Tao Li, Zhu Ying-jie, Lu Xian-mei, Gu Ying, Zhao Ai-guang, Zheng Jian, Fu Chuan-gang, Yang Jin-kun
First Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, China.
Zhong Xi Yi Jie He Xue Bao. 2010 Dec;8(12):1159-64. doi: 10.3736/jcim20101208.
The incidence of colorectal cancer is high among the elderly. Traditional Chinese medicine (TCM) has been widely used in the treatment for colorectal cancer of old people. However, controlled trials with large sample size evaluating the effect of TCM are rare.
This research aimed to evaluate the survival benefit of using TCM syndrome differentiation treatment for elderly patients with stage II or III colorectal cancer.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: A total of 78 patients over 70 with resected stage II or III colorectal cancer were selected from the First Department of Oncology, Longhua Hospital of Shanghai University of Traditional Chinese Medicine, and Department of Anorectal Surgery, Changhai Hospital of Second Military Medical University. Patients were assigned to either integrated treatment group or Western medicine group by their own wills.
Cox regression analysis was performed to determine all the potential factors which may affect prognosis such as gender, primary site, pathological type, TNM stage, chemotherapy period, radiotherapy and TCM therapy.
A total of 78 cases were included in this study with 37 cases in integrated treatment group and 41 cases in Western medicine group. Cox regression analysis suggested that the TNM stage (P=0.001) and TCM therapy (P=0.021) were independent prognostic factors. The hazard ratio [Exp(β)] of TCM therapy was 0.393, and 95% confidence interval (CI) was 0.178-0.870. Median disease-free survival (DFS) of Western medicine group was 41.293 months. DFS of integrated treatment group did not reach the median at the time of analysis. There was significant difference between the two groups (P=0.012). The 1-, 2-, 3-, 4-, and 5-year DFS rates of Western medicine group were 87.7 %, 69.6%, 63.4%, 46.5%, and 29.6%, respectively. The 1-, 2-, 3-, 4-, and 5-year DFS rates of integrated therapy group were 100%, 86.3%, 74.6%, 74.6%, and 74.6%, respectively.
TCM syndrome differentiation and treatment is important for improving the prognosis of stage II or III colorectal cancer in elderly patients. Integrated treatment shows benefit for reducing relapse and metastasis rates, and prolonging survival for elderly patients. The influence of integrated treatment needs to be further evaluated.
老年人大肠癌发病率较高。中医药已广泛应用于老年人大肠癌的治疗。然而，评估中医药疗效的大样本对照试验较少。
本研究旨在评估中医辨证论治对老年Ⅱ、Ⅲ期大肠癌患者生存获益的影响。
设计、场所、参与者和干预措施：从上海中医药大学附属龙华医院肿瘤科一区及第二军医大学附属长海医院肛肠外科选取78例70岁以上Ⅱ、Ⅲ期大肠癌根治术后患者。患者根据自身意愿分为中西医结合治疗组和西医组。
采用Cox回归分析确定性别、原发部位、病理类型、TNM分期、化疗周期、放疗及中医治疗等所有可能影响预后的因素。
本研究共纳入78例患者，其中中西医结合治疗组37例，西医组41例。Cox回归分析显示，TNM分期（P = 0.001）和中医治疗（P = 0.021）是独立的预后因素。中医治疗的风险比[Exp(β)]为0.393，95%置信区间（CI）为0.178 - 0.870。西医组的中位无病生存期（DFS）为41.293个月。分析时中西医结合治疗组的DFS未达到中位数。两组间差异有统计学意义（P = 0.012）。西医组1、2、3、4、5年DFS率分别为87.7%、69.6%、63.4%、46.5%、29.6%。中西医结合治疗组1、2、3、4、5年DFS率分别为100%、86.3%、74.6%、74.6%、74.6%。
中医辨证论治对改善老年Ⅱ、Ⅲ期大肠癌患者预后具有重要意义。中西医结合治疗对降低老年患者复发转移率、延长生存期有益。中西医结合治疗的影响有待进一步评估。
