| As the most common malignant tumor in China, the lung cancer is still the medical challenge because of the high morbidity and mortality. Especially for the NSCLC patients, they’ve been lost the opportunity of surgery to cure the disease generally, and the united chemotherapy regimens based on the platinum compounds also have a very low effective rate for them. At the same time, the chemotherapy can frequently cause serious adverse drug reactions which make the patients" quality of life decline severely, even have the life-threatening condition. Therefore, the advantages of Traditional Chinese Medicine (TCM) in treating the disease becomes catching the people’s eyes. The principle of TCM is treating the patient as the center based on syndrome differentiation. The purpose of TCM treatment of the disease is improving the quality of life and relieving various symptoms, meanwhile extending the life time and postponing the disease progression. With the widely using of TCM in advanced NSCLC, the Chinese and Western Integrative Medicine in the disease tends to the main treatment, as the advantage of improving chemotherapy effect and alleviating chemotherapy adverse reactions in TCM is helpful for these patients. Circulating Tumor Cells (CTCs), is the new testing project for cancer patients recently, whose fast and simple test method could supervise tumor cell, predict prognosis, and guide clinical treatment, which lots of researcher have discovered. With the progress in study recent years, CTCs have been found had closely connection with the invasion and metastasis of solid tumor, which would help us to find a better way to understand its mechanism in order to control the cancer progression. Nowadays, the CTCs testing hasn’t be widely used in China, and the standard of CTCs in lung cancer also hasn’t be unveiled yet. Hence for a better use for Chinese people in the future, we’ve done this research to test if CTCs in advanced NSCLC patients is sensitive and meaningful with TCM treatment, and whether it has the Correlation with the quality of life.1. ObjectsLots of researches have been concluded that CTCs have been found had closely connection with the invasion and metastasis of solid tumor, and can predict the tumor prognosis and direct the individualized therapy as well. Therefore, we plan to test if CTCs is sensitive and meaningful with advanced NSCLC patients in TCM treatment, and whether it will have the influence with its features.The improvement effect in quality of life for advanced NSCLC patients in TCM treatment has been confirmed by many clinical tests. This research is aimed to contrast TCM treatment with combined therapy of Chinese and Western medicine for these patients’quality of life, then to weigh pros and cons of the two therapies for choosing the best treatment for the disease.With the variation of CTCs counts and the items in the quality of life scale EORTC QLQ-C30, we’ll try to find some connections in each group that may get something of value from it.2. MethodsThe study used forward-looking approach, in accordance with the inclusion and exclusion criteria, which collected30cases from April2012to September2012in hospital, from Guang’anmen Hospital. China Academy of Chinese Medical Sciences. The cases were divided into two groups, one was TCM group, the other was Integrated Traditional Chinese and Western Medicine (ITCWM) group, each15cases. Treatment for the TCM group included polyjuice potions and TCM injections, with the principle of syndrome differentiation. The treatment for ITCWM group included4kinds of combination chemotherapies based on The Chinese Version of NCCN Guide in2006, and the other was as the same with the TCM group. The research lasted two therapy cycles, each of which had21days. At the beginning and near the end of the research, we draw blood from each case, while we let them wrote the quality of life scale EORTC QLQ-C30. And at the end of it. we recorded the CTCs counts in the lab and counted the score of QLQ-C30scale.3. ResultsIn the research of the correlation between CTCs counts and quality of life in TCM group, only total state of health had the correlation (P<0.05).And in the ITCWM group, only the function of role had the correlation (P<0.05).The results mean that the CTCS counts were negatively correlated with total state of health in the TCM group, which indicated the more CTCs counts the worst total state of health; the CTCs counts were positively correlated with the function of role, which indicated the more CTCs counts the better function of role.In the compare results of the quality of life in each group, the total state of health, appetite loss, nausea and vomiting had the statistically significant difference before and after TCM treatment (P<0.05), which mean that TCM makes these three items better alter therapy; function of physical, emotion, cognition and society become worse than before ITCWM therapy, and the symptoms of fatigue, pain, shod of breath, appetite loss, nausea and vomiting had become worse than before, which all had the statistically significant difference (P<0.05). The contrast of the two groups, which showed the TCM treatment was better in function of physical, emotion, cognition and role, with the total health condition, and for the improvement of fatigue, pain, shod of breath, appetite loss, nausea and vomiting (P<0.05). Furthermore, with the ITCWM therapy, financial difficulty problem was heavier than the other (P<0.05).4. Conclusions4.1The CTCS counts were negatively correlated with total state of health in the TCM group, while in the ITCWM group were positively correlated with the function of role. The results indicated that as the increase of the CTCs counts, patients with the TCM treatment would have the worse quality of life; while as the decease of the CTCs counts, patients with the ITCWM therapy would have a severe limit in their normal life, which not reflected the better curative effect and prognosis yet. But this conlusion also had its limitations, fistly because of its less cases, the conclusion had less authority; secondly, in the valuation at last, the progressed cases in TCM group were more than the other one, which may had some effect on the CTCs counts.4.2As the new assay index, the CTCs counts have been under research of its connection with the invasion and metastasis of solid tumor for many years. Yet we cannot ignore the influence of quality of life, that means as a clinical researcher we can’t take for granted that the lower CTCs counts the better for the patient.4.3Through this research we find that the CTCs in the advanced NSCLC patients had influenced by the quality of life. In the ITCWM group with the worse quality of life, the CTCs counts and the quality of life were varied as a contradiction. While in the TCM group with good life quality, the CTCs decreasing showed the better quality of life. Thus if as a assay index for quality of life in the future with CTCs counts, we need estimate correctly the influence of quality of life to CTCs.4.4Pure TCM treatment could make the patients’quality of life remain stable, improve the appetite, digestive symptoms and total health condition, and also decrease the CTCs counts which indicates TCM have the ability to control the tumor cell growth. While the Integrated Traditional Chinese and Western Medicine treatment could decrease the CTCs counts after therapy as well, but the quality of life for the patients became low by a large margin. By contrast, the advanced NSCLC patients were more likely to accept the pure TCM therapy than the ITCWM therapy, as a result of fear for chemotherapeutic drug, and on the contrary, TCM could give more patients confidence and better quality of life, and furthermore, the tumor suppression ability in TCM was not bad compared with the ITCWM therapy. |
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