A Clinical Study On The Treatment Of Advanced Triple-negative Breast Cancer With Integrated Traditional Chinese And Western Medicine

This article includes two literature reviews and one clinical research.The first review summarizes the clinical experience of using traditional Chinese medicine to treat different molecular types of advanced breast cancer in recent years,hoping to provide more ideas and methods for the treatment of advanced breast cancer.Different molecular types of advanced breast cancer have different biological characteristics and clinical features,and there are also significant differences in Western medicine treatment.Traditional Chinese medicine is based on the principle of "righting and anti-tumor",and its role in advanced breast cancer is becoming more and more prominent.For advanced breast cancer with different molecular types,its syndrome differentiation drugs also have different focuses.Luminal type breast cancer is mostly liver and spleen disorder.Treatment is often given to liver and spleen,nourishing liver and kidney.Due to the application of anti-Her-2 treatment,the common clinical symptoms of Her-2 thpe breast cancer are heart related,such as heart palpitations,shortness of breath,insomnia,etc.The treatments often focus on replenishing heart,promoting blood circulation and detoxification,etc.Prescription can be Trichosanthes Fruit,Fistular Onion Stalk and Pinellia Decoction and so on.Compared with other types of breast cancer,triple-negative breast cancer has a higher degree of malignancy and a worse prognosis.Clinical treatment is more focused on righting and anti-tumor than other types of breast cancer.Huangqi,Codonopsis pilosula,reish mushroom,cordyceps are commonly used to enhance immunity.Arrowhead and ranunculus ternatus thunb are commonly used to detoxification and anti-tumor.The second review mainly summarizes the progress of treatment of triple-negative breast cancer in recent years,and provides references and bases for clinical treatments of advanced triple-negative breast cancer.Breast cancer is currently become the most common malignant tumor in women,and the advanced breast cancer is still the main body in China.Triple-negative breast cancer lacks endocrine therapy and anti-Her-2 treatment targets,and it is highly heterogeneous.So there is still no standard treatment for advanced triple-negative breast cancer.And relevant basic and clinical trials have also been carried out.Current progress has focused on chemotherapy,targeted therapy,immunotherapy and Chinese medicine.Chemotherapy continues to play a leading role in the treatment of advanced triple-negative breast cancer,and platinum and nab-paclitaxel are thought to contribute to the treatment of advanced triple-negative breast cancer.At the same time,antibody-drug conjugates have a combination of chemotherapy and targeted therapy and are considered to be the hope of treatment for advanced triple-negative breast cancer.With the advancement of molecular subtypes of advanced triple-negative breast cancer,targeted therapy and immunotherapy have also made great progress,such as polyADP-ribosyltransferase,monocyte chemoattractant protein 1 and other prognosis and potential.Treatment targets were discovered one after another.Programmed death receptor 1 and programmed cell death-ligand 1,cytotoxic T lymphocyte-associated protein 4 and other related immunotherapies are also under investigation.In addition,the role of traditional Chinese medicine in the treatment of advanced triple-negative breast cancer has also been confirmed.We expect that triple-negative breast cancer will have more treatments and better survival in the future.Clinical research:Objective:To observe the clinical efficacy of integrated traditional Chinese and Western medicine in the treatment of advanced triple-negative breast cancer.METHODS:A total of 102 patients with advanced triple-negative breast cancer who were treated in Oncology department of China-Japan Friendship Hospital from January 1,2011 to June 1,2018,were collected,and according to the inclusion criteria,80 patients were screened out.The patients were divided into two groups,they were the Western medicine group and the combination of Chinese and Western medicine group.The Western medicine group was treated with Western medicine standard.The combination of Chinese and Western medicine group was treated with traditional Chinese medicine on the basis of Western medicine standard treatment,and the intervention time of Chinese medicine was more than 3 months.Follow-up to March 1,2019 by telephone or medical records.The primary outcome measures were overall survival(OS)and disease progression-free survival(PFS)after first-line treatment.RESULTS:There were a total of 52 in the combination ofChinese and the Western medicine group and 28 patients in the Western medicine group.The median OS after recurrence and metastasis of the combination of Chinese was 49 months,significantly better than that of Western group,which was 27months(p=0.027).The median PFS after first-line treatment of the combination of Chinese and Western medicine group was 19 months,which were longer than that of the Western medicine group at 11monrhs.But the difference was not statistically significant(p=0.082).Patients with early intervention(adjuvant therapy or first-line treatment with traditional Chinese medicine)compared with patients with advanced intervention(second-line treatment or second-line treatment after starting treatment with traditional Chinese medicine),PFS was significantly prolonged in the patients with early intervention,and the difference was statistically significant(p=0.018).Conclusion:Combined with traditional Chinese medicine treatment can significantly prolong the overall survival of patients with advanced triple-negative breast cancer on the basis of Western medicine standard treatment.Early intervention and long-term intervention of traditional Chinese medicine can significantly improve the prognosis of patients with advanced triple-negative breast cancer.