| 中医肿瘤疗效评价标准在晚期非小细胞肺癌的应用 |
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【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＜005）,瘤体稳定率2组无显著性差异（P＞005）；中医组乏力症状明显改善，疗效优于西医组（P＜001）；中医组卡氏评分疗效显著优于西医组（P＜001）；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＞005）。（2）生存情况方面，中医组中位生存期为（80±12）个月，半年、1年、2年生存率分别为6038%、2453%、377%，西医组中位生存期为（59±04）个月，半年、1年、2年生存率分别为4118%、1569%、196%。（3）两种标准评定结果，按照RECIST标准总有效率为962%，总稳定率为7212%；按照《草案》标准总有效率为3462%，总稳定率为8462%，两种标准评定结果比较，差异有显著性意义（P＜001）。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 (RECTCMST) in the therapeutic effect evaluation of Chinese medicine for late nonsmallcell 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 RECTCMST and Response Evaluation Criteria in Solid Tumor (RECIST).ResultsThe RECTCMST evaluation results showed that the effective rate on relieving tumor mass in TCM group was lower than that in WM group (P＜005),the difference of tumormass stable rate was insignificant between the two groups (P＞005);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＜001).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＞005).As for the survival patients,TCM group had a median survival period of （80±12） month [1] [2] [3] [4] [5] 下一页 |
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