Clinical Study On The Prognosis Of Non - Small Cell Lung Cancer By Anti - Cancer Erchen Prescription Based On "physique" Theory

ObjectiveThis paper reviews the research on the application of TCM constitution in lung cancer. Since lung cancer predisposition is relatively stable individual characteristics on the basis of the congenital and acquired formation, Professor Qian Yanfang in clinical uses modified Er Chen Fang in treatment of non small cell lung cancer, and stressed the long-term, sustained medication, in order to achieve the purpose of adjusting the lung constitution. This paper uses the method of retrospective study on 62 cases of advanced analysis of non small cell lung cancer, to explore the rule and the feasibility of using constitution theory of traditional Chinese medicine in the treatment of lung cancer.MethodsThrough the method of retrospective method, this study collected advanced non small cell lung cancer patients who were enrolled from Navy PLA General Hospital Department of traditional Chinese medicine and Oncology from January 1st,2012 to August 31st 2014. According to whether oral professor Qian Yanfang Anticancer Er Chen Fang, the patients were divided into integrated traditional Chinese and Western Medicine Combined Western medicine therapy group. The combination of traditional Chinese and western medicine group was then divided into three pairs of groups, respectively. Patients with oral Chinese medicine, according to the length of medication time, were divided into medication group of less than 1 year and medication group of more than 1 years; according to whether patients continue taking the medicine, the observation group were divided into continuous medication group and intermittent medication group (parents oral traditional Chinese medicine for more than 3 months were included in the inter--mittent medication group); According to the length of distance interval(3 months is the demarcation point) between the start of oral Chinese medicine and the diagnosis of advanced lung cancer,the observation group was divided into medication from diagnosed within 3 months of short interval group and medication from diagnosed more than 3 months. We analysis the difference of survival information between the two groups and each subgroups, of the nutritional status, and physical condition of the two groups. Risk factors for survival of the entire group were analyzed. All data were analyzed statistically by SPSS 20.0 software. Univariate analysis of survival data and survival period were calculated by Kaplan-Meier method. Then we use Cox regression, on the selected variables, analysis multi factors related to survival.Results①The study included 62 patients with advanced non small cell lung cancer, 31 cases of treatment group, combined with traditional Chinese and Western medicine; western medicine treatment group of 31 cases. There were no statistical differences between the two groups of the demographic data of (age, gender, history of smoking),related tumors (primary site of lung cancer, pathological type, with or without pulmonary metastasis, pathological stage), related therapy(Chemotherapy, Radiotherapy,targeted therapy and traditional Chinese medicine injection), KPS core, weight and other baseline data, comparability.②The median survival period of integrated traditional Chinese and Western medicine group and Western medicine therapy group were 59 months and 30 months, with significant difference (P<0.05). The survival rate of two groups of 1 years, 2 years and 3 years are respectively, combining traditional Chinese and Western medicine group 81%,70%,and 50%, while western medicine therapy group 51%,36%, and 6%. The treatment failure rate of the group treated with integrated Chinese and Western Medicine was lower than that of the western medicine group’s. (P <0.05) In the aspect of the mode of disease progression, group with combination of TCM and Western medicine was mainly locally advanced mode, and western medicine treatment group was given priority to distant metastasis (P<0.05)③The median survival period of medication group of less than 1 year, medication group of more than 1 years and western medicine therapy group were 40 months,59 months and 30 months. The survival time of group with medication less than a year and group with medication for more than one year was both longer than the group of Western medicine therapy (P<0.05); Group with medication less than a year and group with medication for more than one year have not significant difference between the survival group(P>0.05). But from the two set of survival curves, we see that, on the observation of 40 months of medication, more than one year group showed a survival advantage.The median survival period of continuous medication group, intermittent medication group and the western medicine treatment group are respectively: 59 months,28 months, and 30 months. Continuous medication group survive longer than intermittent medication group and Western medicine therapy group (P<0.05). There was no statistical difference of survival between Intermittent medication group and the western medicine treatment group,and between continuous medication group and intermittent medication group (P>0.05)The median survival period short interval group, long interval group and the western medicine treatment group are respectively:59 months,46 months and 30 months. Short interval group and long interval group survival were longer than those of Western medicine therapy group (P<0.05). Short interval group had no statistical difference with long interval group.④Markers of half and one year rate of decline was compared between western medicine group and western combined TCM group. Compared with the western medicine therapy group, traditional Chinese and Western medicine group Cyfra211 of one year and CA199 of half year and one year decline was higher (P<0.05). There was no statistical difference between the two groups of other tumor makers.⑤We compared the two groups in the score of KPS. Compared with the western medicine therapy group, traditional Chinese and Western medicine group KPS score of half year and one year decline was smaller (P<0.05).⑥We compared the nutritional status of two groups. Two groups of serum albumin, hemoglobin dropping rate in half a year and one year showed no significant difference. Weight decline rate of the western medicine group patients within six months and one year were both faster than the combination of traditional Chinese and Western medicine group (P<0.05).⑦In order to count single survival factor and multi survival factor risk of the whole group,we combined group treated with Chinese medicine and Western medicine and group treated with Western medicine. Pathological types of lung cancer (squamous cell carcinoma or non squamous cell carcinoma), alcohol history (is or no),time to progression after hospitalization(≦7 months,or>7 months), Cyfra211 at admission (elevated or normal), and targeted therapy (yes or not) had correlation with survival. Time to progression since admission (≦7 months,or >7 months), pathological type (non squamous cell carcinoma or squamous cell carcinoma), Cyfra211 at admission(elevated or normal) were independent prognostic factors for survival.Conclusions:① Long-term, continuous use of Anticancer Er Chen Fang on the basis of western medicine treatment is the protective factor to prevent the progression and prolong the survival time for advanced non small cell lung cancer. Compared with pure western medicine treatment, treatment combined traditional Chinese medicine and Western medicine has a positive effect on reducing of tumor markers, improving strength, and maintaining the nutritional status.②By multivariate analysis, Time to progression since admission(≦7 months, or>7 months), pathological type (non squamous cell carcinoma or squamous cell carcinoma) Cyfra211 at admission(elevated or normal) are independent prognostic factors for survival.③Anticancer Er Chen Fang is the experience prescription of Professor Qian Yanfang in the treatment of lung cancer, aiming at the lung cancer core patho--genesis of Qi and Yin deficiency, with stasis of phlegm and blood. Clinical should be on the basis of syndrome differentiation, adhere to the long-term, continuous medication, in order to achieve the purpose of adjusting physique slow lung cancer, so as to improve the quality of life of patients, delay the progress of the disease, prolong the survival period. In clinical practice, we should adhere to the long-term, continuous medication on the basis of Western therapy, in order to achieve the purpose of adjusting physique of lung cancer slowly, so as to improve the quality of life of patients, to curb the progress of the disease, and prolong the survival period.