Clinical Study On Treatment Of Bone Metastasis Of Breast Cancer With Combination Of Traditional Chinese And Western Medicines

This paper is composed of 2 parts, the literature review as well as clinical research. Literature reviewThe first review is an overview of the mechanisms,diagnosis and treatment of the breast cancer to bone(B2B). Breast cancer is the most commonly diagnosed cancer among women in the world. Bone is the most common site of metastatic lesions,there are lots of discuss about the mechanisms of B2B.Experts at home and abroad have the similar viewpoint for the diagnosis of this disease.Bisphosphonates have been used as a basic medicine and have proved to be effective in preventing SREs in several clinical trials,the other systemic treatment includes endocrine therapy、chemotherapy and molecular targeted therapy. We should consider the following factors:the pathology of the primary tumor or the metastatic, the hormone status, HER-2 status, received therapy, the willing of patients to determine which kind of treatment to chose. Locoregional therapy of bone metastases mainly contain radiotherapy and surgery.The main aim of locoregional therapy is to prevent SREs,palliate pain,maintain the stability of the spine and relief compression of spinal cord.No matter which kind of regimen we choose, the objective is to release symptom, prolong life time and improve the quality of life.The second review is a summarize of the etiology、pathogenesis and treatment of B2B in Chinese medicine. In Chinese medicine, there is close relationship between the bone and kindney according to zang-fu and channels. The insufficiency of kidney essence causes there is no enough nutrient to bone that is the mainly pathogeny of B2B. The occurrence of B2B is in basis of kidney deficiency and caused by blood stasis and toxin gather.Enhance the healthy qi and eliminate the evil qi is the main method for B2B. In detail,tonifying kidney and strengthen bones.Clinical research:The objective of this clinical research is to observe the efficacy and safety of integration treatment for B2B. Method Retrospectively analyses the clinical and pathology dates of 46 B2B treated in Oncology department of China-Japan friendship hospital from Jan 2010 to Jan 2015, follow up to Apr 2016.The primary outcome is the progress free survival after bone metastasis and the relief situation of bone pain. The second is overall survivak CBR and the quality of daily life. Result:The median PFS of research is 18.2 month. The reported PFS after recurrence is from 3.2-12.4 month. We got a much longer survival time than reported.The ECOG score(1.64vs2.16 P=0.02)and NRS(1.09vs3.86 P=0.00)decreased after therapy. Conclusion Integration treatment obviously increased the PFS and OS,improve the quality of life of patients and CBR,relieve the bone pain,have the similar efficacy to sustain the time to SREs with western medicine.it is worthy to widely used in the clinic.