中医药治疗对晚期卵巢癌减瘤术后患者远期生存的影响

Effect of Traditional Chinese Medicine on Long-term Survival of Patients with Advanced Ovarian Cancer After Tumor Reduction

目的:分析中医药治疗对晚期卵巢癌减瘤术后患者生存期的影响,并探讨影响晚期卵巢癌预后的相关因素。方法:收集中国医学科学院肿瘤医院232例晚期卵巢癌肿瘤细胞减灭术后患者临床资料,依据患者术后接受治疗方式的不同,分为西医组和中西医结合组,比较两组患者1、3、5年生存率差异;并对可能影响患者预后的因素进行分析,筛选影响患者预后的独立因素。结果:西医组的1、3、5年生存率分别为89.9%、67.8%、52.5%;中西医结合组的1、3、5年生存率分别为90.2%、73.9%、65.4%;中西医结合组和西医组5年生存率比较,差异有统计学意义(P<0.05)。单因素分析显示,初治年龄、绝经情况、FIGO分期、远处转移、新辅助化疗、术后化疗、靶向治疗、辨证汤剂治疗与患者总生存期相关(P<0.05)。多因素分析显示,初治年龄60岁以上患者的死亡风险是60岁以下患者的1.775倍;发生远处转移患者的死亡风险是未发生远处转移患者的1.927倍;接受靶向治疗患者的死亡风险是未接受靶向治疗死亡风险的0.342倍;术后化疗6次患者的死亡风险是术后化疗6次以下的0.287倍;患者每接受1个疗程(3个月)的辨证汤剂治疗,其死亡风险可降低5.1%。结论:中西医结合治疗在提高晚期卵巢癌减瘤术后远期生存率方面具有一定优势,初治年龄和远处转移是晚期卵巢癌患者术后预后的独立危险因素;靶向治疗、术后化疗足疗程和中药辨证汤剂治疗是晚期卵巢癌患者术后预后的独立保护因素。

Objective:To analyze the effect of traditional Chinese medicine(TCM)as an adjuvant therapy on the survival of patients with advanced ovarian cancer after tumor reduction,and to explore the related factors affecting the prognosis of advanced ovarian cancer.Methods:The clinical data of 232 patients with advanced ovarian cancer after subtraction were retrospectively analyzed in Cancer Hospital Chinese Academy of Medical Sciences.According to the different postoperative treatment methods,the patients were divided into western medicine group and integrated Chinese and Western medicine group.The 1-year,3-year and 5-year survival rates of the two groups were statistically analyzed,and the survival rates of the two groups were compared.The factors that may affect the prognosis of patients were analyzed,and the independent factors that affect the prognosis of patients were screened.Results:The 1-year,3-year and 5-year survival rates of western medicine group were 89.9%,67.8%and 52.5%,respectively.The 1-year,3-year and 5-year survival rates of integrated Chinese and Western medicine group were 90.2%,73.9%and 65.4%,respectively.There was significant difference in survival curve between these two groups(P<0.05).Univariate analysis indicated that age at initial treatment,menopause,FIGO stage,distant metastasis,neoadjuvant chemotherapy,postoperative chemotherapy,targeted therapy,syndrome differentiation decoction treatment were correlated with OS(P<0.05).Multivariate analysis showed that the risk of death in patients older than 60 years 0ld was 1.775 times higher than that in patients younger than 60 years old.The mortality risk of patients with distant metastasis was 1.927 times higher than that of patients without distant metastasis.Patients receiving targeted therapy had a 0.342 times higher risk of death than those not receiving targeted therapy;Postoperative chemotherapy=6 times of death risk was 0.287 times of postoperative chemotherapy<6 times;The risk of death could be reduced by 5.1%for each course(3 months)of syndrome differentiation decoction.Conclusion:Integrated traditional Chinese and Western medicine has some advantages in improving the long-term survival rate of advanced ovarian cancer after reducing tumor.Age at initial treatment and distant metastasis are independent risk factors for postoperative prognosis of advanced ovarian cancer patients.Targeted therapy,full course of postoperative chemotherapy and TCM syndrome differentiation decoction are independent prognostic factors for advanced ovarian cancer patients.