| Background:As the changing of dietary structure,the incidence of colorectal cancer is rising gradually in China.Many colorectal cancer patients suffer from synchronous liver metastasis.Compared to metachronous liver metastases,the former has more serious lesion,more complication,worse prognosis,and shorter survival time.In the past,the diagnosed colorectal cancer patients,who suffer from synchronous liver metastasis,had survival time less than 1 year without treatment.Fortunately,their survival time may be prolonged evidently,because of radical operation.But most of them have no operating chance.No matter if they receive chemotherapy,they must receive palliative treatment,but not operation.Hence,the comprehensive treatment,including the traditional Chinese medicine,is the primary therapy.Objective:To observe the long-term efficacy of the treatment "QU YU JIE DU " to the colorectal cancer patients suffered from synchronous liver metastasis.At the same time,to observe the role of traditional Chinese medicine combined with chemotherapy,analyze the prognosis by parameters influenced the lifetime of patients.Here,we try our best to discovery new treatment to the colorectal cancer patients suffered from synchronous liver metastasis.Subjects and methods:Our clinical date was gained from The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,The First Affiliated Hospital of Guangdong Medical University,and General Hospital of Guangzhou Military Command of PLA.And then,a retrospective analysis of 115 cases of colorectal cancer suffered from synchronous liver metastasis from January 1st 2012 to January 1st 2017 was made.To observe the efficacy of the treatment"QU YU JIE DU",combined with modern medicine anti-tumor treatment,to colorectal cancer patients suffered from synchronous liver metastasis.To compare the survival time,the survival rate and the side reaction of myelosuppression and diarrhoea with single modern medicine anti-tumor treatment group.To identify the protective factors and risk factors by COX proportional hazard model.Result:(1)Compare of overall survival:the median survival time of the control group is 632 days,while the treatment group is 868 days.Difference is statistically significant.Both the 2-year survival rate and the 3-year survival rate of control group are lower than the treatment group.(2)Compare of progression free survival:the median progression free survival of the control group is 233 days,while the other group is 274 days.The progression free survival of the treatment group prolongs 41 days than the control group,while difference is not statistically significant.(3)Compare of survival time of the two groups after stratified:For the patients accepted the resection of original focus,the median survival time of the control group is 924 days,while the treatment group is 868 days.Difference is not statistically significant.For the patients without the resection of original focus,the median survival time of the control group is 524 days,while the treatment group is 823 days.Difference is not statistically significant.(4)We apply 10 parameters,which may influence prognosis,to the COX proportional hazard model,then use stepwise regression method for multiple-factor analysis.At last,we identify 5 parameters,which are statistically significant,including differentiated degree,operation of original focus,ALP,melt of metastasis,traditional Chinese medicine therapy.(5)Compare of the adverse reaction during chemotherapy:the incidence rate of myelosuppression(??°)in the control group is 28.57%,while the treatment group is 11.86%.Difference is statistically significant.The incidence rate of diarrhea(?Grade Three)in the control group is 19.24%,up from 13.56%in the treatment group.But difference is not statistically significant.Conclusion:(1)Combination of Chinese traditional and Western medicine could prolong the survival time of colorectal cancer patients suffered from synchronous liver metastasis,and improve the survival rate.For the patients,who have no chance to receive operation,the combined treatment can improve the overall survival obviously.(2)The treatment "QU YU JIE DU" reduces the incidence of the side reaction of myelosuppression.(3)The result of multi-factor prognostic analysis indicates that the protective factors are operation of original focus,melt of metastasis,traditional Chinese medicine therapy.The risk factors are differentiated degree,ALP.The result proves that the treatment "QU YU JIE DU",combined with operation,intervention,melt,chemotherapy,may improve the prognosis of colorectal cancer patients suffered from synchronous liver metastasis. |
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