Study On The Relationship Between The Classification Of TCM Constitution And The Progression - Free Survival After Treatment With Gefitinib In Patients With Advanced Non - Small Cell Lung Cancer

Background and purpose:Non-small cell lung cancer (NSCLC) is one of the major diseases affecting human health. In recent years, molecular targeted therapy is a major breakthrough in the treatment of NSCLC. Gefitinib is the representative drug for targeted therapy. It has a superior effect at curing a portion of late stage NSCLC patients. The factors affecting the efficacy of Gefitinib treatment has been focused upon throughout the years. In this study, we use TCM constitution as the starting point, and through retrospective analysis, study the influence of Gefitinib treatment for advanced NSCLC patients with different TCM constitutions. Thus, we can speculate the relationship of the efficacy of Gefitinib treatment for patients with different types of TCM constitution and provide a theoretical basis to better guide the medication usage of patients.Research objective and methods:The objective is to research stage IV NSCLC patients that have received Gefitinib treatment. Then, the data is run through statistical software SPSS20.0, using non-parametric tests, and chi-square tests according to the patients’Chinese medicine constitution classification, and finally the data is analyzed.Results:The research included a total of 111 eligible patients of which 48patients were male and 63 were females.The patients’mean age was 64.59 years. There were 59 patients equal to or over the age of 65, and there were 52 patients who were less than 65 years old.There were 104 patients with adenocarcinoma, and 7patients with squamous cell carcinoma.88 patients were diagnosed with EGFR mutations while it remained unclear whether the rest of the patients had EGFR mutations or not.37 patients have undergone previous surgery for lung cancer while 74 patients did not receive surgery treatment for lung cancer; 77 patients had previously received at least one treatment of chemotherapy,34 patients have never received chemotherapy. There were 39 patients who have a history of smoking,79 have no history of smoking. The median PFS for all patients was 10.0 (2.0-22.0) months. As for the patients’ Chinese Medicine constitution distribution,most of the patients were classified as having adeficient constitution (Yang deficiency, Qi deficiency, Yin deficiency). There were fewer patients withmalignant excessive constitution (phlegm dampness, heat dampness,Qi stasis, blood stasis). As for the patients’Chinese Medicine constitution, theirnumbers in descending orderareYang deficiency, Qi deficiency, Yin deficiency, harmony, phlegm and dampness, heat and dampness, Qi stasis, blood stasis, and allergy. We found no significant relationship for the Chinese Medicine constitution distribution between gender, age, smoking history, previous treatment received, etc.As for the relationship between the constitution and the PFS, the Yang deficiency group and the harmony group was significantly higher compared to other types of constitution, yet they showed no significant differences between themselves; The PFS of the Qi deficiency group was lower than the harmony and Yang deficiency groups, but it was significantly higher than that of the other constitutions.The PFS of the Yin deficiency groupwas significantly lower than that of the harmony, Yin deficiency, and Yang deficiency groups. The number of cases of patients with phlegm and dampness, heat and dampness, Qi stasis.blood stasis and allergy constitutions were low, thus the results have limited credibility, and therefore we cannot clearly determine its impact on PFS.Conclusion:1. The median PFS oflate stage NSCLC patients that have undergoneGefitinib treatment is 10.0 months.2. The constitution distribution of late stage NSCLC patients that have undergone Gefinitib treatmentconsisted of mostly deficient constitutions (Yang deficiency, Qi deficiency, Yin deficiency). In contrast, there wasless malignant excessive constitutions (phlegm dampness, heat dampness,qi stasis, blood stasis).There was no significant relationship between constitution and the patients’sex, age, smoking history, previous treatment received, etc.3. For patients with advanced NSCLC, Yang deficiency constitution and harmony constitution may prove to be advantageous when treated with Gefinitib. On the other hand,Yin deficiency constitution may prove to be disadvantageous when treated with Gefinitib.