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目的:观察中西医结合治疗对老年晚期非小细胞肺癌疗效及生存质量的影响。方法:将124例患者随机分为3组(中药组、化疗组及中药加化疗组)。中药组选用中药制剂静脉滴注治疗;化疗组选用标准化疗方案治疗;中药加化疗组在化疗方案进行的同时给予中药制剂;治疗以21 d为1个周期,共4个周期。以实体瘤客观疗效评价标准、中位生存时间、骨髓抑制、消化道不良反应和Karnofsky评分作为观察指标。结果:3组治疗有效率分别为41.5%、51.1%和52.4%,组间差异无统计学意义(P>0.05);3组中位生存时间为7.1、7.9、12.4个月,中药加化疗组明显延长(P<0.05);3组骨髓抑制(Ⅲ°以上)发生率为7.3%、36.6%和11.9%,中药加化疗组和中药组较低(P<0.017);消化道不良反应(Ⅲ°以上)发生率为39.0%、80.5%和40.5%;3组Karnofsky评分“增加(≥10分)”的分别占到51.2%、43.9%和76.2%,中药加化疗组较高(P<0.01)。结论:中西医结合治疗可延长老年晚期NSCLC患者中位生存时间、降低治疗毒副作用和改善生活质量,但近期疗效未见提高。
Objective: To observe the effect of integrated traditional Chinese and western medicine on the efficacy and quality of life of elderly patients with advanced non-small cell lung cancer. Methods: 124 patients were randomly divided into 3 groups (traditional Chinese medicine group, chemotherapy group and traditional Chinese medicine plus chemotherapy group). The traditional Chinese medicine group was treated with intravenous infusion of traditional Chinese medicine; the chemotherapy group was treated with standard chemotherapy; the traditional Chinese medicine plus chemotherapy group was treated with the traditional Chinese medicine preparation while the chemotherapy regimen was being carried out; and the treatment lasted for 21 days for 4 cycles. The evaluation criteria of objective curative effect of solid tumors, median survival time, myelosuppression, gastrointestinal adverse reactions and Karnofsky score were used as the observation indicators. Results: The effective rates of the three groups were 41.5%, 51.1% and 52.4% respectively, with no significant difference between the two groups (P> 0.05). The median survival time was 7.1, 7.9, 12.4 months in the three groups. (P <0.05). The incidences of myelosuppression (Ⅲ ° or above) were 7.3%, 36.6% and 11.9% in the three groups, but lower in the traditional Chinese medicine plus chemotherapy group and the traditional Chinese medicine group (P <0.017) (P <0.05). The incidences of Karnofsky scores were 51.2%, 43.9% and 76.2% respectively in the three groups (P <0.05) <0.01). Conclusion: The combination of TCM and WM can prolong the median survival time, reduce the side effects and improve the quality of life in elderly patients with advanced NSCLC, but no improvement in the short term efficacy.