| Background:At present,lung cancer is still one of the highest incidence and mo rtality of malignant tumors according to the study datas from both the worldwild and China and it has caused severe social burden.In the clinical work,75%of patients w ere diagnosised with the advanced stages before treatment and have lost the opportunit y for surgical treatment.The median survival is only 4 to 5 months without treatmen t.Non-small cell lung cancer(NSCLC)accounts for about 85%in primary lung cance r.Patients with non-small-cell lung cancer represent a heterogeneous population.Differ ent patients have different pathological types and drive genes.NSCLC can be classifie d into adenocarcinoma,squamous cell carcinoma and large cell carcinoma according to the pathological type.Different pathological types have different degrees of malignanc y and adenocarcinoma patients have a high probability of carrying genes.They are m ore likely to liver longer by receiving targeted therapies.According to the NCCN guid eline,the EGFR TKIs have becomed the first-line treatment for advanced EGFR mutat ion-positive NSCLC.Radiochemotherapy which is cornerstone of cancer treatment has proven effective in extending survival.In addition,traditional Chinese medicine combi ned with radiotherapy,chemotherapy and targeted therapies has been confirmed effectiv e in improving the quality of life and prolonging survival by an amount of studies.In addition to the effect of different treatment methods' on the prognosis,there are studi es that have found that the general conditions of the patients such as age,gender or s tage of disease may also affect the prognosis.Method:This study reviewed retrospectively the datas of patients with primary ??b/? stage NSCLC in China-Japan Friendship Hospital between January 1,2011 to Ju ne 31,2017.The basic clinical features,disease characteristics,treatment details were collected and survival datas were obtained by telephone and other wsys.Aim to provi de evidence-based evidence for clinical use,the survival rates of median survival time of 1,2,3 and 5 years were compared with previous studies.univariate and multi-fact or analysis was used to test factors affecting survival.Result:227 patients were included in the study.The median survival timeof all patients was 18.7 months just like the previous studies.Thel-year survival rate wa s 62.1%,the2-year survival rate was39.4%,the3-year survival rate was25.4%,and the5-year survival rate was 10.1%and the results were longer than previous stud ies.Univariate analysis found that the pathological type,EGFR status,EGFR mutati on type,whether the lung surgery,whether taking Chinese herbal decoction,whether taking EGFR TKI,whether EGFR TKI combined,with Chinese herbal decoction,whe ther the first-generation TKI combined with the third-generation TKI were the influe ncing factors to survival(P<0.05).The survival of adenocarcinoma patients was long er than the squamous cell carcinoma and large cell carcinoma;The survival time of patients with positive EGFR mutati on was longer than those with the wild type;Th e survival time of patients with 19 exon del mutation was longer than those with 21 exon L858R mutation;Patients who took traditional Chinese medicines had longer sur vival than those who didn't take TCM;Patients who took EGFR TKI had longer sur vival time than those who didn't take them,but there was no significant difference b etween TKI combined with traditional Chinese medicine and taking TKI or TCM alo ne;Patients who took the the first and third generation TKI have longer survival tha n those who only took the first generation.Besides,the age,gender,smoking history,family history,initial metastasis(bone,liver,brain,pleura,adrenal gland,?2 distant organ metastases),disease status(stage,primary location,pericardial effusion or not,obstructive pneumonia or not,pleural effusion or not)and treatments(chemotherapy or not,brain radiation therapy or not,pleural fixation or not,chest radiotherapy or n ot,)had no significant effect on survival(P>0.05).Multivariate analysis found that EGFR mutation status is the independent prognostic factor.Conclusion:The median overall survival time of the patients included in this st udy are consistent with previous studies.But the survival rate is longer because of c omprehensive treatment.Patients with EGFR TKI and traditional Chinese medicine ha ve a longer survival period,suggesting that EGFR status should be monitored in the treatment of advanced non-small cell lung cancer.If it is positive,the EGFRTKI sho uld be recommended.As the T790M mutation was the most common mechanism of the drug resistance,we should test the mutation as quickly as possible and take the t hird-generation TKIs such as osimertinib.Traditional Chinese medicine can effectively relieve clinical symptoms and improve survival,so it should participate in the entire process of treatment.Lung should be treated as much as possible to reduce tumor b urden and prolong survival. |
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