中医肿瘤疗效评价系统在晚期非小细胞肺癌中的应用

Traditional Chinese Medical Oncologic Evaluation Sys-tem of Response to Treatment (TCMOES) in Advanced Non-small Lung Cancer

[目的]对中医肿瘤疗效评价系统在中晚期非小细胞肺癌(NSCLC)中的应用进行评价。[方法]共纳入191例中晚期NSCLC病人,其中中医组99例,西医组92例。中医疗效评价以总疗效(100%)=瘤体变化(30%)+临床症状(15%)+体力状况(15%)+生存期(40%)计量,75～100分为显效,50～74分有效,25～49分为稳定,<25分为无效;两组病例同时用中医疗效评价系统及实体瘤疗效评价标准(responseevaluationcriteriainsolidtumor,RECIST)两种评价方法进行疗效评价。[结果]按照RECIST评价,中医组CR+PR+SD为66.7%,西医组CR+PR+SD为76.1%,西医组高于中医组(P=0.151);按照中医疗效评价系统评价,中医组显效+有效+稳定为66.7%,西医组为56.5%,中医组高于西医组(P=0.149)。相关分析表明,两种评价方法之间具有相关性(P<0.01)。[结论]中医肿瘤疗效评价系统比单纯瘤体缓解率的评价更能反映出中医的疗效,具有进一步研究价值。

[ Purpose]To evaluate the efficacy TCMOES in advanced non-small cell lung cancer. [Methods]One hundred and ninety-one advanced non-small cell lung cancer patients were enrolled in the clinical trial （ TCM group, 99 patients; western medicine group, 92 patients）. The overall response of TCMOES included change of tumor size （30%）, symptoms （15%）, performance status（15%）, survival time （40%）. The score of 75 to 100 is difinited as obvious efficacy, 50 to 70, effective; 25 to 49, stable disease and less 25, ineffective. Both groups were evaluated with TCMOES and Response Evaluation Criteria in Solid Tumor（RESCIT）. [Results]According to RECIST, CR＋PR＋SD in TCM group was 66.7%, and western medicine group, 76.1%, the latter is higher than the former（P=0.151）. According to TCMOES, overall response rate in TCM group was 66.7% ,and western medicine group, 56.5%, the former is higher than the latter（P：0.149）. Correlative analysis showed that both evaluation system were close correlation （P〈0.01）. [Conclusion]The TCMOES can reflect the efficacy of TCM in treatment for tumor. It is superior to evaluation with response rate only.