中医辨证治疗对放化疗鼻咽癌患者生存率的影响

Influence of Chinese Herbal Medicine on Survival Rate of Nasopharyngeal Cancer Patients After Chemoradiotherapy

【目的】回顾性研究放化疗后结合中医药治疗鼻咽癌患者的生存率。【方法】按患者是否愿意服用中药将230例患者分为治疗组(放化疗配合中医药治疗)107例和对照组(单纯放化疗)123例。治疗组在放化疗基础上每年服中药剂数不少于180剂,至少服用中药2年以上;而对照组则单纯给予放化疗。采用Kaplan-Meier法计算生存率,比较2组的生存曲线。【结果】(1)治疗组1年、3年、5年的生存率分别为99.1%、86.4%、72.5%,对照组1年、3年、5年的生存率分别为95.9%、73.5%、58.3%,2组患者的生存曲线比较,差异有统计学意义(P<0.01)。(2)对230例鼻咽癌患者进行了分层分组分析,结果显示:年龄≥50岁、T3-4、N0、Ⅲ-Ⅳ期、低分化鳞癌的鼻咽癌患者配合中医药治疗,其生存率优于对照组,其生存曲线比较差异有统计学意义(P<0.05或P<0.01)。【结论】鼻咽癌患者在放化疗基础上配合中医药治疗,可提高生存率,延长生存期,尤其对于年龄≥50岁、T3-4、N0、Ⅲ-Ⅳ期、低分化鳞癌的鼻咽癌患者疗效更为明显。

Objective A retrospective study was carried out to investigate the survival rate of nasopharyngeal cancer patients after the combined treatment of chemoradiotherapy and Chinese herbal medicine. Methods Based on the will of the patients, 230 cases were divided into treatment group（N=107） and control group（N=123）.Both groups received chemoradiotherapy, and the treatment group was additionally given oral use of Chinese herbal medicine over 180 doses per year, and the treatment lasted over 2 years. The survival rate was calculated by Kaplan-Meier estimator, and the Kaplan-Meier plot for the two groups was compared. Results（1） In the treatment group, the one-year, 3-year and 5-year survival rate was 99.1%, 86.4%, 72.5%, and was 95.9%,73.5%, 58.3% respectively in the control group. The Kaplan-Meier plot showed that significant difference of patient survival was presented in the two groups（P〈0.01）.（2） The results of hierarchical group analysis of230 nasopharyngeal cancer patients showed higher survival rate can be achieved in the T3-4 and N0 poorly-differentiated squamous carcinoma patients aged 50 years or more at the stage Ⅲ-Ⅳ in the treatment group than that in the control group, and the statistical differences were significant（P〈0.05 or P〈0.01）. Conclusion Chemoradiotherapy combined with Chinese herbal medicine can increase the survival rate, and prolong life span of the nasopharyngeal carcinoma patinets, in particular for the T3-4 and N0 poorly-differentiated squamous carcinoma patients aged 50 years or more at the stage Ⅲ-Ⅳ.