A Retrospective Study Of Yifei Sanjie Formula In The Treatment Of ? Stage Wild-type EGFR Non-small Cell Lung Cancer

ObjectiveTo investigate the effect of Yifei Sanjie formula on the overall survival of stage IV EGFR wild type non-small cell lung cancer(NSCLC)by retrospective study.To find out the prognostic factors of stage IV EGFR wild type NSCLC.To study the effects that TCM syndrome differentiations have on prognosis.MethodsThe retrospective study was performed on 376 cases of stage IV EGFR wild type NSCLC who was diagnosed in the First Affiliated Hospital of Guangzhou University of TCM,the First Affiliated Hospital of Guangdong Pharmaceutical University,General Hospital of Guangzhou Military Region,in last 5 years,received Chinese medicine or combined treatment of Chinese medicine and Western medicine and Western medicine and evaluate the overall survival.Survival was evaluated by the method of Kaplan-Meier and compared by log rank test.Multivariate analysis was evaluated by the Cox proportional hazard model.ResultsThe median survival of three groups were 328 days.338 days and 481 days.There was no statistical significance between Chinese medicine group and Western medicine group.The traditional Chinese medicine group or Western medicine group compared with the combined treatment group has statistical significance.The median survival of wild type EGFR in squamous cell carcinoma of three groups were 294 days,497 days,619 days.There was statistical significance between the TCM group and combined medicine group.Western medicine group had no statistical significance survival compared with other two groups.Each group have four TCM syndrome types which are:Lung heat phlegm and blood stasis(FRTY),spleen deficiency with phlegm(PXTS),yin deficiency with phlegm heat(YXTR),and deficiency of both qi and yin(QYLX).The median survival of four TCM syndromes type were:193 days(FRTY),499 days(PXTS),255 days(YXTR),335 days(QYLX).We can conclude that the median survival of PXTS pattern is the longest.Compared FRTY and PXTS with YXTR,which has statistical significance.Cox regression analysis involves 15 covariates.The result showed that independent prognosis included,the protective factors are TCM syndrome type,the number of cycles of chemotherapy,the lesion site of the disease,the dangerous factors are KPS score,degree of differentiation,number of metastasis organs.There were 4 statistically significant factors in EGFR wild type squamous cell carcinoma.The number of metastatic organs,TCM syndrome type,KPS score and ALK gene status were risk factors of prognosis.Conclusion1.Integrated Chinese and Western medicine treatment can prolong the overall survival of patients with stage IV EGFR wild type NSCLC.There was no difference in overall survival compared Chinese medicine with Western medicine treatment.2.Analysing the overall survival of stage IV patients with squamous cell carcinoma,there was statistical significance between the TCM group and combined medicine group,and no significant difference between western medicine and Chinese medicine group.For the treatment of stage IV patients with squamous cell carcinoma,western medicine is indispensable.3.There were six prognostic factors of stage IV EGFR wild type NSCLC.The protective factors were the number of chemotherapy cycles,TCM syndromes(FRTY),the lesion site of the disease.The risk factors were KPS scores,differentiation degree and number of metastasis organs.The TCM syndrome of FRTY has a better prognosis.4.Yifei Sanjie formula can prolong the survival of patients with stage IV EGFR wild type NSCLC.Chinese medicine treatment has a positive impact on the prognosis of lung cancer,which can be used as an important treatment of patients with stage IV EGFR wild type NSCLC.