| Objective:Based on the analysis of clinical data to explore the prognosis of primary liver cancer,the main risk factors,and to explore the different treatment and intervention mode sequential or superimposed patients with the survival status,and independent choice,the intervention of Chinese medicine intervention starting point and survival period analysis,to observe the comprehensive treatment of traditional Chinese and Western medicine to patients with primary liver cancer,and to build a traditional Chinese medicine treatment of primary liver cancer evaluation system.Method:This study was a retrospective analysis of our hospital from Sept of 2013 to May of2016,which included 50 cases(in all 55 cases,excluding non-compliant five cases,four cases were lost,the clinical data of one case was incomplete)primary liver cancer.we recorded the process of treatment and clinical data,clinical characteristics of patients,tumor characteristics,clinical course of treatment,the median survival,the survival rate of more than 6 months,more than 1-year survival rate,KPS score,liver function child-Pugh score,clinical statistics of every patients from death or last follow-up time and established survival curve,seek to influence the prognosis of primary liver cancer a major risk factor,and to explore the survival of patients with different treatments and interventions under sequential or superimposed,and to analysis the relationship of Chinese medicine intervene starting position and survival under autonomous choose,further more stratified study,to observe the impact of integrative medicine comprehensive treatment for patients.Result:The 50 cases of primary liver cancer,the clinical data show that:1)Including 40 males and 10 females,male to female ratio of 4: 1,similar to the large clinical data published ratio(3: 1).2)The median survival time was 593.4 months,the average survival time was 15.9months,the median survival time was 9.5 months,of which 2 cases were long-term survival patients,survival time more than 7 years.3)The 50 patients,7 patients had no Chinese medicine treatment,43 were selected Chinese medicine treatment,and the intervention time was 323 months.The average intervention time was 6.46 months.4)The rate of 6-month survival was 62%,a year survival rate was 42%,two-year survival rate was 18%,five-year survival rate was 4%.5)Which patients with liver cirrhosis of the proportion accounted for 50%,no liver cirrhosis patients accounted for 50%.6)Hepatitis B virus carrying background patients accounted for 58%,no hepatitis B virus background patients accounted for 42%.7)Patients with the serum AFP value in the normal value accounted for 66%,serum AFP positive patients accounted for 34%.8)Patients with liver function status Child-pugh score A-level accounted for 30%,Child-pugh score B patients accounted for 54%,Child-pugh score C patients accounted for 16 %.9)According to the criteria of liver cancer Barcelona(BCLC)staging,patients of BCLC A accounted for 18%,BCLC B patients accounted for 20%,BCLC C patients accounted for 46%,BCLC D patients accounted for 16%.10)Patients with the initial choice of surgical treatment accounted for 16%,the initial choice of TACE patients accounted for 36%,the initial choice of chemotherapy accounted for 6%,the initial choice of Chinese medicine treatment accounted for 22%,initially selected symptomatic supportive therapy accounted for 20%.11)50 cases of primary liver cancer were univariate analysis showed that age,sex,hepatitis B virus background,liver cirrhosis background,the diagnosis of serum AFP value,the starting point of traditional Chinese medicine intervention on the patient OS was no significant difference(P>0.05).Tumor stage,KPS score,initial treatment pattern,liver function status(Child-pugh score)and duration of intervention in Chinese medicine were significantly different(P<0.05).Further multivariate regression results showed no significant difference in tumor staging,KPS score,initial treatment pattern,liver function status(Child-pugh score)and duration of intervention of traditional Chinese medicine on OS in patients with primary liver cancer were not statistically significant(P>0.05)12)The 50 patients with primary hepatocellular carcinoma in this study,only 43 patients had selected Chinese medicine treatment,and 42 patients with Chinese medicine treatment duration of no less than 4 weeks.A statistic analysis of 42 patients showed that the changes of KPS,KPS,changes of main symptoms,changes of tumor size,changes of liver function status,and changes of liver function,Child-pugh score of these five factors to the primary liver cancer patients on OS were statistically different(P<0.05).Multivariate regression analysis showed that the changes of tumor size and the change of main symptoms were statistically significant(P<0.05).Further increase in the risk of multiple e(1.205 × tumor size changes + 0.701 × main symptoms of the change).the prognosis index(Prognostic Index,PI)is calculated as PI = 1.205 × tumor size changes+ 0.701 × main symptoms of change.The above model is X2 test,X2 = 85.809,P<0.01 with α=0.05,ν=8,which is considered statistically significant and the model equation is reasonable.Conclusion:The treatment of primary liver cancer is a comprehensive treatment process,various treatment methods(such as surgery,radiofrequency ablation,liver transplantation,chemotherapy,radiotherapy,TACE,immunotherapy targeted therapy,Chinese medicine treatment and symptomatic supportive care,etc.)or sequential or Superimposed throughout the treatment.Chinese medicine treatment can be sequential or superimposed on other treatment methods,but the study found that when the choice of Chinese medicine treatment and survival of patients without correlation,and for a primary liver cancer patients,the choice of Chinese medicine treatment time longer,Its survival is relatively long.The study found that the factors affecting the survival of patients with primary liver cancer were tumor stage,KPS score,the initial treatment model,liver function status(Child-pugh score)and the duration of intervention of Chinese medicine 5 factors,but are independent of their independent factors.In the presence of Chinese medicine treatment mode,the factors affecting the survival of patients with primary liver cancer were KPS,KPS changes,changes in the main disease,tumor size changes,liver function status(Child-pugh score)of these five factors,Tumor size changes and the main symptoms of the two factors that affect the survival of the independent prognostic factors,according to the construction of traditional Chinese medicine prevention and treatment of primary liver cancer evaluation criteria: effective: tumor size changes(CR + PR + SD),Changes in the main symptoms of stability or improvement;deterioration: changes in the size of the tumor,the main changes in the disease,≧ 1 deterioration. |
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