Clinical Research On Improving Disease-free Survival Time Of Patients With ?A Stage Non-small Cell Lung Cancer Treated By Combined Treatment Of TCM

Primary bronchial lung cancer is the most common type of lung malignancy,in recent years,the increase in lung cancer incidence and mortality rate in our country,and appeared the trend of younger patients with non-small cell lung cancer(NSCLC)accounts for about 80%-85%of pulmonary malignant tumor,surgical resection is the treatment method of choice for early mid-term non-small cell lung cancer,but there are more postoperative patients relapse metastasis,recurrence and metastasis become the main reason for the failure cause pulmonary malignant tumor surgery.In non-small cell lung cancer patients with postoperative pathological diagnosis of recurrent ?A period patients are more likely to appear,local recurrence and distant metastasis rate is as high as 39%-67%.Treatment of lung cancer has a long history of traditional Chinese medicine,in the era of shells had records of tumor,traditional Chinese medicine is characteristic of tumor treatment in our country.Is based on the guidance of treatment based on syndrome differentiation of TCM therapy for cancer individualized comprehensive treatment,the purpose is to systematically reasonable application of the existing various treatments,including traditional Chinese medicine(TCM)herb tea,proprietary Chinese medicine,paste and other auxiliary treatment,acupuncture and manipulation,Gua Sha,ear acupuncture,hands and feet bath,diet,eight-section brocade,taijiquan,etc.),and maximize the advantages of overall treatment in TCM.Combined treatment of traditional Chinese medicine emphasizes the full use of various treatments and treatment of TCM,play in the process of the entire tumor treatment of traditional Chinese medicine and the advantage of each treatment stage.Based on evidence-based medicine to guide individualized comprehensive treatment as standard solution for the treatment of tumor.Treatment based on syndrome differentiation reflects the clinical treatment of harmonious and unified principle with flexibility,is a highly generalization of individualized treatment.Individualized comprehensive treatment of traditional Chinese medicine to foster the solution treatment,the disease,syndrome differentiation and symptomatic treatment medicine prescription,on the basis of flexible according to the characteristics of the treatment stage choose different treatment methods and treatment,deal with the relationship between the centralizer and eliminate pathogenic,recover the balance of internal environment.Previous research on single intervention to observe,unable to reflect the characteristics of TCM syndrome differentiation and fully displaying the therapeutic effect of TCM.This research for the Ambispective cohort Study(also called A mixed cohort),179 cases of ? A stage non-small cell lung cancer effect A radical cure patients with postoperative observation,analysis of lung cancer comprehensive treatment of traditional Chinese medicine to improve disease-free survival time of patients with curative effect.Research purposes:To ? A stage non-small cell lung cancer postoperative adjuvant radiation and chemotherapy completed 3-4 months of patients as the research object,by DFS(disease-free survival time)for the study of the end of the indicators.To assess the curative effect for the promotion of integrated treatment of traditional Chinese medicine,and to analyze the related factors influencing the prognosis of patients,in order to improve the postoperative survival in patients with non-small cell lung cancer is providing treatment,provide the basis for clearly the advantages of integrated treatment of traditional Chinese medicine.Methods:Using ambispective cohort study method to the scheme design,collecting on March 1,2014 to 2014 on August 31,China academy of traditional Chinese medicine hospital gate,the first affiliated hospital of Guangzhou university of traditional Chinese medicine,Chinese medicine research institute affiliated hospital of Hunan province and Shanxi Province tumor hospital,Zhejiang province tumor hospital,hospitals in Anhui province,Liaoning provincial tumor hospital,Xinjiang uygur autonomous region institute of traditional Chinese medicine,Chongqing institute of tumor,the fourth hospital of Qinhuangdao city,Wuxi city hospital,first visit to Shenzhen baoan district hospital 12 research center III A stage non-small cell lung cancer,and complete with adjuvant radiation and chemotherapy 3-4 months after complete outpatient cases,hospitalization and follow-up data.The combined treatment of traditional Chinese medicine as exposures,as always,whether to accept the traditional Chinese medicine comprehensive treatment can be divided into Chinese medicine queue queue and observation.Participants included III stage non-small cell lung cancer after surgery,A complete 3-4 months adjuvant radiation and chemotherapy after surgery of 179 cases of patients,queue,74 cases of traditional Chinese medicine,obserational cohort of 105 cases.TCM queue to complete the 3-4 months after adjuvant radiation and chemotherapy after surgery,and 2 cycles/cycle(3 months)to prevent postoperative recurrence metastasis combined treatment of traditional Chinese medicine promotion plan of intervention,including traditional Chinese herb tea according to clinical syndrome differentiation for syndrome differentiation(CanYi capsule,profit lung thanh hoa particles);Added in each patient at the same time according to the core mechanism of compatibility of standardized rehabilitation paste and under the guidance of professional training and rehabilitation training.Observational cohort without special treatment,follow-up observation.Main observation indexes for DFS(disease-free survival time),after which patients postoperative adjuvant radiation and chemotherapy to complete review time for the first time to record any time any of the causes of tumor recurrence.The results of the study:1.The general situation179 patients were included in this study,the TCM group 74 cases,observation group 105 examples,from domestic hospitals,12 cases into lost to follow-up and fall off.During treatment,TCM group every 3 months follow-up of patients with 72 cases,accounting for the doctor of traditional Chinese medicine group,97.3%of the total,observation group of 101 cases of observation group and 96.19%of the total;Every 3 months follow-up after treatment,the traditional Chinese medicine group 52 cases of patients,accounts for the doctor of traditional Chinese medicine group,75.68%of the total,observation group 66 examples,for the observation group and 62.86%of the total.A complete review on time rate is high,cases data.Two groups of patients during treatment and after treatment review distribution no statistical difference,P values were greater than 0.05.45 patients with TCM group of male,the female patients 29 cases;Observing group,61 cases of male patients,44 cases of female patients.On the age distribution,TCM group 44 years old,or less 45 to 59,60 or more patients in 5 cases,respectively,37 cases,32 cases;Observation group 44 years old,or less 45 to 59,60 patients respectively in 9 or higher,56 cases,40 cases.Pathological diagnosis of type distribution:the traditional Chinese medicine group of squamous carcinoma,adenocarcinoma,gland scale cancer patients for 18 cases respectively,54 cases,0 cases;Observation group of 27 cases respectively,73 cases,1 case.Distribution:postoperative adjuvant therapy of traditional Chinese medicine group of chemotherapy,radiation therapy,combination treatment of patients with 74 cases,respectively,19 cases,19 cases;Observation group 104 cases respectively,27 cases,27 cases.In gender,age,two groups of patients,center,around the lesion,pathological type and postoperative adjuvant therapy(chemotherapy,radiation therapy,combination treatment),and other aspects the baseline level had no statistical difference(P>0.05),two groups of comparable.2.Two groups of subjects DFS(disease-free survival time)and the rate of recurrence,transfer analysis and comparison2.1 TCM queue median disease-free survival time was 16.13 months(484 days)is superior to observe the queue up to 12 months(360 days),the difference was statistically significant(P = 0.0152),the doctor of traditional Chinese medicine a queue is to observe the queue extended disease-free survival time was 4.1 months(124 days).2.2 subgroup analysis:type,adenocarcinoma,45 to 60 years old in the subgroup analysis,TCM queue median disease-free survival time(months)were 16.72,15.52,15.47;Observe the queue are 11.43,11.83,11.25,respectively.Two groups of DFS distributed statistically significant(P<0.05).Center type,squamous carcinoma,40 and 60 years old or more or less subgroup analysis,the distribution of no statistical difference(P>0.05).2.3 Recurrence metastasis rate the overall relapse metastasis rate of TCM queue,obserational cohort were 32.43%,32.43%,recurrence metastasis rate was reduced by 30.43%.6 months,9 months,12 months,18 months and 24 months recurrence,transfer rate is respectively:TCM queue by 4.05%,17.57%,22.97%,29.73%,32.43%;Observational cohort 19.5%,34.9%,19.5%,34.9%,61.9%.P is less than 0.05,the difference was statistically significant.3.The correlation analysisRehabilitation treatment after the use of traditional Chinese medicine treatment time significantly correlation with DFS positively related(P<0.05),and the correlation coefficients(0.6912)4.The COX proportional hazards model analysisCompared with traditional Chinese medicine group,observation group increased the risk of recurrence,transfer the TCM group was 140.1%,the HR = 2.401,P<0.001,the difference was statistically significant.Age,sex,place,and postoperative adjuvant chemotherapy after surgery and chemotherapy cycle postoperative disease-free survival time and the influence factors,such as auxiliary radiotherapy had no significant correlation(P>0.05).Conclusion:1.the comprehensive treatment of traditional Chinese medicine can effectively prolong ? A stage non-small cell lung cancer patients with postoperative disease-free survival(DFS),reduce recurrence metastasis rate.Type,adenocarcinoma,around 45 to 60 patients can survive in comprehensive treatment of traditional Chinese medicine more benefits.2.non-small cell lung cancer with postoperative DFS significantly correlation with use of traditional Chinese medicine treatment time and adhere to the treatment of traditional Chinese medicine,can make the patients with long-term benefit.3.COX proportional hazards model analysis showed that:Observation group significantly increased risk of relapse in the TCM group transfer,then explain the independent protection of combined treatment of traditional Chinese medicine is a prognostic factor,can effective prevention and control of the transfer of recurrence.