| Objective: Through collect the living status and disease progression data of the advanced NSCLC patients which received the comprehensive TCM treatment and multidisciplinary approach to analyze the influence factors of progression and prognosis.Discuss the advantages and great value of Chinese and western medicine combined treatment on the advanced NSCLC patients.It provides a reference for establishing the model of treating tumor as chronic disease.Methods: A retrospective analysis was made on the clinical data and follow up of 855 inpatients which treated by TCM from Long Hua Hospital the Third Oncology Department.The database was created by Epi Data software,and SPSS 21.0 is used to process and analyze the clinical data.The Kaplan-Meier method was used to calculate the survival rate,OS,MST,PFS and single stepwise regression analyses.Log-rank test was used to make univariate analysis.The meaningful data from the univariate analysis were incorporated into the multivariate analysis to screen out the progression and prognosis factors and establish a COX proportional hazards model to calculate and analyze the prognostic index.Results: 1.The average OS of 855 advanced NSCLC inpatients was 41.1 months,MST was 26.0 months,median PFS was 9 months.2.The 1,2,3,5-year survival rate was 79.2%?54%?36.2%?17.1%.The 1,2,3,5-year progression-free survival rate was 67.8%?53.1%?44.4%?38.1%.3.The factors analysis showed that:(1)Gender,age,clinical stages were the independent risk factors of prognosis.Surgery,radiotherapy,Chinese formulated products,Chinese intravenous products,Chinese decoction,intervention measures and disease progression were the independent protective factors of prognosis.(2)Gender was the independent risk factors of progression.Surgery,radiotherapy and Chinese decoction were the independent protective factors of progression.4.According to the prognostic index,all patients were divided into low,intermediate and high risk groups with MST of 50 months,36 months and 22 months and PFS of 13 months,9months and 8 months.Conclusions: 1.In this study,the median PFS and the long-term OS was longer than the previous research data,which may be related to the continuous effect of the integrated treatment of TCM.2.Female patients have a longer survival period,lower risk of progression and better prognosis than male patients.3.Although younger patients have a higher risk of progression,but their long-term survival is better than that of older patients.4.Clinical staging was positively correlated with total survival,and the later the staging was,the shorter the total survival was.5.Patients with lower PS scores had lower risk of progression and better prognosis.6.The survival period of patients with spleen and kidney deficiency was the longest,qi and Yin deficiency and lung and spleen qi deficiency were the most common,the survival period was similar,and the prognosis of Yin deficiency and internal heat was the worst.7.Patients with localized focus or single-site metastases had longer survival than those with distant or multiple metastases.8.In the choice of second-line treatment,chemotherapy and targeted therapy have more advantages.For patients with the opportunity for surgical resection,surgical resection can significantly prolong survival.9.Radiotherapy can improve the PFS and OS of patients,suggesting that local treatment can effectively control the progression of NSCLC.10.The PFS and the OS of advanced NSCLC patients can be significantly prolonged by the long-term and standardized use of the comprehensive TCM treatment.11.The IIIb/IIIc stage adenocarcinoma female patients with advanced NSCLC may have a longer progression-free survival and overall survival with the combination of TCM treatment and multidisciplinary treatment.12 The calculation of prognostic index and the establishment of prognostic prediction model can provide certain reference basis for clinicians to judge the prognosis of patients with advanced NSCLC,which has high validity and credibility. |
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