| Objectives:To explore the influence of traditional Chinese medicine on the survival of colorectal cancer by a clinical retrospective study by analyzing the data of patients with stage III and IV colorectal cancer that meet the inclusion criteria.And inidentify the independent factors influencing the prognosis of patients with colorectal cancer by multi-factor analysis,to provide as theoretical foundation for the clinical diagnosis,treatment and prognosis of patients with colorectal cancer.Methods:The cases of patients meeting the inclusion criteria from Oncology Department,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine between January 2015 and January 2020 were analyzed retrospectively.Then the patients were distributed into an integrated traditional Chinese and Western medicine group and a Western medicine group in accordance with traditional Chinese medicine treatment was adopted or not.Finally,compare the effects of the two treatments on the survival rate and survival period of patients with taking survival period(months as the unit)as the main observation index.Univariate analysis is used to screen the prognostic factors of Ⅲ and IV colorectal cancer,and the statistically significant factors are analyzed by the Cox proportional hazards model.Finally,Stepwise regression is used for multivariate analysis to screen out the independent prognostic factors of Ⅲ and Ⅳ colorectal cancer.Results:A total of 120 patients with stage Ⅲ and IV colorectal cancer were included in this study.71 cases in the integrated traditional Chinese and Western medicine group,5 were lost to follow-up,with a censorship rate of 7.04%,and 49 cases in the western medicine group,3 cases were lost to follow-up,with a censored rate of 6.12%.The mean survival time and median survival time of stage Ⅲ and Ⅳ colorectal cancer in the integrated Chinese and Western medicine group and western medicine group are 31.89 months and 34.13 months,while the western medicine group are 28.78 months and 30.00 months,P<0.05,the difference is statistically significant.The 1,2 and 3-year survival rates of stage Ⅲ and IV colorectal cancer in the integrated Chinese and Western medicine group are 85.32%,66.78%and 49.24%,respectively,while the western medicine group are 83.17%,59.15%and 41.35%.Univariate analysis showed that pathological stage,pathological features,degree of differentiation,lymph node metastasis,KPS score and CEA level before treatment are prognostic factors of patients with stage Ⅲ and Ⅳ colorectal cancer,P<0.05,the difference is significant.Multiple logistic regression analysis showed that pathological features,pathological stages,degree of differentiation,KPS score before treatment and taking traditional Chinese medicine or not,P<0.05,all were statistically significant.Adenocarcinoma is a protective factor compared to non-adenocarcinoma in pathological features.High differentiation is relatively protective factor,when other influencing factors remain unchanged,the risk of death decreases by 32.7%for each dgree increased in differentiation.The pathological stage in stage Ⅲ decreases the risk of death by 52.2%compared with stage Ⅳ.Before treatment,every increase in the KPS score by one level,the risk of death was reduced by 26.9%.When other factors remain unchanged,those taking traditional Chinese medicine(integrated traditional Chinese and western medicine treatment)can reduce the risk of death by 17.4%compared with western medicine treatment.Conclusions:The mean survival time,median survival time and 1,2,and 3-year survival rates for stage Ⅲ and Ⅳ colorectal cancer treated with integrated traditional Chinese and western medicine are better than those of the western medicine group;KPS score before treatment,pathological features,pathological stage,degree of differentiation and taking traditional Chinese medicine or not are independent prognostic factors having impact on the survival of stage Ⅲ and Ⅳ colorectal cancer;the pathological stage is Ⅲ,the pathological feature is adenocarcinoma,highly differentiated degree,KPS score of 90-100 before treatment and adopting integrated traditional Chinese and Western medicine treatment are classified as protective factors affecting the prognosis of Ⅲ and Ⅳ colorectal cancer.Therefore,traditional Chinese medicine is of great significance in the treatment of Ⅲ and Ⅳ colorectal cancer. |
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