Cryosurgical Combined With Traditional Chinese Treatment Of Primary Lung Cancer Clinical Research

Objective:Using Argon-helium cryoablation combined with Traditional Chinese Medicine(TCM) treated primary lung cancer,and to observe the safety,feasibility, short-term and long-term efficacy.Meanwhile search for the changes of Chinese medical syndrome between preoperative and postoperative.The study tried to find out a new therapy of lung cancer,especially for the elderly and advanced patients, which could attain better outcome.The result may offer some help with the clinic application of Argon-helium cryoablation and TCM.Methods:Using prospective and retrospective research method,we select 88 primary lung cancer patients who had been treated by Argon-helium cryoablation combining with TCM during 2003.9 to 2008.12.The states of behavior,quality of life,clinical symptom,life span and TCM syndrome have been analyzed.Results:1.The evaluation of CT(1) CT monitoring during surgeryCT values about the ablated area of 97 tumors focus on 88 patients were obviously decreased.And there were markedly boundaries around the areas.Thirty tumors were covered by cryosurgery ice ball more than 1 cm to the tumor edge,which could consider to be dispersed completely,account for 30.93%.There are 59 tumor focus of 80%to 100%ice covered tumor account for 60.82%;6 tumor focus of 60%to 80%ice covered tumor account for 5.15%;in addition,2 lesions of less than 60%ice covered due to excessive size or close to aorta.Total effective rate in 88 cases is 91.75%.(2) Curative effect evaluationAccording to the Response Evaluation Criteria In Solid Tumor(RECIST).About 85.57%lesions increased in 1 to 2 weeks after the operation,but the value of CT decreased,and cavitations were found in some tumors.These lesions have already mortified.The effective rate and clinical benefit rate after 3 months,6 months,12 months,24 months and 36 months was 54.64%and 73.20%,58.70%and 83.70%, 47.62%and 73.81%,14.29%and 33.33%,0%and 25.00%.2.Quality of life and Karnofsky gradeDuring 1～6months after cryosurgery,the two evaluation improved obviously. However,after 6months,the improvement rate began to reduce and descend to the level as preoperative in 12 mouths after operation.3.The symptoms of cough,stethocatharsis,hemoptysis,thoracalgia,dispnea, shortness breath and lack of strength were palliated after 14 days.Especially, cough,dispnea,shortness breath and lack of strength had remarkable relief than preoperative(P＜0.05).After 1month to 3months,the improvements of cough, stethocatharsis,dispnea,shortness breath and lack of strength were still satisfying, other symptoms also decreased.All symptoms did not aggravate after 6months except stethocatharsis.4.The TCM syndrome of lung cancer contains sthenic zheng and deficiency zheng. There are five syndromes,as Qi asthenia,Yin deficiency,blood stasis,phlegmatic hygrosis and phlegmatic heat,can be found more frequently in the patients who did not undertake the cryotherapy.During the first week after the treatment,the level of Qi asthenia in those patients descended,but phlegmatic heat ascended. After cryotherapy three months,the TCM syndrome of patients was same as preoperative,there was no different from statistical degree.5.Survival time evaluation(1) The survival time evaluation after cryotherapyAll of the patients were alive in the 3 months after the operation.The survival rate after 6 months,12 months,24 months,36 months and 48 months was 95.19%,46.75%,25.35%,12.50%and 8.89%,respectively.The shortest postoperative survival time was 3.5 months in these 88 patients,and the longest time was more than 59 months.The postoperative median survival time was 15.8 months.(2)Total survival timeThe total survival rate of these 88 patients in 6 months,12 months,24 months,36 months,48 months and 60 months was 96.47%,69.62%,27.03%,14.52%,12.50% and 12.90%,respectively.The shortest and longest survival times were 4.5 months and 96 months.The median survival time reach 19.2 months.6.Completion rate of cryotherapy was 100%.There were not severe adverse reactions during and after the operation.Some complications as cough,pain, pneumothorax,frostbite and fever could relieve in two weeks.Conclusion1.Cryotherapy ablation is a effective treatment with desirable controllability and safety.2.Cryotherapy ablation is a minimally invasive operation without severe side effects.Therefore,the therapy seems more suitable for elderly and advance lung cancer patients than other treatments.3.Qi asthenia,Yin deficiency,phlegm zheng and blood stasis syndrome were the main TCM syndrome before and after cryosurgery in primary lung cancer patients. TCM can supporting body resistance,reduce the side reaction and increase efficiency of cryotherapy.As a follow-up treatment,it can inhibit tumors recurrence and metastasis;as well the survival time could be extended.4.Cryotherapy ablation combine with TCM is a new way that integrates focal treatment and systemic treatment.Its safety and efficacy have through the test. Therefore,this method is worthy to promote in the clinical treatment for primary lung cancer.