| Background:Lung cancer is a malignant tumors in our country with the highest morbidity and mortality.Due to its secretiveness,most patients are advanced when they were first diagnosed and failed to accept operation.The 5-year survival rate is no more than 10%.Non-small cell lung cancer is the most common pathological type of lung cancer,accounting for 85%to 90%of all lung cancer patients.Targeted therapy and chemotherapy are the main treatment methods for patients with advanced non-small cell lung cancer.For patients with advanced non-small cell lung cancer who are not suitable for targeted therapy,platinum-containing combination chemotherapy is the standard first-line treatment.Because of its toxic side effect,it’s not suitable for long-term treatment.Modern medical maintenance treatment,.compared with firstline chemotherapy,has less side effects.But long term treatment still bring damage to patient’s immune function,resulting in a decline in quality of life.With the rapid development of medicine,the evaluation approach for tumor treatment is no longer confined to the control of the size of the tumors and the extension of pure PFS or OS.More an more attention is paid on how to reduce the treatment efficacy,improve the quality of life of advanced patients with tumor.Compared with modern medicine,traditional Chinese medicine(TCM)emphasizes individualized treatment.TCM treatment cannot compare with modern medicine treatment in shrinking tumors.But TCM treatment has less side effects and more effective in keeping tumors stable,improving the quality of life and relieving clinical symptoms.Clinical studies have shown that TCM is no less effective than modern medicine on the maintenance treatment of advanced non-small cell lung cancer.But most researches were randomized controlled trials with single therapy,failing to reflect features of individualized treatment of TCM.Multi-center prospective clinical studies with large sample are needed to provide convincing evidence.Objective:To evaluate the effect of comprehensive TCM maintanence treatment on disease duration,clinical symptoms and quality of life in patients with advanced non-small cell lung cancer.Methods:Through multicenter,prospective,cohort study,106 cases of initial diagnosed patients with adanced non-small-cell with tumor were included.TCM maintanence treatment is defined as an exposure factor.Patients are divided into queue of TCM and western medicine by exposure factor.The treatment of western medicine queue accepts standard maintanece treatment referring to the NCCN guidelines.The general guiding principle for treatment of the TCM queue is YIQI HUOXUE and JIEDUSANJIE.Specific diagnosis TCM syndrome and treatment refers to TCM diagnosis and treatment guidelines for malignant tumors(lung cancer),Observation will not stop until disease progression,followed by follow-up.The main outcome measures are progress free survival(PFS),the change of the clinical symptoms and the quality of life.Data entry was carried out by EPIDATA3.1 database,and SPSS22.0 software was used for statistical analysis.Results:106 patients with advanced non-small cell lung cancer were included,55 cases of traditional Chinese medicine queue and 51 cases of western medicine queue.The baselines of the two queues,patients in gender,age,pathological type and pathological grading,transfer parts,complications,clinical stage,chemotherapy regimen,KPS score,ECOG score,quality of life score each field integral,had no statistical difference(P>0.05),which are comparable.The PFS of the TCM queue and western medicine queue were 5.17 months and 6.33 months,P=0.678,the difference was not statistically significant.The median PFS of patients in ⅢA,ⅢB,IV period are 10.73 months,6.27 months and 10.73 months respectively(P=0.028),the difference was statistically significant.The median PFS of patients with ECOG score 0,1,2 are separately 6.50 months,5.53 months and 2.20 months(P=0.022),the difference was statistically significant.For patients younger than 60 years old,the PFS in the TCM queue extended 3.6 months(7.13 months vs 3.43 months,P=0.005).For patients with clinical stagingⅢB,the median PFS of the TCM queue was longer than that of western medicine,P=0.008,and the difference was statistically significant.After 6 weeks’ and 12 weeks’ treament,the effectiveness in relieving clinical symptoms of the TCM queue was higher than that of the western medicine queue,and the improvement of the clinical symptoms of the TCM queue was more significant than that of the western medicine queue,P=0.028,and the difference was statistically significant.After 6 weeks’treatment,the score of EWB score in FACT-L4.0 scale of the TCM queue was higher than that of western medicine(P=0.037).There was no significant difference of score in total between the two queues after 12 weeks.Conclusion:The overall efficacy of comprehensive TCM treatment of advanced non-small cell lung cancer is no worse than that of modern medicine maintenance treatment in terms of PFS(5.17 months vs 6.33 months,P>0.05),and can relieve the clinical symptoms,improve patient’s quality of life,especially the emotional field.Patients younger than 60 were more likely to benefit from medical treatment on PFS.Meanwhile,ECOG score is an independent factor affecting PFS.Compared with patients with ECOG higher than lpatients with ECOG no higher than is a protective factor to PFS. |
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