A Clinical Reaserch For The Survival Time Of Patients With Stage ? Colorectal Cancer Treated With The Traditional Chinese Medicine Combined With Chemotherapy

Purpose:To analyze and verify the effect of traditional Chinese medicine combined with western medicine on the disease-free survival(DFS)of patients with stage ? colorectal cancer after radical resection;To explore the correlation between the newly diagnosed TCM syndrome type and the start time of Chinese medicine and recurrence and metastasis;To provide more specific reference help for the treatment of stage ? patients after radical resection of colorectal cancer.Methods:Through retrospective cohort study,475 patients with postoperative adjuvant chemotherapy for colorectal cancer were divided into the integrated Chinese and Western medicine treatment group and the Western medicine group.To screen for factors affecting the prognosis of patients with stage ? colorectal cancer,and to calculate the median disease-free sur vival by Kaplan-Meier.The disease-free survival rate was estimated by the Life-table method for 1,2,3,and 5 years,and the difference between the two groups was compared by Log-rank time series test.Cox proportional hazards model was used to analyze independent prognostic factors affecting patients with recurrence and metastasis;Through the chi-square test,the difference in recurrence and metastasis rate between different TCM syndrome types and different starting Chinese medicines was compared.Results:(1)A total of 475 patients were enrolled,including 238 in the integrated Chinese and Western medicine treatment group and 237 in the Western medicine group.Kaplan-Meier univariate analysis showed that oral Chinese medicine(P < 0.001)and pathological stage(P < 0.001)were associated with DFS in the whole group of patients with stage ? disease.There were no significant correlations between the five factors of gender,age of onset,primary site,degree of differentiation,and time of initiation of chemotherapy.Cox multivariate analysis showed that Chinese medicine(P<0.001)and pathological stage(P<0.001)were independent factors affecting DFS in patients with stage ? colorectal cancer after radical resection;The corresponding HR of Chinese medicine was 0.590(95.0% CI: 0.441-0.790),suggesting that Chinese medicine is an independent protective factor affecting DFS in patients with stage ? colorectal cancer.In the ?c group,Kaplan-Meier univariate analysis showed that Chinese medicine(P=0.007)was the influencing factor of DFS in patients with stage ?c.There were no significant correlationsbetween gender,age of onset,primary site,and degree of differentiation,and DFS in patients with stage ?c.Cox multivariate analysis showed that Chinese medicine(HR=0.564,95.0% CI:0.368-0.865)suggested that Chinese medicine is an independent protective factor for DFS in patients with stage ?c after radical resection of colorectal cancer.(2)Among the patients in the total group,the median disease-free survival(DFS)of the Western medicine group was 38.13 months,and the median disease-free survival(DFS)of the integrated Chinese and Western medicine group had not been reached,indicating that the disease-free survival(DFS)was longer in the integrated Chinese and Western medicine treatment group than in the Western medicine group(P<0.001).The disease-free survival rates of 1,2,3,and 5 years in the two groups were calculated.The combination of TCM and Western medicine treatment groups were87%,75%,66%,and 58%,respectively;the Western medicine group was 76%,60%,and 53%,respectively.44%.Among the patients in group ?c,the median DFS of the Western medicine group was 14.37 months,and the median DFS of the integrated Chinese and Western medicine treatment group was29.97 months,P=0.007.The difference was statistically significant,indicating that Chinese medicine combined with Western medicine can prolong DFS of.the patients with stage ?c.The disease-free survival rate of 1,2,3,and 5 years was 74%,59%,48%,and 45% in the integrated Chinese and Western medicine treatment group,respectively,and 65%,38%,30%,and 20% in the Western medicine group.(3)In the total group of integrated Chinese and Western medicine treatment,the recurrence and metastasis rates of the five types of syndromes were: spleen and kidney double deficiency syndrome32.9%,liver and kidney yin deficiency syndrome 24.7%,damp heat accumulation syndrome 17.8%,temper deficiency certificate 16.4%,sputum poisoning internal resistance 8.2%,after chi-square test,P <0.001,indicating that the recurrence and metastasis rate of different syndromes is different.Due to factors such as time and case data integrity,this study did not compare the five types of syndromes,which can be speculated that the recurrence and metastasis rate of spleen and kidney double-loss syndrome is higher than that of damp-heat accumulation syndrome,sputum-toxic internal resistance syndrome,spleen deficiency syndrome,liver-kidney yin deficiency syndrome,and the specific differences need further study.(4)According to the time when Chinese medicine is taken,the combination of Chinese and Western medicine treatment group is postoperative ?6 month group and postoperative>6 month group.After chi-square test,the recurrence and metastasis rate in the two groups was 50.7% in the June group and 49.3% in the June group,P=0.053,the difference was not statistically significant.It may be related to the sample size,the time points of the grouping of the factors,and the more censored data due to the follow-up time limit,which is subject to further follow-up studies.Conclusion:1.Traditional Chinese medicine is an independent protective factor affecting DFS in patient s with stage ? colorectal cancer after radical resection;2.Traditional Chinese medicine combined with Western medicine can prolong the disease-free survival and the disease-free survival rate of 1,2,3,and 5 years after stage ? radical resection of colorectal cancer;3.Traditional Chinese medicine combined with Western medicine can improve the disease-free survival and the disease-free survival rate of 1,2,3,and 5 years with stage ?c after radical resection of colorectal cancer;4.The recurrence and metastasis rate of different syndromes in different diagnoses is different.It can be speculated that the recurrence and metastasis rate of spleen and kidney double-deficiency syndrome may be higher than that of damp-heat accumulation syndrome,phlegm-stasis syndrome,spleen deficiency syndrome,liver-kidney yin deficiency syndrome.