Building Of Advanced Esophageal Cancer Prediction Model Of Survival And Optimization Of TCM Treatment

This study is divided into two parts:review and clinical study.At present,modern medical treatment,such as chemotherapy and radiotherapy,is the primary treatment of advanced esophageal cancer patients.Traditional Chinese medicine plays an auxiliary role in reducing toxicity and synergistic effect during chemotherapy and radiotherapy——Traditional Chinese medicine can significantly reduce the side effects associated with radiotherapy and chemotherapy in patients with advanced esophageal cancer.Therefore,this study firstly reviewed the side effects of traditional Chinese medicine in the improvement of radiotherapy and chemotherapy for advanced esophageal cancer.The clinical study is divided into three parts.Part 1 uses systematic evaluation to verify the toxicity reduction and synergistic effect of traditional Chinese medicine in the treatment of advanced esophageal cancer.In Part 2,data mining method was applied to collect the clinical treatment prescription of esophageal cancer and analyze the prescription medication,summarize the medication rule of traditional Chinese medicine in the treatment of esophageal cancer,and summarize the existing phased treatment plan of advanced esophageal cancer.Part 3:regression to clinical practice.By collecting detailed data of patients with clinical advanced esophageal cancer of a certain sample size,collecting survival data with regular follow-up,and applying corresponding statistical methods,the survival prediction model of advanced esophageal cancer with traditional Chinese medicine characteristics was creatively established.After that,statistical methods were used to screen the possible basic characteristics of the high-benefit groups,so as to find the starting point for the optimization of relevant treatment plans in the future.Research 1 Meta-analysis of Traditional Chinese Medicine combined with chemotherapy in treating advanced esophageal cancerObjective Objectively evaluate the toxicity reduction and synergistic effect of traditional Chinese medicine in chemotherapy for advanced esophageal cancer.Methods Computer retrieval of Chinese databases includes:China journal full-text database(CNKI)and WanFang database;English databases include Pubmed and Cochrane Library.The content of the retrieval is the clinical study of TCM combined with chemotherapy in the treatment of advanced esophageal cancer.According to the quality evaluation criteria recommended by Cochrane Review Handbook 5.3,RevMan 5.3 software was used to analyze the outcome indicators.Results A total of 11 studies were included.From the perspective of total effective rate(=[(CR+PR)/(CR+PR+SD+PD)]x100%),test group was significantly better than the control group(chemotherapy alone),with a statistically significant difference[P=0.01,95%Cl(1.19,2.06)].A total of 6 studies reported leukopenia in the improvement of chemotherapy-related side effects with traditional Chinese medicine,and the results showed that the incidence of leukopenia in the TCM combined chemotherapy group was lower than that in the control group,with a statistically significant difference[P<0.0001,95%Cl(1.75,4.22)].A total of 6 studies reported thrombocytopenia,and the results showed that the incidence of thrombocytopenia in the TCM combined chemotherapy group was lower than that in the control group,with a statistically significant difference[P<0.0001,95%Cl(2.22,5.47)].A total of 6 studies reported gastrointestinal reactions,and the results showed that the incidence of gastrointestinal reactions in the TCM combined with chemotherapy group was lower than that in the control group,and the difference was statistically significant[P<0.00001,,95%Cl(2.27,5.25)].A total of 3studies reported chemotherapy-related anemia,and the results showed that the incidence of chemotherapy-related anemia in the TCM combined chemotherapy group was lower than that in the control group,and the difference was statistically significant[P=0.002,95%C1(1.35,3.98)].Conclusions In clinical practice,the combination of traditional Chinese medicine with chemotherapy in patients with advanced esophageal cancer can increase the effective rate,and reduce the incidence of leukopenia,thrombocytopenia,digestive tract reaction and chemotherapy-related anemia.In the treatment of advanced esophageal cancer,traditional Chinese medicine has the effect of "enhancement" and "detoxification".Research 2 Analysis of the law of Chinese medicine in the treatment of esophageal cancerObjective Through statistical method and clinical application,this paper summarizes the characteristics and rules of traditional Chinese medicine prescription of professor Fengli in the treatment of esophageal cancer,providing effective ideas for the treatment of esophageal cancer and improving the clinical effect of TCM in esophageal cancer.Methods Statistical method was used to analyze the prescription of professor Fengli’s treatment of esophageal cancer.Classifying all drugs by drug category,drug flavor and distributions and counting frequency of each drags under classifications.Results A total of 132 valid prescriptions were collected.The drugs with higher frequency are processed licorice root,codonopsis pilosula,scutellaria baicalensis,Chinese date,pinellia ternata,angelica,coptis chinensis and dried ginger.According to the classification of drugs,the drugs with high frequency are tonifying drugs,heat-clearing drugs and phlegm-relieving drugs.According to the drug properties,the drugs with higher frequency are warm,cold and flat.According to the medicine flavor,the medicine with higher frequency is bitter and sweet and pungent.According to the distribution of drugs,the drugs with higher frequency are spleen,lung and stomach.Conclusions Based on the above analysis,director Fengli’s experience in the treatment of esophageal cancer is summarized.The treatment is mainly based on the combination method of phlegm and stasis and deficiency syndrome differentiation,resolving phlegm and supplementing deficiency and clearing heat.The key prescription is banxia xiexin decoction.Research 3 Analysis and prognosis of Traditional Chinese Medicine treated advanced esophageal cancerObjective To explore the idea and method of the preliminary discrimination model of prognosis and survival in the treatment of advanced esophageal cancer with traditional Chinese medicine.Methods Univariate test was performed on multiple factors affecting the prognosis of advanced esophageal cancer,and variables with statistical significance were included.Non-parametric discriminant analysis was used to establish a survival prediction model of traditional Chinese medicine treatment for advanced esophageal cancer.72 patients with advanced esophageal cancer were included in the study,which were divided into the dominant group,the intermediate group and the disadvantaged group based on the overall survival.Results Univariate analysis showed that location of onset(including upper esophagus),location of onset(including middle esophagus),differentiation degree of cancer cells,metastasis,hot food,smoking history,drinking history,symptom assessment after TCM treatment,emotion assessment after TCM treatment and lung metastasis.Conclusions After incorporating the elements of TCM characteristic syndromes,the prediction model is established through 7/3 verification(70%samples as training set,30%samples as verification set),and the prediction accuracy is 56%.