Professor Zhang Peijun's Observation On The Survival Of Patients With Small Cell Lung Cancer And Clinical Experience

OBJECTIVE:By observing the survival of patients with small cell lung cancer(SCLC)treated by Professor Zhang Peitong,to explore whether the combination of Chinese and Western medicine can improve the survival of SCLC patients,and the effect of TCM treatment on the prognosis of patients with distant metastases.Using the data mining platform of famous doctors in Guang'anmen Hospital to analyze the medication laws and clinical experiences of Professor Zhang Peitong in the treatment of small cell lung cancer,and provide reference for the treatment of small cell lung cancer.METHODS:This study was a clinical observation study using a retrospective and prospective two-way approach.We collected Professor Zhang Peitong's outpatient cases with a clear pathological small cell lung cancer diagnosis,performed baseline evaluation and recorded basic information.The patient received TCM treatment upon syndrome differentiation in our outpatient department and received standard Western medicine(chemotherapy,radiotherapy,and surgery)at the same time.From the beginning of treatment,patients were followed once every 3 months.We followed their survival,tumor development and quality of life,and recorded the patient's treatment.Patients enrolled in the study required at least 2 follow-up visits.The median survival and median progression-free survival of the patients in the group were calculated,and the survival of the patients with distant metastases was analyzed,and compared with the survival period from the literature study.Analyze the prescriptions of outpatients by using Guanghanmen Hospital's "Experiential Data Warehouse and Analytical Mining Platform of Traditional Chinese Medicine in Beijing"to summarize the experience and academic ideas of Professor Zhang Peitong in the treatment of small cell lung cancer.RESULTS:1 Survival analysisThe follow-up period ended on March 15,2018,117 patients were included,of which 61 patients were limited stage small cell lung cancer(LS-SCLC),and 56 were extensive stage small cell lung cancer(ES-SCLC).The median OS of the whole group was 21.73 months,the median PFS was 19.57 months,the median period of limited OS was 27.2 months,the median PFS was 25.57 months,the median period of extensive OS was 16.27 months,and the median PFS was 14.07.Months.In order to analyze the survival of patients with distant metastasis,the post-procedure survival time was defined as the time at which metastasis was diagnosed until death was detected.Loss-of-transit and non-dead patients were recorded according to the truncated value.The median survival time was 6.43 months for liver metastases,8.30 months for bone metastases,14.07 months for lung metastases;and median survival time for brain metastases was 15.27 months(media survival time 5.9 months in literature).Comparing the difference between the survival time of patients with brain metastases in the group and the survival time in literature,it has statistical significance.To further study the factors that affect the prognosis,Log-Rank test showed that age,pleural effusion,liver metastasis,bone metastasis,and treatment time of traditionaI Chinese medicine have an impact on overall survival.On the basis of Cox regression analysis,elderly(RR ?2.429),pleural effusion(RR = 2.005),liver metastasis(RR = 8.208),and lung metastasis(RR= 2.157)were prognostic risk factors.Traditional Chinese medicine treatment is a protective factor for prognosis.The risk of death in Chinese medicine patients who have been treated for more than 3 months is 0.432 times that of patients treated with traditional Chinese medicine for 2 months.2 Summarize Professor Zhang Peitong's Experience in Treating Small Cell Lung Cancer Based on Information Mining TechnologyThe data mining results showed that the efficacy of traditional Chinese medicine was ranked as clearing heat,detoxicating,fortifying the spleen,transforming phlegm,relieving pain,and activating blood circulation in descending order of frequency of use;the meridian tropism of drugs was mainly for spleen,lung,and liver;The drug properties with higher frequencies were flat,warm,lukewarm,and cold.The drug tastes with higher frequency were sweet,bitter,pungent,sour,and pale.Professor Zhang Peitong's core prescription treating SCLC combines Astmgali Radix,Citrus reticulata Blanco,Galli Gigerii Endothelium Corneum,Crataegi Fructus,Corni Fructus,Eucommiae Cortex,Poria,Macrocephalae Rhizoma,Vespae Nidus,Radix Rhizoma Glycyrrhizae,Persicae Semen,Chinese Waxgourd Semen,Coicis Semen,Phragmitis Rhizoma,Trichosanthis Fructus,Platycodonis Radix,Cremastrae Pseudobulbus,Herba Hedyotidis,Angelicae Sinensis Radix,Bulb of Thunberg Fritillary,Anemarrhenae Rhizoma.CONCLUSION:Chinese medicine treatment can help improve the prognosis of patients with SCLC.The combination of Chinese and Western medicine can significantly prolong the survival of SCLC patients with brain metastasis.Patients with good compliance with traditional Chinese medicine treatment may have a good prognosis.Traditional Chinese medicine treatment might need to accumulate for a certain period of time before it could play a role in improving long-term survival.Based on the pathogenesis of lung,spleen and kidney deficiencies together with Phlegm-heat stasis,Professor Zhang Peitong's established the treatment principle of SCLC as tonifying the spleen and kidney,clearing heat and removing toxicity,and reducing phlegm and resolving masses.