临床肿瘤学杂志
臨床腫瘤學雜誌
림상종류학잡지
Chinese Clinical Oncology
2015年
10期
885-889
,共5页
史琳%富琦%许炜茹%杨国旺%江泽飞%张少华%万冬桂%武彪%傅莹%郭勇%杨维泓%卓睿%王笑民
史琳%富琦%許煒茹%楊國旺%江澤飛%張少華%萬鼕桂%武彪%傅瑩%郭勇%楊維泓%卓睿%王笑民
사림%부기%허위여%양국왕%강택비%장소화%만동계%무표%부형%곽용%양유홍%탁예%왕소민
乳腺癌术后%复发转移高危人群%无病生存期( DFS)%总生存期( OS)%中医治疗
乳腺癌術後%複髮轉移高危人群%無病生存期( DFS)%總生存期( OS)%中醫治療
유선암술후%복발전이고위인군%무병생존기( DFS)%총생존기( OS)%중의치료
Postoperative breast cancer%Recurrence and metastasis of high-risk population%Disease-free survival ( DFS)%Overall survival( OS)%Triditional Chinese medicine( TCM)
目的：观察中医辨证治疗对乳腺癌术后复发转移高危人群的疗效，评价中医辨证治疗对乳腺癌高危患者生存率及生存期的影响。方法采用前瞻性队列研究设计，将接受规范化中医辨证治疗作为暴露因素，以ⅡA～ⅢC期乳腺癌术后复发转移高危患者作为研究对象，按照治疗方法将受试者分为中西医结合队列（中药＋内分泌治疗）、中医队列（中医治疗）、西医队列（内分泌治疗）和观察队列，比较4队列累计无病生存率、总生存率及无病生存期（ DFS）和总生存期（ OS）情况。结果中西医结合队列、中医队列、西医队列1、2、3年累计无病生存率均高于观察队列，差异有统计学意义（ P＜0?05）。4个队列的累计总生存率差异无统计学意义（ P＞0?05）。截至随访结束，354例受试者中共有65例乳腺癌术后高危患者发生复发转移、8例死亡，中西医结合队列、中医队列、西医队列、观察队列复发转移患者的中位DFS分别为17?00个月（95％CI：13?97～25?41个月）、16?87个月（95％CI：9?8～40?8个月）、13?93个月（95％CI：10?9～25?61个月）、12?61个月（95％CI：10?41～14?45个月），4队列复发转移患者的DFS差异无统计学意义（ P＞0?05）。4队列中ⅢB～ⅢC期患者的累计无病生存率比较，差异有统计学意义（ P＜0?05）；其中中西医结合队列、中医队列、西医队列患者的累计无病生存率均高于观察队列患者，差异有统计学意义（ P＜0?05）；4队列各肿瘤分期患者累计总生存率的差异无统计学意义（ P＞0?05）。结论中医辨证治疗可提高激素受体阴性乳腺癌术后高危患者的累计无病生存率，尤其是肿瘤分期为ⅢB～ⅢC期的高危患者。无论接受何种治疗方法，尚不能在短期内明显延长乳腺癌高危患者的DFS和OS。
目的：觀察中醫辨證治療對乳腺癌術後複髮轉移高危人群的療效，評價中醫辨證治療對乳腺癌高危患者生存率及生存期的影響。方法採用前瞻性隊列研究設計，將接受規範化中醫辨證治療作為暴露因素，以ⅡA～ⅢC期乳腺癌術後複髮轉移高危患者作為研究對象，按照治療方法將受試者分為中西醫結閤隊列（中藥＋內分泌治療）、中醫隊列（中醫治療）、西醫隊列（內分泌治療）和觀察隊列，比較4隊列纍計無病生存率、總生存率及無病生存期（ DFS）和總生存期（ OS）情況。結果中西醫結閤隊列、中醫隊列、西醫隊列1、2、3年纍計無病生存率均高于觀察隊列，差異有統計學意義（ P＜0?05）。4箇隊列的纍計總生存率差異無統計學意義（ P＞0?05）。截至隨訪結束，354例受試者中共有65例乳腺癌術後高危患者髮生複髮轉移、8例死亡，中西醫結閤隊列、中醫隊列、西醫隊列、觀察隊列複髮轉移患者的中位DFS分彆為17?00箇月（95％CI：13?97～25?41箇月）、16?87箇月（95％CI：9?8～40?8箇月）、13?93箇月（95％CI：10?9～25?61箇月）、12?61箇月（95％CI：10?41～14?45箇月），4隊列複髮轉移患者的DFS差異無統計學意義（ P＞0?05）。4隊列中ⅢB～ⅢC期患者的纍計無病生存率比較，差異有統計學意義（ P＜0?05）；其中中西醫結閤隊列、中醫隊列、西醫隊列患者的纍計無病生存率均高于觀察隊列患者，差異有統計學意義（ P＜0?05）；4隊列各腫瘤分期患者纍計總生存率的差異無統計學意義（ P＞0?05）。結論中醫辨證治療可提高激素受體陰性乳腺癌術後高危患者的纍計無病生存率，尤其是腫瘤分期為ⅢB～ⅢC期的高危患者。無論接受何種治療方法，尚不能在短期內明顯延長乳腺癌高危患者的DFS和OS。
목적：관찰중의변증치료대유선암술후복발전이고위인군적료효，평개중의변증치료대유선암고위환자생존솔급생존기적영향。방법채용전첨성대렬연구설계，장접수규범화중의변증치료작위폭로인소，이ⅡA～ⅢC기유선암술후복발전이고위환자작위연구대상，안조치료방법장수시자분위중서의결합대렬（중약＋내분비치료）、중의대렬（중의치료）、서의대렬（내분비치료）화관찰대렬，비교4대렬루계무병생존솔、총생존솔급무병생존기（ DFS）화총생존기（ OS）정황。결과중서의결합대렬、중의대렬、서의대렬1、2、3년루계무병생존솔균고우관찰대렬，차이유통계학의의（ P＜0?05）。4개대렬적루계총생존솔차이무통계학의의（ P＞0?05）。절지수방결속，354례수시자중공유65례유선암술후고위환자발생복발전이、8례사망，중서의결합대렬、중의대렬、서의대렬、관찰대렬복발전이환자적중위DFS분별위17?00개월（95％CI：13?97～25?41개월）、16?87개월（95％CI：9?8～40?8개월）、13?93개월（95％CI：10?9～25?61개월）、12?61개월（95％CI：10?41～14?45개월），4대렬복발전이환자적DFS차이무통계학의의（ P＞0?05）。4대렬중ⅢB～ⅢC기환자적루계무병생존솔비교，차이유통계학의의（ P＜0?05）；기중중서의결합대렬、중의대렬、서의대렬환자적루계무병생존솔균고우관찰대렬환자，차이유통계학의의（ P＜0?05）；4대렬각종류분기환자루계총생존솔적차이무통계학의의（ P＞0?05）。결론중의변증치료가제고격소수체음성유선암술후고위환자적루계무병생존솔，우기시종류분기위ⅢB～ⅢC기적고위환자。무론접수하충치료방법，상불능재단기내명현연장유선암고위환자적DFS화OS。
Objective To observe the efficacy of traditional Chinese medicine( TCM) syndrome differentiation treatment for breast cancer patients with high risks of recurrence and metastasis. To evaluate the TCM treatment?s influences of survival and survival rates in these high?risk patients. Methods By using prospective cohort study, taking standardization of TCM syndrome differentiation treatment as exposed factors, patients with high?risks breast cancer stagedⅡA toⅢC were selected. The subjects were divided into 4 queues:TCM combination with western medicine queue ( accepted TCM syndrome differentiation treatment and endocrine therapy ) , TCM queue ( accepted TCM syndrome differentiation treatment only) , western medicine queue ( accepted hormone therapy only) and observation queue ( didn?t accept therapy) . To compare the four queues?accumulative disease?free survival ( DFS) rates, accumulative overall survival ( OS) rates, median DFS and OS. Results The 1?, 2? and 3?year accumulative disease?free survival rates of TCM combination with western medicine queue, western medicine queue and TCM queue were higher than observation queue?s, and the difference was statistically significant(P<0?05).The accumulative overall survival rates of four queues had no statistical differences(P>0?05).To the end of the follow?up, in 354 postoperative breast cancer patients with high recurrence metastasis risks, 65 patients were relapsed or with metastasis, 8 were dead. The median DFS of patients with recurrence and metastasis in TCM combination with western medicine queue, TCM queue, western medicine queue and observation queue was respectively 17?00 months( 95%CI:13?97?25?41) , 16?87 months(95%CI:9?8?40?8), 13?93 months(95%CI:10?9?25?61) and 12?61 months(95%CI:10?41?14?45). There was no statistically significant difference of median DFS in four queues patients with recurrence or metastasis. The difference of the 1?, 2?and 3?year accumulative disease?free survival rates in four queues patients stagedⅢB toⅢC was statistical significance( P<0?05) . Among them, the accumulative disease?free survival rates of TCM combination with western medicine queue, western medicine queue and TCM queue were higher than observation queue?s, and the difference was statistically significance(P<0?05). It was no statistically signifi?cance in four queues accumulative verall survival at each tumor stage( P>0?05) . Conclusion TCM based on syndrome differentiation can improve the accumulative disease?free survival rates of hormone receptor negative and postoperative breast cancer patients at high risks of recurrence or metastasis, especially for patients with cancer stageⅢB to stageⅢC. No matter what kind of treatment, it is not obvious in the short term prolong disease?free survival or overall survival in these patients.
