摘要
目的:分析早期非小细胞肺癌(NSCLC)患者根治术后无瘤生存期的影响因素,观察中医药干预对于早期NSCLC患者的影响.方法:采用单臂、单中心数据回顾性研究,分析415例接受中医药干预的早期NSCLC患者的临床资料,运用Kaplan-Meier法对可能影响早期NSCLC预后的因素进行单因素分析,并将经显著性检验后有意义的可疑影响因素纳入Cox回归分析,建立Cox风险比例模型.结果:415例早期NSCLC患者的1年、2年、3年、5年、10年无瘤生存率为96.1％、87.5％、84.0％、76.5％、67.4％.2)单因素分析显示,性别、年龄、吸烟史、手术方式、病理类型、临床分期、中医辨证分型、中医药物及非药物治疗疗程、中医干预空白期、中医综合治疗持续时间为预后相关影响因素(P＜0.05)o Cox回归分析显示,性别、临床分期、中医辨证分型、中成药疗程、中医综合治疗持续时间是影响患者预后的独立危险因素.结论:中医药干预可以提高早期NSCLC患者的无瘤生存率,改善预后.2)早期NSCLC患者中,女性、年轻、不吸烟、行电视胸腔镜辅助手术、肺腺癌(贴壁型为主)、临床分期早、气阴两虚及肺脾气虚型患者预后佳.术后中医药干预空白期短且长期中医综合辨证治疗可以提高患者无病生存率.
Abstract
Objective:To analyze the factors influencing disease-free survival in early-stage non-small cell lung cancer(NSCLC)patients after radical surgery and observe the impact of traditional Chinese medicine(TCM)intervention on these patients.Meth-ods:A single-arm,single-center retrospective study was conducted on clinical data of 415 early-stage NSCLC patients who received TCM intervention.Kaplan-Meier method was used for univariate analysis of potential prognostic factors for early-stage NSCLC.Fac-tors with significant results determined by significance testing were further analyzed using Cox regression to establish a Cox propor-tional hazards model.Results:The 1-year,2-year,3-year,5-year,and 10-year disease-free survival rates of 415 patients with early-stage NSCLC were 96.1％,87.5％,84.0％,76.5％,and 67.4％,respectively.Univariate analysis indicated that gender,age,smoking history,surgical method,pathological type,clinical stage,TCM syndrome differentiation,TCM medication and non-medica-tion treatment duration,blank period of TCM intervention,and the duration of comprehensive TCM intervention were significant prognostic factors(P＜0.05).Cox regression analysis identified gender,clinical stage,TCM syndrome differentiation,duration of Chinese patent medicine treatment,and duration of comprehensive TCM treatment as independent risk factors.Conclusion:TCM in-terventions could improve disease-free survival rates and prognosis in early-stage NSCLC patients.Among these patients,those who were female,younger,non-smokers,underwent video-assisted thoracoscopic surgery,had lung adenocarcinoma(predominantly lepid-ic subtype),early clinical stage,and TCM syndromes of qi and yin deficiency or lung and spleen qi deficiency had better outcomes.A shorter TCM intervention blank period and prolonged comprehensive TCM treatment contributed to increased disease-free survival rates.
基金项目
国家自然科学基金项目(8237150337)
国家自然科学基金项目(82205214)
上海市临床重点专科(中医)建设项目(shslczdzk03701)
中医肿瘤;上海市中医肿瘤临床医学研究中心项目(21MC1930500)
国家科技期刊平台
NSTL
万方数据