| BackgroundIn recent years,due to the development of surgery,chemotherapy and radiotherapy technology,the clinical treatment of esophageal cancer has made great progress,but the 5-year overall survival rate is still less than 30%.Malignant tumors,represented by esophageal cancer,place a heavy burden on family and social belt projects.At present,Western medicine tumor treatment has entered the era of individualized stratification,but targeted therapy based on genotyping still cannot cure advanced tumors,and the applicable population is limited,expensive,and requires long-term hospitalizationTraditional Chinese medicine has unique characteristics in the treatment of cancer,emphasizing the overall concept,syndrome differentiation and treatment,and has the characteristics of being suitable for people,easy to take,and cost-effective.Traditional Chinese medicine combined with radiotherapy,chemotherapy and surgical treatment is unique in improving symptoms and prolonging survival of patients with advanced cancer.However,in terms of clinical experience,not all patients with advanced esophageal cancer can benefit from traditional Chinese medicine treatment.Different patients often have different prognosis under the same Chinese medicine treatment.So far,evidence-based medical evidence has only clarified the principles of Chinese medicine treatment at different stages of the tumor,but which type of patient is more suitable for Chinese medicine treatment?What is the specific benefit of specific Chinese medicine treatment time?And so on is the next research direction.Especially for patients with advanced esophageal cancer,they have lost the chance of surgery and their quality of life has been seriously degraded.If the treatment can be started before the treatment,it is necessary to identify whether the patient is suitable for Chinese medicine treatment,that is,whether it is a dominant group of Chinese medicine,it is an individual in the era of big data The research direction of chemotherapy and precise treatment will also provide new ideas and methods for the treatment of advanced esophageal cancer.ObjectiveTo observe the survivors of advanced esophageal cancer treated by systematic Chinese medicine,and to screen out the dominant Chinese medicine patients with significant medical effects.By comparing with the non-dominant population,the characteristics of the dominant population were identified,and the characteristic prognosis of advanced esophageal cancer treated by traditional Chinese medicine was discussed.Factors,and then explore the possible mechanism of action of traditional Chinese medicine in the treatment of advanced esophageal cancer,providing a preliminary basis for the next step in the accurate and individualized treatment of esophageal cancer.MethodsPhase IV esophagus received from oral administration of Chinese medicine in the registration system of Xiyuan Hospital of China Academy of Chinese Medical Sciences,Dongzhimen Hospital of Beijing University of Chinese Medicine and Cancer Hospital of Chinese Academy of Medical Sciences from December 1,2016 to January 30,2018.Cancer patients,collected various esophageal cancer related data and Chinese medicine information,and regular telephone follow-up,record the survival time,according to the analysis of relevant factors and survival outcomes to summarize the characteristics of TCM population.The differences among different populations were statistically analyzed,and the characteristics of the dominant population were explored by single factor analysis and two-class logistic regression model.ResultsA total of 72 patients with stage IV esophageal cancer who met the criteria for inclusion were included in the study.1.General situation analysis57 males were included in the study,accounting for 79.2%,15 females,accounting for 20.8%,and male to female ratio of 3.8:1.The age ranged from 48 to 80 years,with an average age of 62.0±8.1 years and a median age of 63 years.Drinking people accounted for 68.1%,smoking population accounted for 62.5%,and the proportion of patients who had a history of eating hot food was 44.4%.The pathological types of the patients were mainly squamous cell carcinoma(60 cases,accounting for 83.3%).The location of the disease was the most in the lower esophagus(43.1%),followed by the middle esophagus(33.3%).2.subsistence analysisAs of the end of follow-up,the average IV survival time of the 72 patients was 12.58 months,and the median IV survival time was 13.0 months.The median survival time of traditional Chinese medicine combined with modern medical treatment shows that Chinese medicine has certain curative effect on advanced esophageal cancer.3.Analysis of characteristics of dominant population of traditional Chinese medicineThis study found that there was a statistically significant difference in age between the dominant and non-dominant populations of Chinese medicine,and the proportion of patients?60years old was higher in the dominant population.The logistic model analysis showed that patients aged?60years compared with>60Older patients are more likely to benefit and are more inclined to be Chinese medicine.At the same time,there was a statistical difference in the degree of differentiation.The moderately differentiated patients accounted for a higher proportion of the dominant population(35%vs 9.4%),and the poorly differentiated patients accounted for a higher proportion(46.9%vs 22.5%).There were no statistical differences between the dominant and non-dominant populations in terms of surgery,chemotherapy,targeting,and radiotherapy(P>0.05).There are statistical differences in the time of oral Chinese medicine.Studies have shown that patients with oral Chinese medicine for>6 months account for a higher proportion of the dominant population(92.5%),and patients with<6months of TCM syndrome differentiation have an average IV period.The survival time(7.29±6.93months)was significantly less than the mean IV survival of patients>6months(14.21±5.77months),and the long-term use of traditional Chinese medicine in the two-category Logistic multivariate regression model was the independent influence of the dominant population.Conclusion(1)There were statistical differences in the degree of differenti ation,age and high exposure of TCM in the observed population,suggesting that the dominant population of esophageal cancer in this study might have the following characteristics:differentiation,<60 years,acceptance of more than 6 months of TCM syndrome differentiation and soup intervention.(2)The age and oral Chinese herbal decoction time is the independent influencing factors of the dominant population of stage ? esophageal cancer.The age of?60is more likely to be the dominant group than that of patients aged 60 years old,and the longer the intervention time of traditional Chinese medicine,the more patients tend to become the dominant group of TCM. |
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