| BackgroundThe most important treatment of advanced colorectal cancer is the chemotherapy-based comprehensive therapy. Chemotherapy plays a vital role in improving survival of patients, reducing recurrence and improving the quality of life. However, it also has some damage to the normal tissues and organs at the same time due to the serious side effects. A part of patients can' t bear or even forced to suspend treatment, that would affect the efficiency of chemotherapy to a certain extent. In recent decades, TCM has played a positive role in improving effect and decreasing toxicity made considerable progress. And now improve the quality of life of cancer patients has become a hot topic.Hyperthermia is physical therapy, which has been widely used in clinical treatment of cancer. Local hyperthermia is simple, with fewer side effects, patients would easily accept. And the short course is also very convenient for the doctors and nurses.ObjectiveChoosing the best option and rational use of a variety of combination therapy to improve survival of patients and quality of life is very necessary and with important clinical significance. In this study, the changes in the tumor before and after treatment, symptom scores, quality of life score changes would be observed.The efficacy and quality of life with combined therapy would be evaluated by statistical analysis in order to explore the effect of the TCM combined with hyperthermia and chemotherapy treatment of advanced colorectal cancer.Method60 cases of lung cancer patients diagnosed by pathology in line with the standards would be chosen for the research. Then the patients would be randomly divided into two groups by their out-patient serial number for 30 cases of each group. All patients were treated with 6 cycles of the standard FOLFOX, XELOX, FORFIRI, or XELIRI chemotherapy and other programs, Hyperthermia would be given each two days and last for two weeks for a course of treatment with the implementation of the cycle of chemotherapy. Before and after 6 cycles tumor changes would be reviewed, each patient would be evaluated including their symptoms, KPS score, the scale of QOL, the changes in the main disease, and adverse reactions of treatment. Then take a statistical analysis for the indicators above-mentioned.Result1. General dataFrom September 2009 to December 2010,64 cases in Guangdong Province hospital of TCM were enrolled in the study. There were 4 patients fell off,60 patients finished.30 patients were randomly assigned to the treat group, and 30 patients were randomly assigned to the control group. There was no statistically significant in general information, tumor status, quality of life scores(P>0.05). Data of two groups was comparable.2. Clinical efficacy and changes of quality of lifeCompared with the short term efficacy, the ORR was 23.3 percent and the DCR was 83.3 percent in treat group while control group were 10.0 percent and 53.3 percent after the patients underwent different treatment the statistical comparisons were statistically significant differences (P<0.05). There were3 cases reached complete after treatment, while 6 cases reached partial remission,4 cases stable disease and 2 cases progression disease in 15 cases of patients with ascites.Comparison of long-term efficacy in the treatment group TTP was 9.3 months in the while the control group was 6.2 months, two groups were significantly (P<0.05). For the functional status score, the FACT-C score, KPS score, analysis of TCM syndrome score were improved after different treatment in both group. The quality of life was improved more obvious in the combined treatment group compared with the control group and the difference was statistically significant (P<0.05). Quality of life for colorectal cancer questionnaire (FACT-C) reflected that the combined treatment group improved significantly in the situation in the physical, social/family situation, emotional condition, functional condition, total scale of the situation compared with the control group, and improved the physical condition and emotional status of advantage is more obvious (P<0.05).Adverse response in both group was less and no significant difference between two groups of side effects.Conelusion1. Compared with chemotherapy& TCM treatment, hyperthermia combined with chemotherapy& TCM treatment showed dominant curative effect on the DCR, ORR and the control of malignant ascites for advanced colorectal cancer.2. Hyperthermia combined with chemotherapy& TCM treatment played a positive role on the long term effectiveness,such as the stability of the tumor, showed dominant effect on TTP.3. The improvement of hyperthermia combined with chemotherapy &TCM is more evident in the patients'quality of life in the physical, social/family situation, emotional status, function, pain symptom than chemotherapy &TCM therapy alone.4. Combined treatment significantly had the synergistic effect on KPS, it improved the TCM symptoms, decreased the tumor markers and stabilized the weights. There was no significant changes in blood test, liver and kidney function before and after treatment. Hyperthermia combined with chemotherapy plus TCM treatment is suit for advanced metastatic colorectal cancer with better effect and safety. Combined treatment is a better solution, it is worth implementing in clinical use. |
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