| Objective:To retrospectively analyze the clinical data of patients with limited-stage small cell lung cancer(SCLC)admitted to the oncology department of a hospital between March 2017 and March 2022,to explore whether combined Chinese and Western medicine treatment can delay the progression and improve the survival of patients with limited-stage SCLC,and to analyze the main influencing factors for the provide reliable information on the combined Chinese and Western medicine treatment strategy for patients with limited SCLC.Methods:The search terms"lung malignancy","small cell lung cancer" and"limited-stage small cell lung cancer"were used,and the search formulae were:(subject=lung malignancy)OR(subject=small cell lung cancer)OR(Subject=Limited small cell lung cancer)searched the case information system for the period 1 March 2017 to 31 March 2022,exported the medical records to an Excel spreadsheet,and then manually screened the original medical records to identify patients with limited stage small cell lung cancer at the time of initial diagnosis to create a preliminary retrospective analysis database.Patients were divided into combined Chinese and Western medicine cohorts and Western medicine cohorts based on whether they were exposed to TCM treatment.The primary outcome indicators were Overall Survival(OS)and Progression-free survival(PFS).Secondary outcome indicators were 1-5 year survival and 3,6,9,12,18-month progression-free survival.Data were statistically analyzed using SPSS 26.0,and propensity score-matched balanced confounders using a logistic regression model.The Kaplan-Meier method was used to calculate the median PFS and median OS for both groups.The median PFS and median OS were calculated for both groups,and the life table method was applied to calculate the 1-5 year survival rate and the 3,6,9,12,18-month rate Progression Free Survival(PFS).Log-rank tests were used for univariate analysis of factors influencing survival or progression,and prognostic factors with P<0.05 were included in the COX risk proportional model row for multifactorial analysis.Results:This study included 234 patients with limited-stage small cell lung cancer,87 in the combined Chinese and Western medicine cohort and 147 in the Western medicine cohort.Patients in both cohorts were discordant at baseline after significance testing and propensity score matching were performed,resulting in the inclusion of 142 patients,71 in each of the two cohorts.1.Survival and survival rates:median OS for the combined Western and Chinese medicine cohort was 65.0 months,with 1-5 year survival rates of 84%,71%,63%,58%,and 46%;median PFS was 15.0 months,with progression-free survival rates of 92%,82%,69%,52%and 28%at 3,6,9,12 and 18 months respectively;median OS for the Western medicine cohort was 29.0 months,with 1-5 5-year survival rates of 59%,42%,28%,25%and 18%,median PFS of 12.0 months and progression-free survival rates of 89%,68%,52%,43%and 14%at 3,6,9,12 and 18 months,respectively.2.Analysis of prognostic factors:The results of the univariate analysis showed that first-line efficacy evaluation,organ metastasis,targeted therapy,PCI,and combined Chinese and Western medicine treatment were all associated with PFS and OS(P<0.05).The results of the multi-factor analysis showed that those with≥5 cycles of first-line chemotherapy and efficacy evaluation of PR had a progression-free survival advantage,and those with combined Chinese and Western medicine treatment and no organ metastasis had an overall survival advantage.Conclusion:Combined Chinese and Western medicine treatment has a significant protective effect on PFS and OS in patients with limited stage SCLC,and the improvement in OS is more prominent.Organ metastasis was an independent risk factor for PFS and OS,first-line chemotherapy≥5 cycles and efficacy evaluation to PR was an independent protective factor for PFS,and combined Chinese and Western medicine treatment was an independent protective factor for OS.Compared to Western medicine alone,patients who are male,aged ≤65 years,smokers,no family history,tumour<5cm,clinical stage<Stage ⅢA,≥5 cycles of first-line chemotherapy,and not undergoing surgery,targeted and immunotherapy may be an advantageous group for combined Western and Chinese medicine treatment. |
