| Objective:Through observation that accept Jianpi Jiedu Tongluo Fang combined with tegafur maintenance therapy in patients with advanced gastric cancer, retrospective analysis of the impact of the scheme on PFS,OS, quality of life and toxic reaction in patients with advanced gastric cancer;and through the single factor analysis, clinical pathology prognostic factors in patients with advanced gastric cancer and exploration, so as to provide clinical evidence of certain as maintenance therapy in patients with advanced gastric cancer. Method:Select from 2010 January to 2015 January in An hui Provincial Hospital treatment in traditional Chinese medicine tumor clinic or ward, with clear pathological diagnosis, clinical stage III~IV, has received first-line chemotherapy and achieved a disease control by Jianpi Jiedu Tongluo decoction combined with tegafur in treatment of 30 cases of advanced gastric cancer patients. To observe the accept PFS, OS, quality of life and toxicity of the treat ment after. Through the establishment of the survival curve, the single factor analysis and prognosis of advanced gastric cancer, through further analysis of multi factors, ultimately determine the independent prognostic factors. Result:PFS, the average PFS is 29.689 + 5.684 months, the median PFS was 15±4.674 months.OS, the average OS of 30 patients was 33.230±4.916 months, the median OS was 27±5.439 months, by the end of the observation period, 30 patients were still alive 11. Survival in the crowd, OS more than 5 years(76 months, 75 months, 72 months) and the survival of3 people; to 4 years(48 months) 1; up to 2 years(24 months) of 1 people; more than 1years(16 months, 17 months, 19 months) with 3; another 3 people under the age of 1 years(4 months, 6 months,8 months), still need to continue to observe; died in 19 patients, OS for up to 56 months, the shortest 6 months, the survival time was more than 1 years of 15 people,accounting for more than 78.94%; the survival period of more than 2 years there are 7cases, account for 36.84%; survival up to 3 years of 2 people, accounting for more than 10.52%.Factors related to prognosis, this study from the gender, age, KPS score, there is no operation treatment, pathological type, histological grade, lymph node metastasis, visceral metastasis and other single factor on PFS and OS and analyzes the influence of the effect of a single factor, the results showed, PFS is a non operation treatment, lymph node metastasis and the position of viscera metastasis(P=0.014, P=0.005, P=0.005). The sites of lymph node metastases and metastatic status(P=0.005, P=0.005) is the two single factors of OS. Further mult. Further multivariate COX regression model analysis showed that, the only organ metastasis are independent factors to determine PFS, OS length(P=0.002, P=0.005).To improve the quality of life, through the dialectical therapy of traditional Chinese medicine, and the reasonable prescription at medicine, state of life in the medication periodall patients improved obviously.Adverse reactions, 30 cases of patients with tolerance of tegafur is good, I see the blood Idegree of toxicity and gastrointestinal reaction I-II degree, does not appear due to drug toxicity reaction and no one discontinuation of chemotherapy related death. Conclusion:Jianpi Jiedu Tongluo decoction combined with tegafur maintenance therapy can improve the therapeutic effect of patients with advanced gastric cancer, and improve the living quality, prolong time to progression and overall survival have extended trend, and low toxic side effect and good tolerance.Through the multi factor regression analysis to explore the prognostic factors of the model,the results showed metastasis are independent prognostic factors.This maintenance treatment program for safe, effective and easy to accept for patients with advanced gastric cancer, worthy of further research and application. |
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