Clinical Observation On Treatment Of Lung Cancer Targeting Drug - Related Rash By

Currently, the world’s highest cancer mortality is the primary lung cancer (lung cancer), and the morbidity and mortality showed a rapid rising trend. According to the "World Cancer Report 2014", the latest research data show that in 2012 due to lung cancer deaths of more than 1600000, accounting for 1/5 of the total number of death. At the same time the global number of new cases of 1.8 million lung cancer, accounting for 1/10 of the total cancer. Treatment of lung cancer has been widespread concern in the world. Traditional treatment has been well-known, as such as surgery, chemotherapy and radiotherapy are still essential, but indications limitations, side effects to the treatment suffered a bottleneck, and as genomics, molecular development of biological technology. Depending on the genetic characteristics of lung cancer patients individualized targeted therapy to tumors into a new era. Molecular targeted therapy refers to the biological basis, with a specific or relatively specific molecular tumor cells become therapeutic targets. Use of a ligand or antibody to combine with a target, guide or direct the clinical treatment methods for therapeutic purposes. Targeted drugs is to make the maximum advantage transported to target drugs directly to diseased cells or tissues, the maximum inhibitory effect of these drugs on tumor cells with high selectivity, to minimize damage to normal tissue, which chance of eliminating or inhibiting tumor cell greatly improved over the previous, high efficiency, low toxicity effects in recent years, making it a hot topic. For the most common drug research targeting primarily the epidermal growth factor receptor EGFR (epithelial growth factor receptor) pathway inhibitors currently in clinical vascular endothelial cells to produce inhibitors, multi-target inhibitors. When conventional treatments experienced a plateau, targeted therapy for the treatment of lung cancer develop a new direction, the application prospects which is very broad and development is rapidly.Currently, the targeting of drugs commonly used in clinical lung cancer on second and third-line treatment, but studies showed that, in patients with EGFR (epithelial growth factor receptor) mutation positive, the treatment group of first-line gefitinib PFS (progression-freesurvival) is clear superior to the use of chemotherapy drugs in the control group. Another study in patients with first-line advanced non-small cell lung cancer survival benefit, after the EGFR inhibitor combined with platinum-containing chemotherapy, regardless of the type of organization. Many studies have shown that EGFR mutation-positive advanced lung cancer patients with EGFR tyrosine kinase inhibitors (EGFR- TKIs) can be achieved in a median survival time of 3.5 years, effectively improve the prognosis.Targeted therapy allows us to benefit from the same time also gives us some problems, its side effects can not be ignored,severe cases can lead to discontinuation of treatment.Skin toxicity, gastrointestinal toxicity, cardiovascular toxicity is the most common adverse reactions, Secondly also include thromboembolism, gastrointestinal perforation, liver toxicity, proteinuria, nervous system toxicity, respiratory toxicity, thyroid dysfunction and other rare adverse reactions. Western medicine treatment of toxicity is not yet reached satisfactory results, clinical studies have shown that early intervention in medicine we should take measures in the whole course of treatment, Control side effects and maximize drug targeting the inhibition of tumor, in order to give patients with to most survival benefit.Objective:to observe the clinical curative effect of the formulas of nourishing lung and eliminate rash in the treatment of lung cancer targeted drug induced skin rash,The observation relates to the treatment of targeted drugs Gefitinib (Iressa), Erlotinib(Tarceva ),Icotinib(Conmana),Crizotinib(Saikerui). Observed in patients with skin rash gradin g,TCM symptoms integral, skin disease patients quality of life score, tumor marke rschange, and his own safety evaluation at the same time.Methods:a total of 80 patients with gefitinib,erlotinib,icotinib,crizotinib were randomly divided into 2 groups by a rash.(the treatment group 40 cases, control group 40 cases).Treatment group give the formulas of Nourishing Lung and eliminate rash oral and topical to treat. The control group was treated with hydrocortisone cream treatment. Two groups of patients were treated for 14 days, the observation period is 14 days,30 days for one treatment cycle.Before and after treatment.According MASCC (Multinational Association of Supportive Care in cancer skin toxity study group) classification system for patients with skin toxicity grading, evaluation of the patient’s TCM symptom scores, according to the DLQI (Dermatology life quality index)evaluated patient’s quality of life, changes in tumor markers were recorded. After one cycle, using SPSS20.0 statistical data.Results:through statistical analysis,30 days later treatment and control groups rash grade, symptom scores, quality of life scores were decreased. Two groups have significant differences in skin rash grading after treatment(P<0.05), treatment group curative effect is better than control group, treatment group rash and the total effective rate was 75%, control group total effective rate was 55%.Two sets of TCM syndrome contrast, statistically significant differences (P<0.01), treatment group TCM syndrome was significantly better than the control group.Quality of life scores between the two groups compared statistics show a significant difference (P<0.01), quality of life scores in treatment group was better than the control group.Comparison of levels of tumor markers, before and after treatment CEA, CYFRA211, NSE showed no significant difference between their difference (P>0.05).