no correlation with survival period.6. This study also discusses the relationship between body weight and height, survival period, as a significant test of regression equation of the constant term included analysis of variance. Regression regression, SS regression and=470.576, the1degrees of freedom, MS regression=470.576;Residual SS residual, residual=89050.501, the128degrees of freedom, MS residual error=695.707. F=MS/MS=0.676regression residuals. Visible by F significance test, F=0.676, p=0.412>0.05were not significant, research found that body mass index and survival, there is no correlation.7. This study explored survival from the age, the median survival time of78age group above the age of68months, the median survival time of78years old of the following age group was50months, the results of Log rank test on survival rate in two groups:X2=7.97, P=0.005<0.05, with statistical significance, can think the survival rate of the two groups are different, the age group above the age of78living longer than the age of78.8. This study was carried out to investigate the survival from the pathological score, Gleason score<8grouping median survival time was68months, median survival time Gleason score≥8group was45months, the results of Log rank test on survival rate in two groups:X2=25.19, P=0.000<0.05, with statistical significance, can think the survival rate of the two groups are different, the Gleason score<8survival packet in Gleason score≥8group. Conclusion1. Application of traditional Chinese medicine Fuzheng anti tumor therapy in patients with advanced prostate cancer, the median survival time was56.81months, and5year survival rate was44%, the standard error is3%, and5year survival rate of patients with95%confidence interval was44%±1.96×3%, namely (38.12%,49.88%). The median survival time of AIPC was27months, the median survival time was22months in HRPC.2. The study found that prostate cancer syndromes distribution is the main influencing factors of qi deficiency, blood deficiency, yin deficiency, Yang deficiency, qi stagnation, blood stasis, phlegm, heat, toxin, associated with lung, spleen, kidney three organs; Qi deficiency accounted for92.9%, blood stasis accounted for80.7%, kidney accounted for70.4%, Yang Xu accounted for60.5%, phlegm accounted for36.6%, spleen accounted for35.2%, damp heat accounted for28.6%.3. Treatment for213cases of patients with advanced prostate cancer were analyzed, all patients underwent traditional Chinese medicine Fuzheng Yiliu therapy, IHT therapy in120cases, MAB treatment47cases, radiotherapy in35cases, chemotherapy in11cases. The castration is discussed, the median survival time of operation of ovariectomized group was49months, median survival time in drug therapy group was72months, curative effect of drug castration group is better than control group operation. The endocrine therapy of median survival time of IHT group was50months, the median survival time of group MAB was56months, with no significant difference and the effect of MAB and IHT group. The endocrine therapy drug choice are discussed, the median survival time of bicalutamide group was56months, the median survival time of flutamide group was58months, curative effect and fluorine bicalutamide group has no difference in efficacy.4. Senile Prostate Disease Cancer of late stage, lesion extensive, multi organ involvement, physical condition is relatively poor, with disease, hypertension, diabetes is more common, with disease and malignant tumor also have often make the elderly patients by double or even multiple strike, deterioration will raise the basis of disease and even death. Therefore, in clinical work to active treatment of underlying diseases, medical personnel should inform the patient related life guidance and regulation, reduce the associated mortality.5. Relationship between patients with advanced prostate cancer related index and survival, serum chlorine test index, serum potassium, serum albumin, unconjugated bilirubin, serum globulin, alkaline phosphatase, urine specific gravity, platelet count, white blood cell count, serum creatinine, aspartate aminotransferase, red blood cell count, blood urea nitrogen, total bilirubin, serum sodium, hemoglobin, serum total protein, serum alanine aminotransferase, the correlation between total bilirubin19influence index and prostate cancer survival, through the correlation analysis of variance found no correlation with the survival period of existence.6. This study also discusses the relationship between weight and survival, height, body mass index and survival study found no correlation.7. This study examines the relationship between basic diseases, diabetes and hypertension survival, on the results of this study, the median survival time of hypertension group was45months, the median survival time of non hypertension group was65months, no significant correlation between the groups and the survival period.8. This study explored survival from the age, the median survival time of78age group above the age of68months, the median survival time of78years old of the following age group was50months, the age group above the age of78living longer than the age of78. 9. This study was carried out to investigate the survival from the pathological score, Gleason score<8grouping median survival time was68months, median survival time Gleason score≥8group was45months, with the correlation between Gleason score and survival. The higher Gleason scores, the shorter survival time of the patients; the lower the Gleason score, the longer survival period. The Gleason score can be used as an important factor in predicting prostate cancer survival. |
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