| ObjectiveThis study retrospectively analyzed the clinical data of modified Wumei Pills combined with erlotinib and S-1 and erlotinib combined with S-1 in the treatment of patients with advanced pancreatic cancer,and explored the effect of modified Wumei Pills on the quality of life of patients with advanced pancreatic cancer,clinical efficacy and side effects,and provide new treatment ideas for patients with advanced pancreatic cancer who cannot tolerate intravenous chemotherapy.MethodsThis retrospective study collected data from patients diagnosed with pancreatic malignant tumors who were treated at the Cancer Center of the First Affiliated Hospital of Anhui Medical University,integrating traditional Chinese and Western medicine from January 2018 to December 2022.After screening according to inclusion criteria,patients were divided into an observation group receiving modified Wumei pills combined with Erlotinib and S-1,and a control group receiving only Erlotinib and S-1.All enrolled patients were followed up by telephone or outpatient visits.Data analysis was performed using SPSS 26.0 software to compare tumor response,Traditional Chinese Medicine(TCM)syndrome,quality of life scores,tumor markers,and pain scores after two treatment cycles between the two groups.The study also compared the occurrence of progression-free survival(PFS),overall survival(OS),and grade and incidence of toxic and side effects.The clinical efficacy and safety of modified Wumei pills combined with Erlotinib and S-1 in treating advanced pancreatic cancer were evaluated using a scientific approach to narrative.Results1.Short-term curative effectAfter two cycles of treatment,the objective response rates(ORR)of the two groups were 8.6% and 2.8%,respectively,with no significant difference(P>0.05);the disease control rates(DCR)were 37.1% and 22.2%,respectively,with a statistically significant difference(P<0.05).2.Long-term curative effect(1)PFS: The median PFS in the observation group and control group were 3 months(95% CI: 2.522-3.478 months)and 2.5 months(95% CI: 1.77-3.23 months),respectively.According to the log-rank test,P>0.05,and the difference was not statistically significant.(2)OS: As of the follow-up cut-off date(January 31,2023),a total of 28 patients in the observation group and 31 patients in the control group were followed up.The median OS in the observation group and control group were 5 months(95% CI: 3.221-6.779months)and 4 months(95% CI: 3.441-4.559 months),respectively.According to the logrank test,P<0.05,and the difference was statistically significant.The 1-year survival rates of the two groups were 10.7% and 3.2%,respectively,with no significant difference(P>0.05).3.TCM syndrome comparison:(1)After testing,there was no statistically significant difference in TCM syndrome scores between the observation group and the control group before treatment(P>0.05);after treatment,the differences in TCM syndrome scores between the two groups were comparable(P<0.05);There was no significant difference in symptom scores before and after treatment(P>0.05);there was a statistically significant difference in symptom scores in the observation group before and after treatment(P<0.05).(2)Comparing the progression of TCM symptoms between the two groups of patients,the results showed that pain,poor appetite,vomiting,and constipation improved significantly more in the observation group than in the control group(P<0.05).(3)According to the standard for evaluating the efficacy of TCM syndrome,there was a significant difference in the overall efficacy between the two groups of patients(P<0.05).The effective rates of TCM syndrome in the two groups were 54.3% and 30.6%,respectively,and the difference was comparable(P<0.05).4.Quality of life comparison: After treatment,the changes in KPS before and after treatment were compared between the two groups,with a statistically significant difference(P<0.05).The effective rates of the observation group and the control group were 14.3% and 2.8%,respectively,and were comparable(P<0.05).5.Tumor marker comparison: After testing,there was no statistically significant difference in the outcome of CA19-9 between the two groups of patients after treatment(P>0.05).The effective rates of CA19-9 reduction were 8.4% and 5.6% for the two groups,respectively,with no statistically significant difference(P>0.05).6.Pain level comparison: Before treatment,there was no significant difference in pain level between the two groups of patients(P>0.05).After treatment,there was a statistically significant difference in pain level between the two groups of patients(P<0.05).The difference before and after treatment was significant in the observation group(P<0.05),while there was no statistically significant difference in the control group(P>0.05).7.Toxic and side effectsAdverse reactions in the observation group and the control group mainly manifested in the blood system,digestive system reactions,liver damage,rash,and respiratory system.Upon comparison,significant differences(P<0.05)were observed between the two groups in the severity level of gastrointestinal reactions,as well as the incidence of elevated bilirubin,nausea and vomiting,and diarrhea.Only skin reactions appeared as grade IV adverse reactions,with a rate of 2.9% in the observation group and 5.5% in the control group,respectively.However,the difference was not statistically significant(P>0.05).Conclusion1.Modified Wumei Pills combined with erlotinib and S-1 can effectively improve the disease control rate and prolong the median survival time of patients with advanced pancreatic cancer compared with simple western medicine treatment;2.In the treatment of advanced pancreatic cancer,the combination of traditional Chinese medicine "Wumei Pills" can effectively improve the quality of life of patients,reduce pain levels,and significantly improve patients’ traditional Chinese medicine symptoms of pain,anorexia,vomiting,and constipation;3.With the participation of traditional Chinese medicine,it can effectively improve the gastrointestinal reactions caused by erlotinib and S-1,and at the same time reduce the incidence of gastrointestinal reactions and elevated bilirubin. |
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