Discussion On The Advantages Of Chinese Medicine Combined With Radiotherapy In The Treatment Of Advanced Prostate Cancer And Analysis Of Prognostic Factors

1.ObjectiveMulti-center collection of cases for retrospective analysis,to explore the advantages of integrated traditional Chinese and Western medicine radiotherapy i the treatment of advanced prostate cancer and to explore the prognostic factors affecting PFS and OS in patients with advanced prostate cancer after radiotherapy combined with endocrine th erapy,in order to provide advanced prostate cancer with integrated Chinese and Western medicine radiotherapy Ideas and evidence.2.MethodCollection of clinics diagnosed by histopathology and receiving radiotherapy combined with endocrine therapy at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin Medical University Cancer Hospital,Tianjin Medical University General Hospital from January 1,2016 to December 31,2019 Complete inf ormation on advanced prostate cancer cases.According to whether it is combined with traditional Chinese medicine treatment,it is divided into a combination of Chinese an d Western medicine radiotherapy group and radiotherapy group.The measurement data of the two groups of patients will be described using the mean ± standard deviation,and the comparison between the groups will be analyzed by analysis of variance,rank sum test;Statistical descriptions were made,and comparisons between groups were performed using the X2 test,Fisher's exact test,and the rank sum test of two independent samples.Prognostic factors were analyzed for all cases that meet the criteria for inclusion,and a total of 22 influencing factors were included.Among them,Kaplan-Meier method and Log-rank model test were used for univariate analysis to screen the risk of PFS and OS in patients with advanced prostate cancer.Factors: Factors with meaningful results from single factor analysis were incorporated into the Coxproportional hazards model,and multi-factor analysis was conducted to determine independent prognostic risk factors.3.resultsA total of 53 cases were included in this study according to the criteria of NAP.Among them,17 cases were in the combined radiotherapy group and 36 cases in the radiotherapy group.The baseline levels of the two groups were the same.Control of prostate lesions after 6 months of radiotherapy: 3 cases of CR,8 cases of PR,5 cases of SD,and 1 case of PD in the combination of Chinese and Western medicine radiot herapy group;2 cases of CR,10 cases of PR,and SD in the radiotherapy group 22 cases,2 cases of PD.ORR was 64.71% in the combined Chinese and Western medicine radiotherapy group,33.33% in the radiotherapy group;DCR was 94.41% in the combined Chinese and Western medicine radiotherapy group,and 94.44% in the radiotherapy group.In terms of radioactive adverse reactions: 2 cases(11.8%)of grade I bone marrow suppression,0 cases(0.0%)of grade II bone marrow suppression,2 cases(11.8%)of grade I urinary tract injury,and grade II urinary tract injury 1 case(5.9%),1 case of lower digestive tract injury(5.9%),0 case of lower digestive tract injury(0.0%);14 cases of grade I bone marrow suppression(38.9%),grade II bone marrow ap peared in the radiotherapy group Inhibited 4 cases(11.1%),5 cases of grade I urinary tract injury(13.9%),3 cases of grade II urinary tract injury(8.3%),9 cases of grade I lower gastrointestinal injury(25.0%),grade II lower digestive tract 4 cases(11.1%)were injured.In terms of PFS: 18 months disease progression rate in the combined Chinese and Western medicine radiotherapy group was 5.9%(1 case),24 months diseas e progression rate was 64.7%(9 cases),PFS was 25.69±4.59 months;18 months disease progression rate in the radiotherapy group was 8.3 %(3 cases),24 months disease progression rate was 63.9%(23 cases),PFS was 22.26 ± 3.52 months.OS: The OS of the two groups of patients was 35.31±2.938 months(95%CI 31.401-34.599),the OS of the combined Chinese and Western medicine radiotherapy group was 37.6±2.408 months(95%CI 34.61-40.59),and the OS of the radiotherapy group was 34.27±0.787 months(95%CI 32.52-36.03);the total mortality rate in the combined Chinese and Wes tern medicine radiotherapy group was 29.4%(5 cases),and the total death rate in the integrated Chinese and Western medicine radiotherapy group was 30.6%(12 cases).Influencing factors of prognosis: GS9-10 points,M1 stage,bone metastases,prostate volume before radiotherapy>30ml,HGB?120g/L before radiotherapy,tPSA>20ng/ml be fore radiotherapy,ALP before radiotherapy>140 IU/L,Non-combined Chinese medicine treatment and qi-blood deficiency syndrome are the prognostic risk factors for PFS after radiotherapy combined with endocrine therapy in advanced prostate cancer.Among t hem,GS9-10 points and tPSA before radiotherapy>20ng/ml are independent risk factors.M1 stage,bone metastases,clinical stage IVB,NLR before radiotherapy>2.99,ALP before radiotherapy>140 IU/L,are prognostic risk factors for OS after radiotherapy co mbined with endocrine therapy in advanced prostate cancer patients(P<0.05),of which Bone metastasis is an independent risk factor for OS in patients with advanced prost ate cancer after radiotherapy combined with endocrine therapy.4.Conclusion4.1 Radiotherapy combined with traditional Chinese and Western medicine can improve PFS and OS in patients with advanced prostate cancer,and improve the disease control rate of prostate cancer lesions to a certain extent4.2 Integrated Chinese and Western medicine can reduce the occurrence of radioactive adverse reactions.4.3 GS9-10 points and tPSA>20ng/ml before radiotherapy are independent risk factors for PFS in patients with advanced prostate cancer after radiotherapy combined with endocrine therapy.4.4 Bone metastasis is an independent risk factor for OS in patients with advanced prostate cancer after radiotherapy combined with endocrine therapy.