放疗合并中药治疗食管鳞癌的远期疗效  

Analysis of Long-term Survival for Radiotherapy Plus Traditional Chinese Medicine for Esophageal Squamous Cell Carcinoma

作　　者：陈志峰[1] 林培中[2] 宋国慧 王岩 丁镇伟[2] 侯浚[1] 

机构地区：[1]河北医科大学第四医院肿瘤研究所,石家庄050011 [2]中国医学科学院肿瘤研究所 [3]河北磁县肿瘤医院

出　　处：《肿瘤防治研究》2012年第3期335-338,共4页Cancer Research on Prevention and Treatment

摘　　要：目的探讨中药增生平对食管鳞癌放疗的远期疗效。方法 1998年6月—1999年12月在食管癌高发现场开展了增生平提高食管癌放疗患者远期生存的前瞻性观察。选择210例食管癌患者,治疗组口服中药增生平,对照组不给予辅助治疗。服药12月以上的病例为有效病例,将死亡率作为终点统计指标。选择临床分组、分期、性别、年龄、Karnosky评分、肿瘤遗传史、吸烟、饮酒、吸烟加饮酒为危险因素,用Cox风险比例模型分析各因素对患者远期生存的影响。结果治疗组Ⅲ期和Ⅳ期患者1、2、3、4、5、6年生存率分别是80.2%、50.2%、42.1%、27.4%、17.3%和14.2%;对照组76.7%、41.8%、18.8%、15.2%、10.6%和9.6%,P=0.039;中位生存期分别是23.5月和18.9月,P=0.027。但临床Ⅰ期和Ⅱ期的远期生存、中位生存期差异均无统计学意义。Cox多因素分析提示临床分组、分期和肿瘤遗传史是影响预后的独立危险因素;其回归系数分别是:0.44、0.32和0.28,P<0.05。全组病例随访93.0%。结论中药增生平可以提高食管鳞癌Ⅲ期和Ⅳ期远期生存。Objective To investigate the long-term survival for radiotherapy plus traditional Chinese medicine zeng sheng ping（ZSP） for ESCC.Methods From June 1988 to December 1999,a prospective observation study was made to investigate how ZSP improved long-term survival of esophageal cancer patients undergoing radiotherapy in High-risk area of esophageal cancer.Two hundred and ten cases with esophageal cancer were selected,among which the treatment group was treated with ZSP,while the control group given no adjuvant therapy.Taking continuous medication for more than 12 months was regarded as effective cases,and the mortality rate endpoint indicators.Cox Proportional Hazards model was used to analyze various to impacts on the long-term survival,which includes clinical stage,gender,age,genetic history of cancer,karnofsky functional status score and smoking,alcohol.Results Study showed that 1,2,3,4,5,6-year survival rate of patients with stage Ⅲ and Ⅳ,was 80.2%,50.2%,42.1%,27.4% 17.3% and 14.2% in the treatment group respectively,control group was 76.7%,41.8%,18.8%,15.2%,10.6% and 9.6%,P=0.039;median survival times was 23.5 months,and 18.9 months,P=0.027.However,the long-term survival and median survival were not statistically significant for the clinical stage Ⅰ and Ⅱ.Cox Multivariate analysis showed that the clinical group,tumor stage and genetic history of cancer were independent risk factors.The regression coefficients were：0.44,0.32 and 0.28,P0.05.The percentage of follow-up patients was 93.0%.Conclusion ZSP can increase the long-term survival for esophageal squamous cell carcinoma with stage Ⅲ and Ⅳ.

关 键 词：中药 食管鳞癌 放疗 远期生存 COX分析 

分 类 号：R735.1[医药卫生—肿瘤]