| Lung cancer is one of the most common malignant tumors in recent years, the incidence of it has risen year by year dramatically. Due to the lack of effective diagnostic methods of early stage, the mortality rate of lung cancer has been as high as 90%. Western medicine takes surgery, radiotherapy and chemotherapy as three kinds of most main treatments, however, the cure rate is very low. Currently, the treatment of advanced lung cancer is based on traditional chinese medicine (TCM). For patients with advanced lung cancer, the main goal of the treatment is to alleviate main symptoms,improve quality of life and prolong survival period, but not to decrease the size of tumor and kill cancer cells. The characteristics of TCM is " coexistence with the tumor". Currently, the efficacy of tumor is evaluated by the underlying criterion—WHO solid tumor response criterion, with emphasis on decreasing the tumor and killing cancer cells. It can not objectively reflect the characteristics of TCM. The National Cancer Academic Conference has developed a malignant tumor response criterion for herbal treatment. Although the symptom alleviation and improve of quality of life have been included, but the criterion emphasis on the disappearance of the symptoms too much,and lack of quantitative criteria, so it is difficult to exchange.Therefore, there's urgent need to develop a tumor response evaluation system for TCM, which is rational, standardized, fully reflection the characteristics of TCM and can be widely recognized and accepted at home and abroad.So we can evaluate the effect of TCM objectively in integrated therapy. At present, many scholars in this field had more in-depth study and exploration, but there haven't a standardized criterion evaluation for it, and we need this response criterion urgently.The part of literature review sum up the progress study of the lung cancer treatment of TCM and the progress study of clinical evaluation system within the latest years. It also analysis the characteristics of TCM and integrated medicine treatment, and analysis the reasons why the currently existing standard does not apply to response evaluation of TCM. We retrieve more than 40 articles about clinical efficacy observation of lung cancer's TCM or integrated medicine treatment within the latest ten years. We compare and analyze the efficacy evaluation indexes involved, there are 8 kinds of indexes most clinical researchs used include the size of tumor, quality of life, the main symptom, survival period, toxicity, laboratory parameters, weight and cost effective ratio.Clinical research part is a retrospective study on the advanced non-small cell lung cancer patients admitted in Dong Zhi Men hospital from 2009 to 2010. we select four kinds of response evaluation indexes to measure the outcome, the indexes include size of tumor, quality of life, the main symptom and survival period, which are used by more than half of the literature, appeared the highest frequency, and commonly used in clinical studies. We also compare the outcome with the literatures', attempt to explore and embody which evaluation index can objectively reflect characteristics and advantages of advanced lung cancer's TCM treatment.Through the study, we found that TCM have advantages in stabilizing the size of the tumor, alleviating main symptoms,improving the quality of life, prolonging the patients survival period. They can reflect characteristics and advantages of TCM very well, so we think that the stable rate of the tumor, the main symptoms, quality of life, survival period are the main indicators of response evaluation. |
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