医学论文-中医肿瘤疗效评价标准在晚期非小细胞肺癌的应用.docVIP

医学论文-中医肿瘤疗效评价标准在晚期非小细胞肺癌的应用 【摘要】? 　　【目的】探讨《实体瘤的中医肿瘤疗效评定（草案）》(简称《草案》)在中医药治疗晚期非小细胞肺癌（NSCLC）疗效评价应用中的客观性和全面性。【方法】采用回顾性临床对照研究方法，收集Ⅲ~Ⅳ期NSCLC病例共104例，其中中医组53例，西医组51例，同时采用《草案》和实体瘤疗效评价标准（RECIST）对2组进行疗效评定，分析、比较两种不同标准评定的结果。【结果】（1）按照《草案》标准，中医组瘤体缓解有效率明显低于西医组（P＜005）,瘤体稳定率2组无显著性差异（P＞005）；中医组乏力症状明显改善，疗效优于西医组（P＜001）；中医组卡氏评分疗效显著优于西医组（P＜001）；总疗效方面，中医组总有效率、总稳定率略高于西医组，但无显著性差异（P＞005）。（2）生存情况方面，中医组中位生存期为（80±12）个月，半年、1年、2年生存率分别为6038%、2453%、377%，西医组中位生存期为（59±04）个月，半年、1年、2年生存率分别为4118%、1569%、196%。（3）两种标准评定结果，按照RECIST标准总有效率为962%，总稳定率为7212%；按照《草案》标准总有效率为3462%，总稳定率为8462%，两种标准评定结果比较，差异有显著性意义（P＜001）。两种标准评定结果的一致性分析表明其评价结果存在一致性，但一致程度不够理想。【结论】以《草案》标准评价中医药治疗晚期NSCLC疗效，其结果能较好地反映中医疗效特点和优势，较之RECIST标准更为客观和全面，建议逐步完善后在临床推广应用。 【关键词】? 肺肿瘤/中药疗法；非小细胞肺癌/中药疗法；评价研究 　　Abstract:ObjectiveTo investigate the objectivity and comprehensiveness of Response Evaluation Criteria of Traditional Chinese Medicine for Solid Tumor (RECTCMST) in the therapeutic effect evaluation of Chinese medicine for late nonsmallcell lung cancer (NSCLC).MethodsA retrospective study was carried out in 104 NSCLC patients in the stages of Ⅲ~Ⅳ.Of 104 patients,53 received traditional Chinese medicine (TCM group),and 51 received western medicine (WM group).The therapeutic effect in the two groups was evaluated with both RECTCMST and Response Evaluation Criteria in Solid Tumor (RECIST).ResultsThe RECTCMST evaluation results showed that the effective rate on relieving tumor mass in TCM group was lower than that in WM group (P＜005),the difference of tumormass stable rate was insignificant between the two groups (P＞005);the symptom of weakness was much relieved,and effect on Karnofsky score was good in TCM group as compared with that in WM group (P＜001).The total effective rate and total stable rate in TCM group were a littler higher than those in WM group,but the difference was insignificant (P＞005).As for the survival patients,TCM group had a median survival period of （80±12） months,and survival rates for half a year,o