Observation On The Therapeutic Effect Of Antipruritic Skin Cream On EGFR - TKI - Related Rash

Background:Cancer, a malignant disease and persistent ailment, which is one of the r easons that resulted in the deaths of modern humans. Due to the uncertainty of its et iology and the limitations of treatments, it now has become a worldwide multiple and difficult miscellaneous disease.Thestatistics of United Nations show that in 2012 one in eight in human mortality was caused by cancer on average in the worldwide. The epidemic of cancer cases of the top three are:lung cancer(1.8 million), breast cancer (1.7 million) and colon cancer (1.4 million), while the mortality rate is:lung cancer,1 iver cancer, gastric cancer. Along with the growth of environment pollution and aging of population in recent years, Lung-cancer, the highest incidence and most malignant tumor in our country, has gained lots of attentions, and since the 1970’s, lung adeno carcinoma has gradually become the highest incidence of clinical pathological type.Tar geted therapy become more and more popular in clinical treatment due to its’good c urative effect and low side effects. As the results of further researches, it has found t hat EGFR (epidermal growth factor receptor) mutation occurs mostly in lung adenocar cinoma patients, therefore, EGFR-TKI(epidermal growth factor receptor tyrosine kinase inhibitor)is gradually applied in clinical treatment of non-small-cell lung cancer.But, a s every coin has two sides,the side effects during the EGFR-TKI treatment have also concerned the patients, such as skin toxicity, pernicious vomiting, diarrhea, pulmonary fibrosis, etc,and the incidence rate of skin toxicity is as high as 80%. The Clinical s ymptoms of EGFR-TKI related skin toxicity are as similar as acne,and because of the high morbidity rate and long duration, it has produced a great impact on patients’d aily life or even on the treatment adherence. The western medicine treatment don’t ha ve the positive effect while the Traditional Chinese Medicine (TCM) has a great potent ial in the aspect of reducing drug side effect. This is a small sample of clinical obse rvation, it aims to observe the efficacy of Chinese herb preparation-Zhiyangrunfushua ng in the treatment of epidermal growth factor receptor tyrosine kinase inhibitor relate d skin toxicity, and hope to accumulate some valuable relevant data for further resear ch of TCM treatment to this disease.Objective:Observe the efficacy of Chinese herb a preparation-Zhiyangrunfushuang in the treatment of epidermal growth factor receptor tyrosine kinase inhibitor related skin toxicity, to study the relieve symptoms of patients’skin rash after the medication, in order to accumulate some valuable relevant data for traditional Chinese medicine treatment in lighten targeted drug side effects.Method:According to the established standard of diagnosis, inclusion and exclusion,6 0 patients with definite pathological diagnosis(non-small-cell lung cancer) who have re ceived targeted therapy(Iressa, Tarceva, Conmana) and experienced the symptoms of s kin rash which conform to the NCI-CTCAE4.0 rash classification above level I (co ntains level I). Using the method of stochastic indicator divided them randomly into two groups:the treatment group and the control group, each group has 30 patients. T he treatment group use Chinese herb preparation-Zhiyangrunfushuang,while the control group use Silicon cream, during the test,any of the therapeutic drugs for the skin ras h which haven’t contained in this test should be used. Compare and analysis the objec tive curative effect and improvement situation of rash symptoms.Results:60 cases of patients have all finished the test. Before the treatment, the gende r, age, rash level, KPS score, itch and pain rating and clinical symptoms had no stati stical differences. After a treatment course (14 days), the rash has got a degree of c ontrol in both group, after a statistical comparison, P<0.05, which says that the drugs used in two group have some certain curative effect in rash controlling. And the eff ective rate in the treatment group is 80%, while the control group is 57%, according to statistical comparison,P<0.05, that means the curative effect of Chinese herb prepar ation-Zhiyangrunfushuang is better than the Silicon cream. But after statistics operatio n between treatment group and control group before and after medication, medication after the comparison between treatment group and control group, the symptom of itch and pain have no statistical differences due to P>0.05. It says both of the two drugs can not control the itch and pain. Make statistics operation, the rash ease for the fir st time of two groups, The median number of days in treatment group is 5 day, whil e the control group is 8 day. That means the patients whose skin rash symptom has been relieved, the first time of rash ease in the treatment group is earlier than the co ntrol group.Both two groups of patients haven’t create any adverse reaction, it appears both two drugs are safe.Conclusion:First, the curative effect of treatment group which use Chinese herb preparation-Zhiya ngrunfushuang is better than that in the control group; Second, in those patients whose skin rash symptom has been relieved, the first time of rash ease in the treatment group is earlier than the control group; Third, the improvement of itch and pain is not obvious on both two groups; Fourth, the medicine used in both two groups is safe.