中药复方辨证治疗对胰腺癌R0切除术后无病生存期的影响

目的:探讨中药复方辨证治疗对胰腺癌R0切除术后无病生存期的影响。方法:纳入161例胰腺癌R0切除术后患者,运用非随机同期对照研究方法,根据患者是否愿意接受中医药治疗持续3个月及以上,将患者分成中药治疗组(简称"中药组",84例)和非中药治疗组(简称"非中药组",77例)。采用门诊随访、定期电话随访或信访方式,记录患者的无病生存期(DFS)及1、2、3、5年无病生存率;采用Cox多因素比例风险模型分析患者DFS的相关预后因素。结果:入组时KPS评分(P=0.000)及中医药治疗(P=0.000)是胰腺癌R0切除术后DFS的独立预后因素。中药组中位无病生存期(MDFS)为15.8个月(95%CI:12.545~19.055),非中药组MDFS为8.2个月(95%CI:6.062~10.338),中药组的无病生存期较非中药组明显延长(P=0.000)。中药组患者的1、2、3、5年无病生存率分别为64.0%、29.3%、21.9%、15.6%,非中药组分别为29.9%、2.8%、1.4%、0%,中药组的1、2、3、5年无病生存率均高于非中药组(P0.05,P0.01)。结论:中药复方辨证治疗是影响胰腺癌R0切除术后患者预后的独立保护因素,在延长胰腺癌R0切除术后患者DFS方面具有一定的优势。

Effect of Chinese Medicine Therapy Based on Syndrome Differentiation on Disease-free Survival of Patients with Pancreatic Cancer Undergoing R0 Resection

Objective： To explore the effects of Chinese medlcine therapy based on syndrome differentiation on disease- free survival （DFS） of patients with pancreatic cancer undergoing R0 resection. Methods： A total of 161 patients with pancreatic cancer undergoing R0 resection were selected. A non-randomlzed concurrent control method was adopted, and the patients were divided into Chinese medicine group （84 cases） and non-Chinese medicine group （77 cases ） according to whether they were willing to receive Chinese medicine treatment for more than 3 successive months. By using follow-ups at clinics, by letter, and by telephone, the DFS and 1-, 2-, 3- and 5-year DFS ratios were recorded; the prognostic relevant factors of DFS were analyzed by Cox regression model. Results： The KPS scores （P = 0. 000） and Chinese medicine treatment （P = 0. 000 ） were the independent prognostic relevant factors of DFS in patients with pancreatic cancer undergoing R0 resection. The median DFS of Chinese medicine group was 15.8 months （95% CI： 12. 545-~ 19. 055 ）, and the median DFS of non-Chinese medicine group was 8.2 months （95% CI： 6. 062 - 10. 338）, with a statistical difference between the two groups （P = 0. 000）. The 1-, 2-, 3- and 5-year DFS ratios in Chinese medicine group were 64.0% , 29.3% , 21.9% and 15.6% respectively, and they were 29.9%, 2.8%, 1.4% and 0% respectively in non-Chinese medicine group. The 1-, 2-, 3- and 5-year DFS ratios of Chinese medicine group were higher than those of the non-Chinese medicine group （ P 〈 0.05, P 〈 0.01 ）. Conclusion： Chinese medicine therapy based on syndrome differentiation is an independent protective factor for the patients with pancreatic cancer undergoing R0 resection, and Chinese medicine therapy has some advantage in prolonging the DFS for patients with pancreatic cancer undergoing R0 resection.