Chinese Medicine Treatment Of Acute Radioactive Lung Injury In Preliminary Exploration

1.ResearchbackgroundRadiotherapy is one of the main treatment of tumor, During the radiotherapy of thoracic tumor, such as lung cancer, esophageal cancer, breast cancer, radiation-induced lung injury may occur, which seriously affect the curative effect of radiotherapy and the patient’s quality of life.Radiation-induced lung injury includes acute radiation-induced lung injury and chronic radiation-induced lung injury. Generally refers to the acute radioactive lung injury occurred within1to3months after radiotherapy of lung injury and chronic radiation lung injury refers to a lung damage after three months. Radiation-induced lung injury in the main clinical symptoms are cough, mild or severe breathing difficulties, low thermal, etc. The serious patients can appear serious respiratory insufficiency. Imaging performance mainly has lung slice appears consistent with the radiation field of fuzzy shadow, which is not restricted by lung, pulmonary segments. Chronic phase appear article fiber rope shadow or local pleural thickening.Pathogenesis of radioactive lung injury is classified into the following theories:1. The alveolar epithelial injury.2. Pulmonary vascular endothelial cell injury.3. Alveolar macrophages growth factor.4. Immune response.5. Lymphatic involvement.6. The CMV. Molecular biology mechanisms:may cause fibrosis cell growth factors including tumor necrosis factor alpha, fibroblast growth factor beta, transforming growth factor beta, epidermal growth factor, interleukin1, interleukin6, platelet-derived growth factor, growth factor and macrophage fiber connection element. These cytokines may by alveolar cells, fibers, alveolar macrophages to produce and secrete.Immediately after lung radiation has many growth factors and inhibiting factor synthesis and secretion and continuously for several weeks to several months after, macrophages after radiation to produce at least twelve different kinds of growth factors, stimulate the proliferation of fibroblasts.The main measures of western medicine treatment of acute radioactive lung injury is the use of hormones, antibiotics, drugs, and symptomatic treatment. The side effects of Hormone and antibiotic medication are more obvious, such as immune suppression, aggravating and induce infection, dysbacteriosis, gastrointestinal bleeding, abnormal blood sugar, etc.Traditional Chinese medicine believes that radioactivity is a burning heat evil, damage the body, resulting in deficiency of lung yin and blood stasis.Since to carry out radiation therapy, we who work in oncology,contact with many patients with acute radiation-induced lung injury, have accumulated a number of effective treatment of acute radiation-induced lung injury. For the systematic study of Chinese medicine treatment of radiation-induced lung injury, we will quantify the clinical symptoms of radiation-induced lung injury in order to study its efficacy.2.Research objectiveObserved the clinical efficacy in the treatment of acute radiation-induced lung injury by traditional Chinese Medicine.3.Research methodUsing randomized controlled design, patients with acute radiation-induced lung injury who visited to Department of Oncology, Xiyuan Hospital of China Academy of Traditional Chinese Medicine, Department of Radiation Oncology, Beijing Cancer Hospital, Department of Radiation Oncology, Beijing Chaoyang Hospital, were randomly divided into treatment group and Western medicine control groups from September2010to March2012. The follow-up time of1month. Before treatment, after two weeks, and one month after the start of treatment were observed.1month after the start of treatment to determine efficacy, determine the efficacy of mainly based on clinical symptoms and radiographic changes.4.ResultsCough, chest pain, dyspnea, fever and other clinical symptoms over the previous are relieve in Chinese medicine treatment group after treatment. And clinical symptom scores before and after treatment comparison, P<0.05. Statistically significant. Western medicine treatment group after treatment, cough, chest pain, dyspnea, fever than before remission. Comparison of the clinical symptom scores before and after treatment, P<0.05. Statistically significant. Between the two groups after the treatment, the clinical symptom score was not statistically significant. After treatment, imaging findings was not statistically significant.5.Conclusion1. Traditional Chinese medicine treatment can improve the clinical symptoms of acute radioactive lung injury, can make its better imaging of pathological changes.2. Western medicine treatment can improve the clinical symptoms of acute radioactive lung injury, can make the imaging on the pathological changes of getting better.3. The acute radioactive lung injury and the treatment efficacy of Chinese medicine treatment group and the control group no difference in statistics.