| ObjectiveThrough the method of retrospective analysis,we observed the influence of different treatment methods on the survival time and survival rates of patients with advanced liver cancer,discussed the related factors affecting the survival prognosis of patients with advanced liver cancer,and evaluated the influence of integrated traditional Chinese and Western Medicine on the survival of patients with liver cancer,so as to provide references for the individualized treatment of advanced liver cancer with integrated traditional Chinese and Western medicine treatment.MethodsThis study adopts the method of retrospective analysis.The patients diagnosed as advanced primary liver cancer in the inpatient department of Guangdong Province Traditional Chinese Medical Hospital from January 1,2010 to June 30,2020 were selected as the research objects.The patients diagnosed as "liver malignant tumor" were collected through the inpatient case system of the hospital,and then the hospitalization data of these patients were exported one by one.According to the inclusion and exclusion criteria,the general information of the included patients was recorded,including gender,age,hospitalization times,personal history(history of smoking and drinking),family history of malignant tumor,TNM stage(T,N,M stage and metastasis site),clnc stage,BCLC stage,tumor number and maximum diameter at the time of onset,portal vein tumor thrombus invasion,hepatic vein invasion,intrahepatic bile duct dilatation,pathological diagnosis and pathological type,background of liver cirrhosis and hepatitis,child Pugh score and grade,AFP,CA199,antiviral therapy,treatment methods,clinical features,initial symptoms,duration of TCM Intervention,symptom scores before and 3 months before and after TCM treatment(no score for less than 3 months)and survival time were established.Spss26.0 statistical software was used for data analysis.Life table method was used for survival rate calculation.Kaplan Meier method was used for life rate function curve.Cox proportional hazards model was used for univariate and multivariate analysis.P<0.05 was considered as statistically significant.result(1)208 cases were lost to follow-up until December 31,2020.The median survival time(MOS)of 221 patients with advanced primary liver cancer was 12.0(95%Cl 10.2,95%Cl 10.2),The overall 1-year,2-year and 3-year survival rates were 46.15%,15.39%and 6.33%;according to the treatment methods,the 1-year,2-year and 3-year survival rates of the operation group were 70.97%,16.13%and 9.68%;the 1-year,2-year and 3-year survival rates of the intervention group were 51.13%,17.29%and 7.52%;the 1-year,2-year and 3-year survival rates of the immunotherapy group were 61.54%,23.08%and 7.69%;the 1-year,2-year and 3-year survival rates of the targeted therapy group were 51.13%,17.29%and 7.52%,respectively The survival rates were 59.68%,19.35%and 8.06%respectively;the 1-year,2-year and 3-year survival rates of chemotherapy group were 62.96%,11.11%and 7.41%respectively;the 1-year,2-year and 3-year survival rates of pure Chinese medicine group were 32.70%,11.32%and 1.92%respectively.The 1-year,2-year and 3-year survival rates were 39.62%,13.21%and 1.9%in the single treatment group,40.86%,16.13%and 6.5%in the combined treatment group and 66.7%,20.0%and 10.67%in the comprehensive treatment group.(2)In terms of traditional Chinese medicine intervention,221 patients with advanced liver cancer were treated with traditional Chinese medicine.The total intervention time was 2785 months,with an average of 12.60± 10.40 months for each patient.According to the time of TCM Intervention,the remission rate of 3-6 months group was 16.67%,and that of 6-12 months group was 89.66,which was greater than that of 1 year group The rate was 100%.In terms of dialectical classification,113 cases(51.1%)were of liver depression and spleen deficiency syndrome,and the prognosis was the best(MOS=12.5 months);the prognosis of liver kidney yin deficiency syndrome and damp heat stasis syndrome was the worst(MOS=8.5 months and 8.0 months respectively).(3)Univariate and multivariate analysis showed that there were 11 prognostic factors including hospitalization times,T stage,CNLC stage,BCLC stage,portal vein invasion,ECoG score,KPS score,child Pugh level,total number of intervention,treatment mode and duration of TCM intervention.Then the above 11 prognostic factors were introduced into Cox model one by one.After multivariate regression analysis(LR forward method),a total of 4 items with statistical differences were obtained,including portal vein invasion,ECoG score,total number of intervention times and Chinese medicine intervention time.ECoG score(1.096)was the highest.Conclusion(1)The clinical characteristics of advanced primary liver cancer in our hospital:mainly male,mostly middle-aged and elderly,most of them have a history of smoking and drinking,combined with hepatitis and cirrhosis,and received good treatment of traditional Chinese medicine.(2)In terms of TCM dialectics,liver depression and spleen deficiency syndrome is the most common syndrome in patients with advanced liver cancer,and the prognosis is good.The syndrome of dampness heat stasis and liver kidney yin deficiency had the worst prognosis.(3)Compared with single treatment,multiple treatment combination can bring more survival benefits to patients.In clinical practice,combined with the situation of each patient,multiple treatment methods can be combined to strengthen tumor control under the tolerable condition.In addition,traditional Chinese medicine treatment can reduce toxicity and increase efficiency,strengthen the body and inhibit tumor,so that patients have better survival treatment and survival benefits.(4)This study suggests that the independent risk factors affecting the survival and prognosis of patients with advanced liver cancer are mainly portal vein invasion,ECoG score,total times of intervention and the time of traditional Chinese medicine intervention. |
