Lu Xian-Mei, Zheng Jian, Zhu Ying-Jie
Department of Oncology, Jinhua Guangfu Hospital, Zhejiang 321000.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Sep;32(9):1166-70.
To study the effects of Chinese materia medica (CMM) combined chemotherapy on the recurrence, metastasis, and the disease free survival (DFS) of stage II and III colorectal cancer (CC) patients after radical cure.
Recruited were 366 inpatients and outpatients with stage II and III colorectal cancer (CC) from Changhai Hospital, Second Military Medical University, and Tumor Department of Longhua Hospital, Shanghai University of Traditional Chinese Medicine from January 2002 to December 2008. A non-randomized concurrent control method was adopted. Patients were assigned to the combination group (treated by CMM + chemotherapy, 189 cases) and the chemotherapy group (177 cases) according to whether they were willing to receive the CMM treatment for more than 6 successive months. By using follow-ups at clinics, by letter, and by telephone, the DFS, 1-, 2-, 3-, and 5-year DFS ratios were observed. The correlations between DFS and the gender, age, tumor location, staging of clinical pathology, pathological type, chemotherapeutic cycle, radiotherapy, CMM treatment, end point event (recurrence and metastasis) were analyzed.
The recurrence or metastasis occurred in 145 cases (39. 61%) of the 366 patients. Of them, local recurrence occurred in 17 cases (11.72%), liver metastasis in 45 cases (31.03%), lung metastasis in 52 cases (35.86%), and metastasis in other parts in 53 cases (36.55%). Results of one-factor analysis showed six factors such as the tumor location, pathological type, staging of clinical pathology, chemotherapeutic cycle, radiotherapy, and CMM treatment were correlated with the DFS, showing statistical difference (P<0.01, P<0.05). Results of multifactor analysis showed staging of clinical pathology, chemotherapeutic cycle, and CMM treatment were correlated with the DFS, showing statistical difference (P<0.01). Results of stratified study on the staging of clinical pathology indicated that the primary tumor location (P=0.016) and the pathological type (P=0.047) were the independent predictors for DFS of stage II CC. The median DFS of the two groups could not be calculated. Results of stratified study on the stages of clinical pathology indicated that CMM treatment (P=0.000) and chemotherapeutic cycle (P=0.017) were independent predictors for DFS of stage III CC. As for comparing the composition ratio of the two therapeutic cycles, results showed the baselines of the chemotherapeutic cycle of the two groups were balanced. Further comparison showed the median DFS for the chemotherapy group at stage III was 24. 16 months, while it could not be calculated in the combination group. The DFS, 1-, 2-, 3-, and 5-year DFS ratios were 92%, 72%, 61%, and 59%, respectively in the stage III CC combination group, while they were 74%, 50%, 36%, and 20%, respectively in the stage IlI CC chemotherapy group.
CMM combined chemotherapy could prolong the DFS of stage III CC patients after radical cure.
研究中药联合化疗对Ⅱ、Ⅲ期结肠癌患者根治术后复发、转移及无病生存期（DFS）的影响。
选取2002年1月至2008年12月在第二军医大学长海医院、上海中医药大学附属龙华医院肿瘤科住院及门诊的366例Ⅱ、Ⅲ期结肠癌患者。采用非随机同期对照方法。根据患者是否愿意连续接受6个月以上中药治疗，将患者分为联合组（中药+化疗治疗，189例）和化疗组（177例）。通过门诊随访、信函随访及电话随访，观察DFS、1年、2年、3年及5年DFS率。分析DFS与性别、年龄、肿瘤部位、临床病理分期、病理类型、化疗周期、放疗、中药治疗、终点事件（复发和转移）之间的相关性。
366例患者中145例（39.61%）出现复发或转移。其中，局部复发17例（11.72%），肝转移45例（31.03%），肺转移52例（35.86%），其他部位转移53例（36.55%）。单因素分析结果显示，肿瘤部位、病理类型、临床病理分期、化疗周期、放疗及中药治疗6个因素与DFS相关，差异有统计学意义（P<0.01，P<0.05）。多因素分析结果显示，临床病理分期、化疗周期及中药治疗与DFS相关，差异有统计学意义（P<0.01）。临床病理分期分层研究结果显示，原发肿瘤部位（P=0.016）和病理类型（P=0.047）是Ⅱ期结肠癌DFS的独立预测因素。两组的中位DFS无法计算。临床病理分期分层研究结果显示，中药治疗（P=0.000）和化疗周期（P=0.017）是Ⅲ期结肠癌DFS的独立预测因素。比较两个治疗周期的构成比，结果显示两组化疗周期基线均衡。进一步比较显示，Ⅲ期化疗组的中位DFS为24.16个月，联合组无法计算。Ⅲ期结肠癌联合组的DFS、1年、2年、3年及5年DFS率分别为92%、72%、61%和59%，Ⅲ期结肠癌化疗组分别为74%、50%、36%和20%。
中药联合化疗可延长Ⅲ期结肠癌患者根治术后的DFS。
