Combination Of Chinese Medicine And Vinorelbine For Treating Elderly Patients With Advanced Non-Small Cell Lung Cancer

Objective: To observe the therapeutic efficacy and toxicity of Xiaoji-decoction/Huachansu/Vinorelbine against elderly stageⅢB/ⅣNon-Small Cell Lung Cancer(NSCLC).Methods:According to inclusion and exclusion criteria, from January 2000 to March 2006, 120 patients withⅢB/Ⅳnon-small cell lung cancer were enrolled in our study. These patients were divided into three groups according to the different therapy methods: In the first group, there were 45 patients who received Xiaoji-decoction (60ml/m~2, P0, d1-21), Hua Chansu (20ml/m~2, intravenously, d1-10) unite Vinorelbine (30mg/m~2, intravenously, d1, 8). There were 30 patients in the group two who accepted the union chemotherapy plan; The third group with totally 35 patients only received Chinese medicine treatment. Finally, The tumor size changing, 1-year survival rate, median survival time and toxicity were calculated and compared among this three groups.Results:Group one:Forty-six patients received on average 3.2 cycle of the first group treatment. Alleviation rate: Nine case (19.6％) had partial response, 32(89.1％) had stable disease and 5(10.9％) underwent progressive disease. By Kaplan-Meier survival analysis, the median time to disease progression was 5.2 months and the median survival was 7.2 months, 1-year survival rate was 28.3％. PS scores and the quality of life improved after the therapy. The major toxicity was myelosuppression. GradeⅣleucopenia was observed in 1/46 patients(2.2％). Two patients had gradeⅡvomiting(4.3％). GradeⅠ—Ⅱliver functional lesion was observed in 4/46 patients(8.7％), None of the patients had serious functional lesion of heart and kidney. No death appeared relating to therapy.Group two:There were 30 example patients who received on average 3.0 cycle of the second treatment. Alleviation rate: Six case (20％) had partial response, 18(80％) had stable disease and 6(20％) underwent progressive disease. By Kaplan-Meier survival analysis, the median time to disease progression was 5.2 months and the median survival was 7.0months. 1-year survival rate was 33.0％. PS scores and the quality of life improved after the therapy. There were 12 patients who have myelosuppression. GradeⅣleucopenia was observed in 2/30 patients(6.7％), liver functional lesion was observed in 4/30 patients(13.3％), 1/30 patients(0.3％) has kidney functional lesion. None of the patients had serious functional lesion of heart. No death appeared relating to therapy.Group three:There were 35 example patients who received the third treatment. Alleviation rate: 1 case (2.9％) had partial response, 18(51.4％) had stable disease and 16(45.7％) underwent progressive disease. These patient' s the median time to disease progression was 2.5 months and the median survival was 4 months. No toxicity appeared relating to therapy.Compared results:The effective rate was 19.6％20.0％and 2.9％respectively, there has significant differences between three groups(P＜0.05). The main side effect and toxic response was leucopenia and gastric response. Rates of leucopenia, anemia, thrombocytopenia, gastric response in group 1 and group 2 were 26.1％, 60％, 4.3％, 43.3％respectively, there were significant differences in leucopenia(P＜0.05) and gastric response(P＜0.05) between two groups, there were no significant differences in anemia, thrombocytopenia, hair losing, hepatic and renal damage, neural toxicity between two groups, there were significant differences in MST,TTP,1-year survival rate and ps (P＜0.05) among three groups. The tow group of chemotherapy therapy was better than the group which received pure Chinese medicine treatment. Conclusions:1. Therapy of Xiaoji-decoction, Huachansu unite Vinorelbine have the good effect on the old age later period non-small cell lung cancer. Compared with other union chemotherapy plan, the change of tumor size, 1-year survival rate, median survival time, median time to progression of this combination therapy were similar. But it was better than the therapy of using Vinorelbine only, also better than the group which received pure Chinese native medicine treatment.2. The combination of Xiaoji-decoction/Huachansu/Vinorelbine has fewer adverse effects than other union chemotherapy plan. The patients were easy to endure, and survival quality obtained the enhancement.3. Compared with other therapy, patients' the qualities of life were improved after the therapy of Xiaoji-decoction/Huachansu/Vinorelbine.