世界中医药

基金项目:十三五“重大新药创制”科技重大专项（2017ZX09304001）——恶性肿瘤等疾病示范性中药新药临床评价技术平台建设；上海市科委中医引导类项目（12401905700）；上海市级医院新兴前沿技术联合攻关项目（SHDC12016114）——基于CTC检测中西医结合精准干预非小细胞肺癌术后的预后研究

作者	单位
黄婉怡1，赵丽红2，田建辉2，徐蔚杰2，周蕾2，姚逸临2，慕晓艳2，肖凌2，刘吟絮2，朱丽华2，侯宛昕2，尤圣富3，李和根2，周之毅2	1 上海中医药大学，上海，201203； 2 上海中医药大学附属龙华医院肿瘤科，上海，200032； 3 上海中医药大学附属龙华医院临床评价中心，上海，200032

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中文摘要:

目的：探讨中西医结合治疗对老年晚期非小细胞肺癌患者生存期的影响，确定预后因素和中医药治疗的优势人群，为个体化治疗方案提供一定的参考依据。方法：回顾性分析2011年1月至2015年12月上海中医药大学附属龙华医院肿瘤三科收治的老年晚期非小细胞肺癌住院患者74例，根据治疗手段分为化疗组19例，中药组21例，中药联合化疗组34例。结果：中药组、化疗组和联合组的中位生存期分别为761、521和769 d，中位疾病无进展生存期分别为239、195和245 d，组间比较差异均无统计学意义（均P>0.05）；3组1年生存率分别为89%、67%和67%，3年生存率分别为27%、16%和37%，5年生存率分别为9%、0%和17%。单因素分析得出中药静脉治疗≥8疗程或口服中药≥6月（P<0.01,r=0.48）、靶向治疗时间≥1年（P<0.01,r=0.33）和并发症（P<0.01,r=-0.28）为预后影响因素。对靶向和化疗进行分层后，仍得出中药干预为预后因素。多因素分析同样得出中药干预（OR=0.09）和靶向治疗（OR=0.15）为预后影响的独立因素。结论：中西医结合治疗可为老年晚期非小细胞肺癌群体带来获益。

English Summary:

To investigate the effects of integrative Traditional Chinese Medicine (TCM) and Western Medicine cancer treatment regimen's impact on survival time and rate，prognosis factors，and the suitable treatment group of elderly patients with advanced non-small cell lung cancer; and to provide a concrete reference for planning an individual's cancer treatment regimen. Methods:Retrospective analysis was used to analyze 74 cases of elderly patients with advanced non-small cell lung cancer in Longhua Hospital Oncology Department from January 2011 to December 2015; and the patients were divided into chemotherapy group (n=19)，traditional Chinese medicine (TCM) group (n=21)，and chemotherapy combined with traditional Chinese medicine (n=34). Results:The median survival time of TCM，chemotherapy and the combined group were 761 days，521 days and 769 days respectively. The median progression free survival time was 239 days，195 days and 245 days respectively (P>0.05). In addition，1-year survival rate are 89%，67% and 67% respectively; 3-year survival rates were 27%，16% and 37% respectively; and 5-year survival rates were 9%，0%，and 17% respectively. Moreover，the univariable analysis showed receiving TCM intravenously 8 treatments or orally 6 months (P<0.01，r=0.48)，targeted therapy time 1 year (P<0.01，r=0.33)，comorbidity (P<0.01，r=-0.28) are the prognosis factors. After stratifying both targeted therapy and chemotherapy data，we still found TCM intervention played an important prognosis impact factor. Multivariate analysis also concluded that TCM intervention (OR=0.09) and targeted therapy (OR=0.15) were the independent prognosis factors. Conclusion:Elderly patients with advanced non-small cell lung cancer can benefit from receiving the integrative Traditional Chinese Medicine and Western Medicine cancer treatment regimen.

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