A Retrospective Study Of The Characteristics Of Simple Chinese Medicine In The Treatment Of Advanced Non-small Cell Lung Cancer

Background:Lung cancer remains the leading cause of cancer-related mortalities,among which 85%of deaths are caused by non-small-cell lung cancer(NSCLC).Up to 70%of NSCLC patients were diagnosed at an advanced stage with no chance of curative resection.The expected survival time of patients with locally advanced NSCLC is less than 6 months if patients did not receive any medical intervention.For patients with stage III-IV NSCLC,treatments are delivered to the patients with a goal of achieving a local tumor control and preventing the systemic metastases.First-line treatment:Chemotherapy,particularly combined with targeted therapy,can offer some benefits of prolonging over-all survival(OS)to the patients with advanced NSCLC.However,a large number of patients at an advanced tumor stage are not eligible for the currently available treatment modalities due to their poor general conditions and intolerability to severe toxicities after one or more cycles of first-line chemotherapy,especially the severe adverse events occurring in vital organs.In the meanwhile,clinical trials have shown that second-line chemotherapy has only limited therapeutic effect on patients with good or intermediate performance status(PS:0-2).Therefore,there is a pressing demand of using effective and less toxic alternative treatments for the patients in despair after the failed chemoradiation therapy.For patients with status(PS:3-4)are usually treated by best supportive care(BSC).In china,Traditional Chinese Medicine are widely used in comprehensive treatment.It has been proved that TCM can play an important role in improving patients' quality of life,proloning life time and alleviating tumor burden.However,the certain benefit population is still unknown.Accuracy and individualization is the future of medicine development.Based on syndrome differentiation,TCM has a major step forward.Objective:The objective of this study was to assess the characteristics of TCM therapy alone in improving the survival of patients with failed first-line chemotherapy and targeted therapy with advanced non-small-cell lung cancer(NSCLC).Method:60 patients were devided into one group.Excel and SPSS were applied to deal with the statistics.PFS and OS were the main index to be measured with patients' clinical characteristics and syndromes.The patients should be accordance with the inclusion criteria:(1)Confirmed by pathology or cytology in III-IV stage;(2)Accepted no chemotherapy,radiation therapy;Or prior chemotherapy ?cycle2,and/or uncomplete radiotherapy,and/or?one month targeted therapy;treated with TCM alone for>3 months;(3)Over-all survival should be>1 year(4)The age:from 18 to 80;(5)Can be followed-up.Results:9288 patients were involved and among them 60 patients being selected as observative ones.1.General condition:The peak age were in 61-80,and the number of male patients were 2.3 larger than female patients.Smokers(58.3%);Tumor site was given priority to central type 63.3%.The incidence of right lung was higher than the left lung.Adenocarcinoma VS squamous cell carcinomas(58.3%VS 40.0%);phase IV 35 cases(58.3%)for the most,pulmonary metastasis were the most(33.3%),complications with pleural effusion up to 35.0%.2.The median progression-free survival time was 12 months for the patients.Kaplan-Meier survival analysis showed that the median survival time of patients' was 28.5 months.Smoking history,history of treatment,tumor type,distant metastasis,TNM stage,tumor distribution situation,Chinese medicine treatment duration can affect survival time.3.COX analysis showed the age and smoking history are the two independent risk factors of NSCLC patients' prognosis.4.Logistc analysis showed prognosis of lung temper deficiency syndrome better than blood stasis syndrome.5.The most number of Chinese syndrome was retention of phlegm and dampness.TCM syndrome:Wet phlegm and blood stasis syndrome>lung spleen-deficiency syndrome>qi and Yin deficiency syndrome>Toxic heat indicates pulmonary syndrome(33.5%>27.7%>33.5%>27.7%);TCM syndrome elements:Phlegm dampness syndrome>Yin deficiency syndrome>qi deficiency syndrome>blood stasis syndrome(31.0%>29.6%>24.9%>11.5%>3.0%).Increasing vital qi and removing evil is the key principle of treating NSCLC patients.Conclusion:Female,?60 age,adenocarcinoma,peripheral,stage ?A,non-smoker,phlegm and dampness type was ment to be the benefit population in this study.Chinese medicine alone can also prolong the survival time of unresectable and first-line chemotherapy failed patients.The median OS was 28.5 months,and median PFS was 12 months.