中药综合治疗晚期非小细胞肺癌患者:一项多中心、前瞻性队列研究。
Comprehensive treatment with Chinese medicine in patients with advanced non-small cell lung cancer: A multicenter, prospective, cohort study.
作者信息
Liu Jie, Lin Hong-Sheng, Hou Wei, Hua Bao-Jin, Zhang Pei-Tong, Li Jie, Wang Shen-Yu, Xie Ying, Zhang Yue, Xie Guang-Ru, Zhang Mei-Ying, Shi Wen-Guang, Guan Nian-Bo, Guan Tian-Yu, Li Cong-Huang, Lu Li-Yuan, Zhang Ying, Li Dao-Rui, Liu Hao
机构信息
Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
Department of Integrative Oncology, Liaoning Cancer Hospital, Shenyang, 110042, China.
出版信息
Chin J Integr Med. 2017 Oct;23(10):733-739. doi: 10.1007/s11655-016-2737-1. Epub 2016 Oct 28.
OBJECTIVE
To determine whether additional Chinese medicine (CM) could prolong survival and improve the quality of life (QOL) in patients with advanced non-small cell lung cancer (NSCLC) compared with Western medicine (WM) alone.
METHODS
This was a multicenter, prospective cohort study. A total of 474 hospitalized patients with stage III-IV NSCLC were recruited and divided into 2 groups. Patients in the WM group received radiotherapy, chemotherapy, and optimal supportive therapy according to the National Comprehensive Cancer Network (NCCN) guidelines. In the integrative medicine (IM) group, individualized CM (Chinese patent medicines and injections) and WM were administered. The primary end point was overall survival, and the secondary end points were time to disease progression, adverse events, and QOL. Follow-up clinical examinations and chest radiography were performed every 2 months.
RESULTS
The median survival was 16.60 months in the IM group and 13.13 months in the WM group (P<0.01). The incidences of loss of appetite, nausea, and vomiting in the IM group were significantly lower than those in the WM group (P<0.05). The QOL based on Functional Assessment of Cancer Therapy-Lung in the IM group was markedly higher than that in the WM group at the fourth course (P<0.05).
CONCLUSIONS
Additional CM may prolong survival and improve the QOL patients with NSCLC. The adverse effects of radio- and chemotherapy may be attenuated as CM is used in combination with conventional treatments.
目的
确定与单纯西医治疗相比,加用中药是否能延长晚期非小细胞肺癌(NSCLC)患者的生存期并改善生活质量(QOL)。
方法
这是一项多中心前瞻性队列研究。共招募了474例III-IV期NSCLC住院患者并分为两组。西医组患者根据美国国立综合癌症网络(NCCN)指南接受放疗、化疗及最佳支持治疗。中西医结合组给予个体化中药(中成药和注射剂)及西医治疗。主要终点为总生存期,次要终点为疾病进展时间、不良事件及生活质量。每2个月进行一次随访临床检查及胸部X线检查。
结果
中西医结合组中位生存期为16.60个月,西医组为13.13个月(P<0.01)。中西医结合组食欲减退、恶心及呕吐的发生率显著低于西医组(P<0.05)。在第四个疗程时,中西医结合组基于肺癌患者功能评估量表的生活质量明显高于西医组(P<0.05)。
结论
加用中药可能延长NSCLC患者的生存期并改善其生活质量。中药与传统治疗联合使用时,放化疗的不良反应可能会减轻。