Effect of Traditional Chinese Medicine on Survival of Elderly Patients with Phase Ⅲ-Ⅳ Lung Squamous Cell Carcinoma and the Analysis of Prognostic Factors:an Ambispective Cohort Study

doi:10.13288/j.11-2166/r.2021.12.010

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Effect of Traditional Chinese Medicine on Survival of Elderly Patients with Phase Ⅲ-Ⅳ Lung Squamous Cell Carcinoma and the Analysis of Prognostic Factors:an Ambispective Cohort Study

更新时间：2021-11-10

- Effect of Traditional Chinese Medicine on Survival of Elderly Patients with Phase Ⅲ-Ⅳ Lung Squamous Cell Carcinoma and the Analysis of Prognostic Factors:an Ambispective Cohort Study
- Journal of Traditional Chinese Medicine Vol. 62, Issue 12, Pages: 1059-1064(2021)
- 作者机构：
  
  1. 中国中医科学院广安门医院
  2. 北京中医药大学东直门医院通州院区
  3. 北京中医药大学研究生院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2021.12.010
  CLC： R273
- Published：2021
- 稿件说明：
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[1]李媛,朱广辉,李杰.中医药治疗对Ⅲ、Ⅳ期老年肺鳞癌患者生存状况的影响及预后相关因素分析——双向性队列研究[J].中医杂志,2021,62(12):1059-1064.

Effect of Traditional Chinese Medicine on Survival of Elderly Patients with Phase Ⅲ-Ⅳ Lung Squamous Cell Carcinoma and the Analysis of Prognostic Factors:an Ambispective Cohort Study[J]. Journal of Traditional Chinese Medicine2021, 62(12): 1059-1064.
[1]李媛,朱广辉,李杰.中医药治疗对Ⅲ、Ⅳ期老年肺鳞癌患者生存状况的影响及预后相关因素分析——双向性队列研究[J].中医杂志,2021,62(12):1059-1064. DOI： 10.13288/j.11-2166/r.2021.12.010.

Effect of Traditional Chinese Medicine on Survival of Elderly Patients with Phase Ⅲ-Ⅳ Lung Squamous Cell Carcinoma and the Analysis of Prognostic Factors:an Ambispective Cohort Study[J]. Journal of Traditional Chinese Medicine2021, 62(12): 1059-1064. DOI： 10.13288/j.11-2166/r.2021.12.010.

摘要

目的分析中医药对Ⅲ期、Ⅳ期老年肺鳞癌患者生存期的影响

并探讨影响其预后的相关因素。方法采用双向性队列研究方法

2013年2月1日开始回顾性收集2003年1月至2012年12月病例资料

若收集所得病例未出现死亡事件

则前瞻性随访患者生存状况

自2013年2月1日起每3个月电话随访1次。纳入96例接受中医药治疗的年龄≥65岁的Ⅲ期（50例）、Ⅳ期（46例）肺鳞癌患者

将各期患者分为中医药治疗组及中医药治疗配合化疗组

建立病例报告表并采集信息

对比不同分期两组患者症状改善情况、不良反应发生率

一年生存率、二年生存率

无进展生存时间（PFS）、中位生存时间（MST）

并筛选影响患者预后的相关因素。结果截至2020年11月20日最后一次随访

共失访11例

其余85例患者均观察至终点死亡结局。老年Ⅲ期肺鳞癌患者

两组在症状改善、一年生存率、二年生存率、中位PFS方面组间比较差异无统计学意义（P>0.05）

中医药治疗组的MST长于中医药治疗配合化疗组（P<0.05）。老年Ⅳ期肺鳞癌患者

中医药治疗配合化疗组的症状改善情况优于中医药治疗组（P<0.05）

中医药治疗组一年生存率、二年生存率、中位PFS、MST均低于中医药治疗配合化疗组（P<0.05）。老年Ⅲ期、Ⅳ期肺鳞癌患者中医药治疗组不良反应发生率均明显低于中医药治疗配合化疗组（P<0.05）。预后相关多因素分析显示

无吸烟史、经过放疗治疗是老年Ⅲ期、Ⅳ期肺鳞癌患者预后的独立保护因素。结论中医药干预Ⅲ期、Ⅳ期老年肺鳞癌患者可改善症状、降低不良反应发生率

但在提高生存率、延长无进展及总生存时间方面

中西医结合治疗较单纯中医药治疗更有优势;同时放疗是重要治疗手段

而吸烟可影响患者预后。

Abstract

Objective To analyze the influence of traditional Chinese medicine（TCM） on the survival of elderly patients with phase Ⅲ-Ⅳ lung squamous cell carcinoma（LSCC）

and to explore the related prognostic factors. Methods An ambispective cohort study was designed. The data on medical cases from January 2003 to December 2012 were retrospectively collected

and was followed up through telephone every three months if the patient was still alive since February 1 st

2013. Totally 96 cases LSCC patients including phase Ⅲ 50 cases and phase Ⅳ 46 cases who were ≥65 years old and were treated by TCM therapies were enrolled and were grouped into TCM group or TCM plus chemotherapy（TCM-chemo） group. Case report form was developed to collect the data. The symptom improvement

adverse reactions

one-year survival rate

two-year survival rate

progression-free survival time（PFS）

and median survival time（MST） were assessed and compared between groups at different disease stage. And prognostic factors were analyzed. Results Upto the last follow-up on November 20 th

2020

11 patients were lost to follow-up while the remaining 85 patients were followed up till the end-point outcome of death. Regarding the elderly patients with phase Ⅲ LSCC

there were no statistical differences in symptom improvement

one-year survival rate

two-year survival rate and median PFS between TCM group and TCM-chemo group（P>0.05）; but TCM group had longer MST than in TCM-chemo group（P<0.05）. For elderly patients of phase Ⅳ LSCC

the results favored TCM-chemo group on symptom improvement compared to TCM group（P<0.05）

and one-year survival rate

two-year survival rate

median PFS and MST was significantly lower in TCM group than TCM-chemo group（P<0.05）. The adverse reaction rate of TCM group was significantly lower than that of TCM-chemo group for both phase Ⅲ and phase Ⅳ elderly LSCC patients（P<0.05）. Multivariate analysis showed that no history of smoking and having received radiotherapy were independent protective factors for prognosis of elderly patients with phase Ⅲ and Ⅳ LSCC. Conclusion TCM can improve symptoms and reduce adverse actions when treating phase Ⅲ-Ⅳ elderly LSCC patients. TCM in combination with chemotherapy is supperior to TCM therapy alone in increasing survival rate and prolonging PFS and overall survival time. Radiotherapy is an important therapy for phase Ⅲ-Ⅳ elderly LSCC patients

and smoking can affect the prognosis.

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