针药结合治疗老年非小细胞肺癌100例远期疗效观察

目的:观察针药结合治疗Ⅲ、Ⅳ期老年非小细胞肺癌(NSCLC)的远期疗效。方法:采用前瞻性、多中心、随机、对照的研究方法,将199例符合纳入标准病例按1∶1比例分成治疗组(采用针药结合治疗)和对照组(采用西医治疗),对照组则根据患者的PS评分分为化疗组(PS≤2)和最佳支持治疗组(BSC组)(PS=3)。治疗组以PS评分进行分层(PS≤2或PS=3),分别与化疗组及BSC组对照。观察两组疾病进展时间、中位生存期及生存率。结果:治疗组与对照组中位生存期分别为295 d、301 d(PS≤2组),271 d及213 d(PS=3组),两组1年生存率分别为31.6%、24.1%,组间比较,差异均无统计学意义(P>0.05)。两组中位疾病进展时间分别为120 d、127 d(PS≤2组),107 d及91 d(PS=3组),其中治疗组(PS=3)与BSC组比较,差异有统计学意义(P<0.05)。结论:对于一般状况较好的老年NSCLC患者,针药给合治疗与化疗比较生存时间相近,而毒副反应减轻;对于一般状况较差的老年本病患者,中医药治疗可延长患者中位生存期,提高生存率。

Long Term Effect of the Elderly with Advanced Non-small-cell Lung Cancer Treated by Traditional Chinese Medicine and Acupuncture.

Objective To observe the Long Term effect of elderly patients with non-small-cell lung cancer(NSCLC) in Ⅲ or Ⅳ stage treated by traditional Chinese medicine(TCM) and acupuncture.Methods A total of 199 patients in 3 hospitals were randomly assigned into two groups,100 in TCM & Acupuncture group and 99 in control group.Each group was divided in two groups according to PS scores.In TCM & Acupuncture group,there were 55 patients in A groups(PS≤2),and 45 in B groups(PS=3).In control group there were 51 in A groups(PS≤2) which received chemotherapy,and 48 in B groups(PS=3) which received best support care(BSC).Time to disease progression(TTP),The median survival time(MST) & Survival rate are the main evaluation index.Results In A group(PS≤2),the MST was 295 and 301 days in T&A group and control group,respectively.In B group(PS=3) was 271 and 213 days respectively.The cumulative survival rate for one year was 31.6% and 24.1% in T&A group and control group,respectively(P>0.05).In A group(PS≤2),the TTP was 120 and 127 days in T&A group and control group,respectively(P>0.05).In B group(PS=3) was 107 and 91 days respectively(P<0.05).Conclusion TCM therapy has equivalent efficacy and less toxic and side reaction with chemotherapy for the patients with good performance status,and prolong survival time for the patients with poor performance status.