序贯化、放疗结合中药治疗54例晚期非小细胞肺癌患者的预后分析  

Prognostic analysis of advanced non small cell lung cancer treated by sequential chemo-radiation therapy combined with traditional Chinese medicine:A report of 54 cases

作　　者：韩明权[1] 苏晋梅[1] 黄海茵[1] 龙为红[1] 秦丽萍[1] 秦萍[1] 刘巍[1] 盛兆瑛[1] 

机构地区：[1]上海市肺科医院中西医结合科,上海200433

出　　处：《中西医结合学报》2003年第3期195-198,共4页Journal of Chinese Integrative Medicine

摘　　要：目的　回顾分析序贯化、放疗结合中药治疗 54例晚期非小细胞肺癌 (NSCLC)患者的疗效 ,及对生存质量和生存率的影响 ,并探讨影响预后的因素。方法　选择 2 0 0 0年 1月～ 2 0 0 1年 12月的 54例未经治疗的晚期NSCLC患者 (Ⅲ期 2 0例 ,Ⅳ期3 4例 ) ,采用序贯化、放疗结合中药的综合疗法 ,同时减少化疗疗程 ,延长疗程间隔时间 ,观察疗效及其对生存质量和生存率的影响 ,并分析影响预后的因素。结果　完全缓解 (CR) 1例 ,部分缓解 (PR) 2 0例 ,总缓解率 (CR +PR)为 40 .4% ;中位生存期为15.3个月 ;1、2、3年的生存率分别为 53 .7%、2 8.9%、9.6%。其中Ⅲ、Ⅳ期患者的中位生存期分别为 2 1.8个月和 12 .5个月 ;Ⅲ期患者 1、2、3年的生存率分别为 65.0 %、49.5%、2 4.7% ;Ⅳ期患者 1、2、3年的生存率分别为 47.0 %、2 3 .3 %、0 %。绝大多数患者的生活质量得到提高。Cox回归模型分析显示 ,患者生活质量的提高和坚持中药治疗对生存期的延长有显著意义。结论　序贯化、放疗结合中药治疗晚期NSCLC患者 ,可减少化疗疗程 ,延长疗程间隔时间 ,从而改善生活质量。ObjectiveTo evaluate the influence of fewer course s and prolonged intervals of chemotherapy on survival rate of advanced non small c ell lung cancer (NSCLC) patients treated by sequential chemo-radiation therapy combined with traditional Chinese medicine(TCM). MethodsFrom Ja n.2000 to Dec.2001,54 untreated advanced NSCLC patients(2 stage Ⅲa,18 stage Ⅲb,34 stage Ⅳ) were treated by sequential chemo-radiation therapy combined with TCM. The courses of chemotherapy were reduced and the intervals of chemothe rapy were longer than that of the standard regimen. The efficacy and survival ra te were documented and the prognostic factors were analyzed. ResultsWTBZ Complete remission(CR)was observed in 1 case and partial remission(PR)in 20 cases. The overall objective response rate was 40.4%. Median survival was 15. 3 months,1-,2- and 3- year survival rate were 53.7%,28.9% and 9.6% respect ively. The median survival of stage Ⅲ and Ⅳ were 21.8 months and 12.5 months r espectively. The 1-,2-,and 3- year survival rates of stage Ⅲ were 65.0%, 49.5%,24.7% and that of stage Ⅳ were 47.0%,23.3%,0%,respectively. The quali ty of life was improved in most of the patients. Cox’s proportional hazards reg ression showed that improved quality of life and treatment of TCM were the signi ficant prognostic factors of overall survival. ConclusionChemothe rapy and radiotherapy combined with TCM is beneficial to extending the interval of chemotherapy,improving the quality of life,and increasing the survival rate of advanced NSCLC patients.

关 键 词：序贯化 放疗 中药 治疗 晚期 非小细胞肺癌 预后 

分 类 号：R734.2[医药卫生—肿瘤]