The Clinical Observation Of Nasopharyngeal Carcinoma Treatment According To Radiotherapy Rombined With TCM Symptoms Differentiation

Nasopharyngeal Carcinoma (NPC) is one of the most widespread cancers and radiotherapy is usually used as the first choice in treatment.The survival rate of NPC patients 5 years at the early period (period Ⅰ and Ⅱ) after radiotherapy is 76 % - 90 %. However, at the middle and late period (period Ⅲ -Ⅳ) the survival rate of NPC patients 5 years after radiotherapy is only 20% - 50 %. Most of the patients when they come to clinic are already in the middle or late period of the disease. The treatment usually is radiotherapy and chemotherapy. Even though the curative effect in the near future has improved significantly, but the reports about the general survival rate are not consistent, and side effects of the treatment are severe. To use Traditional Chinese Medicine (TCM) searching for a less toxic, high effective herbal treatment to improve the patient's sensitivity for radiotherapy is a very important task in the clinical research on NPC. The current research is guided by the theoretical TCM concept of wholism and the clinical diagnosis and treatment based on overall analysis of symptoms and signs, the cause, nature and location of the illness and the patient's physical condition according to the basic theories of TCM (later referred to as "TCM diagnosis and treatment according to symptoms differentiation"), the treatment of NPC by means of TCM diagnosis and treatment according to symptoms differentiation combined with radiotherapy, to provide prove for the better clinical use of TCM diagnosis and treatment according to symptoms differentiation. Objective1. Clinical observation of TCM diagnosis and treatment according to symptomsdifferentiation increasing treatment results combined with NPC radiotherapy.2. Clinic observation of TCM diagnosis and treatment according to symptoms differentiation and prophylaxis of acute side effects caused by NPC radiotherapy.3. Analysis of the improvement of immunity functions and the patient's life quality (QOL) by TCM diagnosis and treatment according to symptoms differentiation.MethodsFifty eight cases (58) of NPC patients treated by radiotherapy in the first time were randomly allocated into two groups: the therapy group (n= 37) were treated by radiotherapy and TCM herbal medicaments from the first day of period of treatment (the TCM herbal medicaments were modified two times per week according to TCM diagnosis and treatment according to symptoms differentiation) until the end of treatment period; the control group (n = 21) were treated by radiotherapy only. The observational index include clinical symptoms, extinctive condition of the cancer, reactions to the radiation on skin, pharyngeal mucosa, salivary glands, gastrointestinal tract and bone marrow, QOL, hemanalysis, hepatic and renal function, immunity function.Result1. The two groups got good treatment results, completely anesis is referred to as (CR), part abesis as (PR). The CR of the tumor NPC in therapy group is 83.78% and control group 71.4%. The CR of neck lymph metastasis in therapy group is 37.9% and control group 31.25%. Although the curative effect in the near future has no significant difference, the treatment result of therapy group was slightly better than that of control group. The irradiation dosage for idiopathy NPC was (71.35±4.81) Gy in therapy group and (73.21±2.30) Gy in control group; for neck lymph metastasis (61.68± 12.33) Gy in therapy group and (64.63±15.71) Gy in control group. There is no statistically significant difference between the two groups (P>0.05), however, the irradiation dosage for therapy group was lower than for control group.2. The reaction of mucosa, salivary gland secretion, gastrointestinal tract of thetherapy group decrease very obviously compared to the control group (P<0.01); skin reaction, reduced white blood cells show a significant difference (P<0.05), and the reactions of the treatment of therapy group was much lighter. There is no considerable difference in hemoglobin, blood platelets, neutrality cells to the control group (P>0.05). During treatment period the WBC of the control group were reduced very noticeable, patients 10/21, it was necessary to use drugs to increase WBC. For the treatment therapy group, there have not been used any drugs to increase WBC except for TCM herbal medicaments.3. QOL of therapy group has been better than that of control group, to a remarkable difference (P<0.01), KPS also was better, to a statistically significant rate (p<0.05), bodyweight of the 2 groups before and after the treatment period were significantly different (P<0.01). The bodyweight of therapy group did not change a lot, the loss of bodyweight in control group was remarkable.4. Because of limited conditions, there was only measuring of CD3, CD4, CD8 and NK activity, immunity (IgG, IgA, IgM), (C3, C4) for therapy group. The difference before and after the treatment period, was not significant (P>0.05). Because the comparison data for control group is lacking, a reliable conclusion was not possible for this index.5. The research results points out that, all of the patients suffer from a stomach and lung yin deficiency, secondary from stomach and spleen yin deficiency, qi and blood deficiency and kidney essence deficiency is very seldom.ConcIusion1. The observation rudiment proves that TCM diagnosis and treatment according to symptoms differentiation improves the sensitivity of NPC patients for radiotherapy.2. TCM diagnosis and treatment according to symptoms differentiation decrease acute radical reaction of skin, pharyngeal mucosa, salivary glands, gastrointestinal tract and bone marrow. TCM herbal medicaments improve WBC and RBC specified functions.