Survival Observation Of 23 Patients With Pancreatic Cancer Treated By

Background:Pancreatic cancer is a highly malignant gastrointestinal tumor. In the United States and other developed countries, pancreatic cancer ranked #10 for men and #9 for women in the estimated number of new cancer cases in 2013. It is ranked #4 for cancer mortality rate. Pancreatic cancer patients often do not show any typical symptoms. About 60% of diagnosed pancreatic cancer patients already have metastasis, with 25% of patients already having advanced stage cancer and cannot undergo radical surgery. Their median survival period was only 6-9 months. Only 15% of the patients can undergo surgery, and they have a median survival period of 15 months with an approximate 5% five year survival rate. The main treatments for pancreatic cancer are radical surgery, gemcitabine-based chemotherapy, increasing amounts of radiotherapy, minimally invasive therapy, biological therapy, Chinese Medicine treatment and other types of treatments and therapies. However, pancreatic cancer cells possess gene-based drug resistance, and the soft tissues around the pancreas are intolerant to strong radiation therapy. Thus, these factors have hindered the further development of chemotherapy and radiotherapy treatments. At the same time, a growing number of studies are showing that Chinese Medicine treatments are able to effectively treat pancreatic cancer patients. It also possesses a certain advantages in improving the symptoms of patients with pancreatic cancer and improving their quality of life. It is becoming one of the indispensable treatments of advanced pancreatic cancer.Purpose:The purpose of this study is to analyze the factors influencing the prognosis of pancreatic cancer patients by observing their survival period, survival rate, and median survival period. We also explore and understand the efficacy of treatments based on the "Warming Yang and Clearing Dampness" method. We also determine the clinical value of using treatments based on this method.Methods:This study is a follow up of the survival periods of 23 patients diagnosed with pancreatic cancer that have undergone over three months of "Warming Yang and Clearing Dampness" treatment from January 1st 2009 to December 31st 2014 in China-Japan Friendship Hospital’s Integrated Chinese and Western Medicine Oncology Department. This study explores the effect of using the "Warming Yang and Clearing Dampness" method on the patients’1,2,3 year survival rate and median survival time. It also provides methods and a selection basis for clinical Chinese Medicine treatment of pancreatic cancer.Results:All 23 patients were followed up to December 31st,2014. The amount of follow-up time for the patients ranged from 4.80 to 67.7 months. Of the patients,14 were female (accounting for 60.8% of the total number of patients), and 9 of them were male (accounting for 39.13% of the total number of patients). The average age of the patients was 48.09 years old, ranging from 33 to 81 years old. There were eight cases of censored data (34.78%). and 15 cases of full data (65.22%). The 1,2,3 year survival rate of all 23 patients were: 52.17%、19.56%、19.56% respectively. The median survival period was 8.83 months. The average survival period was 15.73 ± 3.624 months. The average survival period of current patients exceed 4 months, up to 67.7 months. Log-rank test showed:CA199 levels and lymph node metastasis are the major univariate factors for pancreatic cancer.9 cases of patients who had CA199≤500 levels before treatment had a median survival period of 23.80 months.14 cases of patients who had CA199> 500 levels before treatment had a median survival period of 8.06 months. The difference is statistically significant (P= 0.03).13 patients who had no lymph node metastasis had a median survival period of 10.830 months; 10 patients with lymph node metastasis had a median survival period of 7.90 months. The difference is statistically significant (P= 0.039). We put KPS rating, patient genders, TNM stage, existence of liver metastasis, CA199 levels and 16 other relevant factors into Cox regression analysis. The results showed that the tumor site, the existence of liver metastases， and the TCM treatment factors are statistically significant (P<0.01). Their P values were:0.003,0.039, and 0.000 respectively. Among them, Chinese Medicine treatment (B=-0.681, P= 0.000, RR= 0.506) is a protective factor. Tumor location (B= 1.580, P= 0.003, RR= 4.853) and the existence of liver metastases (B= 1.710, P= 0.039, RR= 1.181) is a risk factor.Conclusion:The "Warming Yang and Clearing Dampness" treatment method is an effective treatment method of advanced pancreatic cancer. The treatment can increase the survival period of many patients. The level of CA199 and the existence of lymph node metastasis is an independent factor of the prognosis of advanced pancreatic cancer. Tumor location and the existence of liver metastasis is a risk factor of the prognosis of pancreatic cancer.