| ?Background?Traditional Chinese medicine?TCM?is an important part of conventionalmedicine.In recent years,TCM has shown great potential in cancer treatment,Its advantages include:alleviation of the side effects caused by radiotherapy and chemotherapy,effective prevention of tumor cells proliferation,induction of tumor cell apoptosis,and enhancement of cellular as well as patient's immunity.Clinically,the use of combination therapy of traditional Chinese and Western medicine is becoming increasingly common.The rational use of traditional Chinese medicine for adjuvant treatment does not only take advantage of each other's strengths,but also enhance each other's efficacy and reduce each other's adverse reactions during treatment,which helps patients undergoing tumor treatment.Hepatocellular carcinoma?HCC?is one of the most serious malignant tumors that threaten humanhealth,which has a high morbidity and mortality.HCC is concealed due to its morbidity and lacks typical early clinical symptoms.Most patients are in the advanced stage at the time of diagnosis,thus losing the best opportunity for surgical treatment.With the continuous development of interventional techniques,transcatheter arterial chemoembolization?TACE?has become the first choice for the treatment of non-surgical treatment of advanced HCC.However,simple TACE treatment can cause a series of adverse reactions such as acute liver failure or liver function damage,which seriously affects the therapeutic effect of HCC patients.Studies have shown that the simple use of traditional Chinese medicine for liver protection or the use of TACE combined with traditional Chinese medicine can effectively reduce adverse reactions and improve patients'quality of life.?Objective?The aim of this study is to investigate the factors that influence the prognosis ofHCC,also to explore the role of TCM adjuvant therapy in the prognosis of HCC patients,and further investigate the efficacy of TCM to reduce solid tumors.?Methods?This study used a retrospective cohort study.According to inclusion and exclusioncriteria,148 HBV-HCC patients were screened.The clinical data of liver cancer patients were retrospectively analyzed.T-test and non-parametric test were used to compare the differences between groups.COX proportional hazard regression model or logistic regression model was used for univariate as well as multivariate analysis,and Kaplan-Meier method was used for survival analysis.The log-rank method was used to test the P value between the two groups.?Results?According to the strict inclusion exclusion criteria,148 patients with HBV-HCCwere finally enrolled.The specific results are as follows:?1?Out of 148 patients with HBV-HCC?median age=57.5;average age=57.05±11.22?,most ofthem were middle-aged and older male patients?84.5%?,and the ratio of male to female was about 5.4:1.This is similar to the overall characteristics of China's HCC.The 1-year,2-year,and 3-year cumulative survival rates of patients were 52%,40.7%,and 34.10%,respectively,the overall prognosis of patients was poor.?2?Univariate analysis showed that Child-Pugh classification(P=4.16×10-5),HBV-DNA content(P=1.63×10-4),AST level?P=0.001?,GGT level(P=4.26×10-6),ALP level(P=1.28×10-6),AFP level?P=0.003?,TACE treatment(P=9.21×10-9)and TCM adjuvant therapy(P=2.88×10-5)were significantly associated with HCC prognosis.?3?Multivariate analysis showed that Child-Pugh classification?P=0.001?and HBV-DNA content?P=0.011?were independent risk factors for HCC prognosis;TACE treatment?P=0.012?and TCM adjuvant therapy?P=0.038?were independent protective factors for the prognosis of HCC.?4?There were significant differences in the cumulative survival rates between patients withdifferent Child-Pugh classification,HBV-DNA content,TACE treatment and TCM treatment,while their P values were 5.96×10-6,6.19×10-5,3.13×10-10,and 7.62×10-6,respectively.?5?TCM adjuvant treatment was a protective factor affecting the prognosis of patients in malesubgroup?P=0.045?,cancer-free subgroup?P=0.030?,alcohol history subgroup?P=0.025?,and low AST level subgroup?P=0.047?.?6?The survival prognosis of patients with TACE combined with TCM adjuvant treatment groupwas better than that of TACE treatment group,TCM adjuvant treatment group and the untreated group.The P value was 1.46×10-9.?7?While comparing the TACE-TCM adjuvant therapy with TACE alone in HCC patients,theORR of the disease was better in the former than the latter?P=0.074?,and the DCR was significantly better in the former than the latter?P=0.001?.?8?On the basis of TACE treatment,the use of TCM adjuvant therapy is an independent protectivefactor for ORR?OR:0.259,95%CI:0.068-0.985,P=0.047?and DCR?OR:0.079,95%CI:0.017-0.366,P=0.001?in HBV-HCC patients.?Conclusion?This study showed that TCM adjuvant therapy is an independent protective factorfor the prognosis of HCC,and can significantly improve the prognosis of patients.TACE combined with TCM adjuvant therapy can not only effectively improve the survival rate of patients,prolong the survival time of patients,but also significantly inhibit the deterioration of tumors in patients.This indicates that TCM adjuvant therapy is an effective clinical adjuvant treatment for patients with HBV-HCC. |
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