A Correlation Study Between Tcm Syndrome Types In Patients With Advanced Non-small Cell Lung Cancer And Progression-free Survival After EGFR-TKIs Treatment

Background and purpose:The incidence and mortality of malignant tumors are increasing year by year,and the incidence and mortality of lung cancer are the first in malignant tumors.In recent years,targeted therapy has been widely used in lung cancer.The use of EGFR-TKIs prolongs the survival of patients and improves the quality of life of patients.In this study,we investigated the relationship between TCM syndrome differentiation and progression-free survival after EGFR-TKIs treatment in patients with advanced non-small cell lung cancer,and speculated the effects of different TCM syndromes on the efficacy of EGFR-TKIs,and analyzed the factors associated with lung cancer prognosis.To provide a reference for better medication for patients.Objectives and Methods:Patients with advanced non-small cell lung cancer treated with EGFR-TKIs with EGFR19 Del or L858 R mutation were enrolled in the study.Under the premise of informed consent,the investigator will register each patient with TCM syndrome differentiation and strictly standardize the investigation.Statistical analysis was performed on the collected data using SPSS 22.0 statistical software.Results:A total of 109 eligible patients are enrolled,including64 males and 45 females;the mean age is 58.5 years,31 cases are older than 65 years,78 cases are less than or equal to 65 years old;102 cases of Non-small cell lung adenocarcinoma,7 cases of non-small cell squamous cell carcinoma;15 cases of lung cancer surgery,94 cases of unoperated patients;62 cases of patients who had undergone at least one cycle of chemotherapy,47 cases of patients without chemotherapy;There were 45 patients with history of smoking,64 patients who had never smoked,47 patients who had received radiotherapy,and 62 patients who did not receive radiotherapy.All patients had EGFR mutations detected by genetic testing.The median PFS of all patients was 10.0(2.0-33.0)months;the distribution of TCM syndromes: the distribution of each syndrome is 35 cases of spleen deficiency and dampness type,27 cases of kidney yang deficiency type,and 20 cases of qi stagnation and blood stasis type.There are 19 cases of qi-yin deficiency type and 8 cases of yin deficiency and internal heat type.Distribution pattern of each type of syndrome: gender subgroup: the male yang deficiency type was significantly higher than that of the female group;there was no significant difference in the distribution of other syndrome types;age subgroup: spleen deficiency and phlegm type and yin deficiency and internal heat type in the younger age group Significantly more than the older group;the distribution of other syndromes did not differ significantly;pathological type subgroup: the distribution of five syndromes in the adenocarcinoma group was significantly more than the squamous cell carcinoma group;smoking group: The distribution of yin deficiency and internal heat type in no smoking is significantly higher than that in the smoking group.There was no significant difference in the distribution of other syndrome types.Surgical group:The distribution of the five syndrome types in the unoperated group was significantly higher than that in the operation group.The chemotherapy group: the distribution of kidney-yang deficiency type in the chemotherapy group is significantly higher than the no chemotherapy group,there was no significant difference in the distribution of other syndrome types;in the radiotherapy group: the distribution of yin deficiency and internal heat type in the non-radiation group is significantly higher than that in the radiotherapy group,and there is no significant difference in the distribution of other syndrome types.The relationship between TCM syndrome type and PFS: PFS of spleen deficiency and dampness type is better than kidney yang deficiency type(P<0.05)and qi stagnation and blood stasis type(P<0.05).PFS of kidney yang deficiency type is superior to qi stagnation and blood stasis Type(P<0.05),both qi-yin deficiency type and yin deficiency and internal heat type PFS were superior to qi stagnation and blood stasis type(P<0.05),but there was no significant difference in PFS contrast between the two groups.There was no significant difference in PFS comparison between the other syndrome types.Conclusion:1.The median progression-free survival(PFS)of patients with advanced NSCLC after treated with EGFR-TKIs is 10.0months;2.The distribution of syndromes in patients treated with EGFR-TKIs is mainly characterized by intermingled deficiency and excess syndromes(spleen deficiency and dampness type,qi stagnation and blood stasis type),There are also a distribution of deficiency syndrome type(kidney yang deficiency type,qi-yin deficiency type,yin deficiency and internal heat type),There is no significant correlation between the distribution of TCM syndrome types of lung cancer and age(use 65 years old as the boundary),pathological type,history of smoking,history of surgery,history of chemotherapy,and history of radiotherapy.3.For patients with advanced NSCLC treated with EGFR-TKIs,spleen deficiency and dampness type may be the dominant factor in the efficacy of EGFR-TKIs.Kidney yang deficiency may be an unfavorable factor in the efficacy of EGFR-TKIs.