固肺消积饮联合支气管化疗灌注治疗老年局部晚期非小细胞肺癌27例

Clinical effect of Gufei Xiaoji decoction combined with bronchial perfusion chemotherapy in treatment of locally advanced non-small cell lung cancer in the elderly: An analysis of 27 cases

目的:观察固肺消积饮联合支气管化疗灌注治疗老年局部晚期非小细胞肺癌的临床疗效。方法:将51例老年局部晚期非小细胞肺癌患者随机分为治疗组(27例)和对照组(24例)。2组均行支气管化疗灌注治疗,治疗组在其基础上加用固肺消积饮治疗,对照组在其基础上加用六君子汤治疗。观察2组患者无进展生存期(PFS)、实体瘤疗效、中医证候疗效、卡氏评分(KPS)疗效,并观察治疗过程中所出现的消化道不良反应、骨髓抑制情况。结果:PFS治疗组为7.19个月,对照组为5.80个月,2组比较,差异有统计学意义(P <0.05)。治疗组瘤体的客观缓解率(ORP)、疾病控制率(PCR)及中医证候评分总改善率、KPS评分总有效率分别为29.63%(8/27)、85.19%(23/27)、88.89%(24/27)、92.59%(25/27),均高于对照组的16.67%(4/24)、54.17%(13/24)、54.17%(13/24)、45.83%(11/24),2组比较,差异均有统计学意义(P <0.05)。在安全性方面,胃肠道不良发生、血红蛋白减少、血小板减少的总发生率治疗组分别为66.67%(18/27)、44.44%(12/27)、0(0/27),对照组分别为91.67%(22/24)、75.00%(18/24)、12.50%(3/24),2组比较,差异均有统计学意义(P <0.05或P <0.01)。结论:固肺消积饮协同化疗灌注治疗老年局部晚期非小细胞肺癌能提高患者PFS,缩小瘤体,改善中医证候,提高生活质量,并减轻支气管化疗灌注所发生的毒副作用。

Objective: To investigate the clinical effect of Gufei Xiaoji decoction combined with bronchial perfusion chemotherapy in the treatment of locally advanced non-small cell lung cancer in the elderly. Methods: A total of 51 elderly patients with locally advanced non-small cell lung cancer were randomly divided into treatment group with 27 patients and control group with 24 patients. The patients in the treatment group were given bronchial perfusion chemotherapy combined with Gufei Xiaoji decoction,and those in the control group were given bronchial perfusion chemotherapy combined with Liujunzi decoction. The two groups were compared in terms of progression-free survival( PFS),solid tumor response,treatment outcome of traditional Chinese medicine( TCM) syndrome,and Karnofsky Performance Scale( KPS)score,and adverse gastrointestinal reactions and bone marrow suppression were evaluated during treatment. Results: There was a significant difference in PFS between the treatment group and the control group( 7. 19 months vs 5. 80 months,P <0. 05). Compared with the control group,the treatment group had significantly higher objective response rate [29. 63%( 8/27) vs 16. 67%( 4/24),P < 0. 05],disease control rate [85. 19%( 23/27) vs 54. 17%( 13/24),P < 0. 05],overall improvement rate of TCM syndrome score [88. 89%( 24/27) vs 54. 17%( 13/24),P < 0. 05],and overall response rate of KPS score [92. 59%( 25/27) vs 45. 83%( 11/24),P < 0. 05]. As for safety,there were significant differences between the treatment group and the control group in the overall incidence rates of adverse gastrointestinal reactions[66. 67%( 18/27) vs 91. 67%( 22/24) ],decrease in hemoglobin [44. 44%( 12/27) vs 75. 00%( 18/24) ],and thrombocytopenia [0( 0/27) vs 12. 50%( 3/24) ]( P < 0. 05 or P < 0. 01). Conclusion: In the treatment of locally advanced non-small cell lung cancer in the elderly,Gufei Xiaoji decoction combined with bronchial perfusion chemotherapy can improve patients’ PFS,reduce tumor volume,improve TCM syndrome and quality of life,and alleviate the toxic and side effects of bronchial perfusion chemotherapy.