Objective To investigate the influencing factors of traditional Chinese medicine（ TCM） syndrome differentiation combined with epidermal growth factor receptor tyrosine kinase inhibitor（ EGFR-TKI） on the survival of patients with advanced lung adenocarcinoma with epidermal growth factor（ EGFR） gene-sensitive mutation. Methods The clinical data of 104 patients with advanced lung adenocarcinoma EGFR gene-sensitive mutations treated with TCM syndrome differentiation combined with EGFR-TKI were collected

including gender

age

pathological type

TCM syndrome type

EGFR gene subtype

physical status score（ PS score）

metastatic site

treatment period（ divided into first-line

second-line

third-line）

smoking status

clinical efficacy

etc. The survival rate was calculated by Kaplan-Meier method

and the factors affecting survival were screened by Log-rank test. The Cox model was used for multi-factor analysis. Results Among 104 patients

70 died and 34 suvived

and the median overall survival time was（ 20. 20 ± 2. 23） months. The one-year survival rate was 49. 3%

the two-year survival rate was24. 4%

and the three-year survival rate was 19. 4%. Univariate analysis showed that EGFR subtype

treatment period

smoking status

TCM syndrome

and clinical efficacy affect survival（ P < 0. 05）

while gender

age

metastatic site

PS score

EGFR-TKI drug factors had no effects on survival（ P > 0. 05）. Multivariate analysis showed that two factors of treatment and efficacy entered the Cox model. Compared with first-line treatment

second-line and third-line treatment increased the risk of death by 3. 019 times and 65. 923 times

respectively. Compared with the efficacy of partial remission

the risk of death in patients with the effect evaluation as stable and progression of disease increased by 2. 764 times and 8. 010 times

respectively. Conclusion First-line EGFR-TKI therapy and efficacy are independent factors affecting the survival of patients with advanced lung adenocarcinoma EGFR gene-sensitive mutations.