Clinical Research On Yifei Fang Combining With Chemotherapy In The Treatment Of Medium Or Late Stage Non-small Cell Lung Cancer (NSCLC)

Background for this researchLung Cancer including non-small cell lung cancer (squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma) and small cell lung cancer. About80%of the total number of lung cancer belongs to primary non-small cell lung cancer (NSCLC). Owing to the lack of effective means of early diagnosis, lung cancer mortality is high, that become the leading cause of death of human cancer and threat to human's health and life. The clinical diagnosis of lung cancer based on clinical performance and varieties of imaging presentation, but the final clinical diagnosis of lung cancer is according to cytology or histopathological evidence, beside cytological or histopathological diagnosis, it could not be recognized as the final diagnosis. At present, the first choice to treat early-stage NSCLC (â… A, IB, â…¡A, â…¡B), is surgical complete resection. The overwhelming majority in the clinical diagnosis of lung cancer in advanced stage (â…¢B, or â…£), have lost opportunities for surgical cure. For those who are not suitable for surgery, chemotherapy is one of the treatment of advanced NSCLC (â…¢B, â…£), chemotherapy with platinum drug-based chemotherapy regimens were the GP scheme, TP, DP program, the NP program and PP solutions etc. Chemotherapy drugs including GEMCITABINE GEM, DOCETAXEL DOC, VINORELBINE NVB and PACLITAXEL TAX, and Taxol so on. Advent of new drugs ALIMTA invented, which further improve the efficacy of NSCLC. In addition, the biological treatment of molecular targeted therapy such as IRESSA, ERONTINIB, advent a new direction to treat lung cancer. Taken together, cure rate is low, the treatment effect is still not optimistic. Due to the chemotherapy drug resistance, toxic side effects and can not tolerate the response to chemotherapy in advanced lung cancer patients, often voluntarily give up chemical treatment and that affect subsequent cycles of chemotherapy and treatment. With the malignant tumor "comprehensive treatment" concept, emphasizing the integrative medicine, Chinese medicine in the status of the prevention and treatment of malignant tumors of increasing attention. Therefore, in order to seek the treatment effect of advanced NSCLC, to study medical treatment of advanced NSCLC has important clinical significance. Under the guidance of Professor Chen Rui shen, I modified the Yifei Fang provide by Professor Chen (Radix Codonopsis25g, Houttuynia30g, Radix Ranunculus Ternati30g, Codonopsis lanceolata Benth30g, Radix Asparagil5g, Bulbus Fritillariae Thunbergii15g, Gekko5g, Herba Agrimoniae15g, Fructus AurantiilOg, FoliumEriobotryae10g, Rhizoma Phragmitis15g, Radix Notoginseng10g) combined with chemotherapy (GP, TP, DP program) in the treatment of patients with medium or late stage non-small cell lung cancer (NSCLC, â…¢B, â…£) on clinical research.Object ive(1) to investigate short-term effect of Yifei Fang combining with chemotherapy in the treatment of medium or late stage non-small cell lung cancer(NSCLC).(2) research tumor marker changes of Yifei Fang combine chemotherapy in medium or late stage non-small cell lung cancer(NSCLC).(3)observed the effect in patients with medium or late stage non-small cell lung cancer (NSCLC) response in Reducing Toxicity by Yifei Fang a combined with chemotherapy.(4)Observation the quality of life for the role in patients with medium or late stage non-small cell lung cancer (NSCLC) by treated with Yifei Fang combined with chemotherapy.Method60patients in1st Affiliated Hospital of Guangzhou TCM University and the Main PLAHospital in Guangzhou inpatient and outpatient in medium or late stage non-small cell lung cancer NSCLC (â…¢B, â…£), randomly divided into A and B, the two groups. A group was the treatment group,30patients (23males and7females, ages45to77years old),30patients (Group B) was the control group (18males and12females aged from31to71years old). Group A Integrative treatment combined with chemotherapy<Yifei>; Group B was treated with chemotherapy containing cisplatin or carboplatin treatment in each group were treated for two cycles (every4weeks for a cycle). Questionnaire developed by the researchers designed, recorded during the treatment of common clinical symptoms of the patient's general index of indicators of tumor size, biochemical blood, liver, renal function, quality of life index, weight change, physical condition, Karnofsky index. SPSS13.0statistical software was used for statistical analysis and processing. To evaluate the recent therapeutic effect after observing two cycles.Results(1)Recent efficacy of Group A (treatment group)were the total response rate (RR) was33.3%(10/30), complete remission rate (CR)0%, partial response (PR),33.3%(10/30), stable rate (SD),63.4%(19/30), deterioration (PD),3.3%(1/30). Group B (the control group) were RR of23.3%(7/30), CR0%, PR23.3%(8/30), SD of73.4%(22/30), PD3.3%(1/30). Showed no significant difference P>0.05.(2)About CEA carcinoembryonic antigen changes:There was a significant difference of CEA decreased (P<0.001) after treatment in the Group A; CEA levels have a significant difference (P<0.001) after treatment with group B.(3)Toxicity:After treatment, the toxicity of reaction more than2degrees showed in varying degrees, such as diarrhea, nausea and vomiting, symptoms of infection. Group A showed the lightest, whereas Group B with more severe symptoms. Significant difference, P<0.05.(4)Quality of life changes in the two sets of chest pain symptoms, a significant difference, P<0.001; cough changes have a significant difference, P<0.001; and bloody sputum changes in Group A, showed significant difference P<0.01. There were no significant differences P>0.05in Group B.(5) Physical condition before and after treatment on Karnofsky comparison:Karnofsky score has increased in these two groups after treatment. Group A increased more significantly, there are significant differences P<0.05, Group B showed no significant difference P>0.05.(6)Body weight before and after treatment:Group A showed a slight increase in body weight after treatment, and Group B showed general decline after treatment. the data showed a significant difference, P<0.05. The average age of these two groups of patients59.7years and53.2years respectively. Two groups of pathological types:Group A,20cases of adenocarcinoma,10cases of squamous cell carcinoma; Group B, adenocarcinoma19cases,11cases of squamous cell carcinoma. Lesion sites of two groups: Group A18cases of central type, around12cases; Group B16central cases, around14cases. Clinical stages of the two groups:Group A had nine cases of the â…¢ B,21cases of the â…£. Group B showed III B12cases,18cases of â…£. The two sets of general information Statistically and comparable, the differences were not statistically significant (P>0.05).ConelusionsThe Yifei Fang in combination with chemotherapy (TP, GP, DP) in the treatment of medium or late stage non-small cell lung cancer (NSCLC) more effective than chemotherapy containing platinum therapy. Clinical study was proved Yifei Fang combined chemotherapy in the treatment of medium or late stage non-small cell lung cancer (NSCLC) is effective in the clinical symptoms improved, the rate of tumor stability, improve the quality of life, reduce the toxicity, etc. which are the main indicators of the efficacy evaluation and to adjuvant chemotherapy in the treatment procedure completely. The prominent Chinese and Western medicine combined with the features and advantages of the comprehensive treatment to provide a reference for medium or late stage non-small cell lung cancer (NSCLC) treatment options and research.