摘要
背景:晚期胃癌生存率低,中医药治疗胃癌有抑瘤、延长带瘤生存期和提高生活质量等作用。目的:观察中西医结合治疗对晚期胃癌患者生存期和生活质量的影响。设计、场所、受试者和干预措施:共95例患者入组,分为综合组48例和对照组47例。综合组为上海龙华医院肿瘤一科住院晚期胃癌患者,按上海龙华医院肿瘤一科胃癌中西医结合诊疗常规进行中药结合化疗的治疗,同期收集的上海仁济医院和瑞金医院单纯化疗患者为对照组,对照组患者不服用中药。主要结局指标:随访和比较两组患者的生存时间。观察综合组生活质量,包括Karnofsky评分、体质量和欧洲癌症研究与治疗组织生活质量问卷(The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire,EORTC QLQ-C30)评分,并计算有效率,观察化疗毒副反应。结果:综合组预计中位生存时间为16.12个月,长于对照组的9.64个月(P<0.05)。综合组QLQ-C30生活质量核心量表中功能子量表和症状子量表评分均下降,总健康状况子量表分数上升,表明生活质量有改善。治疗后体质量较治疗前有所增长(P=0.037),而Karnofsky评分治疗前后比较,差异无统计学意义(P=0.061)。综合组所有患者均为可评价病例,完全缓解0例,部分缓解3例,疾病稳定34例,疾病进展11例,部分缓解率为6.25%(3/48),疾病控制率为77.08%(37/48)。未见因严重化疗不良反应而终止治疗者,也无化疗相关死亡病例。结论:中西医结合治疗晚期胃癌能延长生存期,改善患者生活质量,提高综合疗效。
Background: Advanced gastric cancer has a low survival rate while traditional Chinese medicine (TCM) therapy has effects in inhibiting tumor growth, lengthening survival time and improving the quality of life.
Objective: To analyze the effects of integrated traditional Chinese and Western medicine therapy on the survival time and quality of life of advanced gastric cancer patients.
Design, setting, participants and interventions: A total of 95 advanced gastric cancer patients were enrolled and divided into comprehensive group (48 cases) and control group (47 cases). The patients in the comprehensive group from the First Department of Oncology, Longhua Hospital, were treated with TCM therapy and chemotherapy based on the gastric cancer treatment guidelines made by the First Department of Oncology of Longhua Hospital, and the patients in the control group from Renji Hospital and Ruijin Hospital in Shanghai were treated with chemotherapy only.
Main outcome measures: The survival time in the two groups were observed and compared. The Karnofsky score, body weight, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) score, response rate and chemotherapy-related adverse events in the comprehensive group were observed.
Results: The estimated median survival time in the comprehensive group was 16.12 months, longer than 9.64 months in the control group (P〈0.05). The scores of function and symptom of EORTC QLQ-C30 in the comprehensive group decreased, while the overall health status increased, and the results indicated that the quality of life of the patients in the comprehensive group was improved. In the comprehensive group, the body weight after treatment was higher than that before treatment (P=0.037), while there was no difference in Karnofsky scores between that before and after treatment (P=0.061). All the patients in the comprehensive group were assessable. The complete response rate was 0, 3 cases had a partial response, 34 cases had stable disease, and 11 cases had disease progression. The overall response rate was 6.25% (3/48), and the disease control rate was 77.08% (37/48). No patient withdrew because of severe adverse events and there was no chemotherapy-related death.
Conclusion: Integrated traditional Chinese and Western medicine can prolong the survival time and improve the quality of life of advanced gastric cancer patients, and enhance the comprehensive effects.
出处
《中西医结合学报》
CAS
2010年第2期116-120,共5页
Journal of Chinese Integrative Medicine
关键词
胃癌
中西医结合疗法
生存期
生活质量
临床对照试验
gastric cancer
integrated traditional Chinese and Western medicine therapy
survival time
quality of life
controlled clinical trial