| Objective:By observing the recent effects and side effects of Semi-liver alternating and Intensity Modulated Radiation Therapy combined with Zhangshikang’ai powder for primary diffuse hepatocellular carcinoma to explore an effective treatment of primary diffuse hepatocellular carcinoma, in order to prolong the lifetime for patients with primary diffuse hepatocellular carcinoma, improve the life quality, reduce the side effects caused by radiation therapy, and explore new ways of combining traditional Chinese and western medicine treatment for primary diffuse hepatocellular carcinoma. Methods:The selected 78 cases are all hospitalized patients from tumor 2 area of the fifth hospital in wuhan during October 2010 to December 2013,all patients were matches the diagnosis of primary diffuse hepatocellular carcinoma. We divided 78 cases of primary diffuse hepatocellular carcinoma patients into A, B two groups randomly. Group A was Traditional Chinese Medicine combined with radiation therapy group.Group B only to the radiation therapy. We divided liver target into left and right semi-liver and all patients treated by Semi- liver alternating and Intensity Modulated Radiation Therapy,1.7Gy-2Gy/F,5F/W,irradiated the more side of liver lesions in the morning and the less side in the afternoon,the time interval was more than six hours, the total dose was about 30 Gy.Group A plus Traditional Chinese Medicine on the basis of radiation therapy,taking them a week before radiotherapy until one to three months after radiotherapy.Group B patients only with radiotherapy and without Traditional Chinese Medicine.The method and dosage were the same as group A.Monitoring the score of clinical syndrome,recent effects, survival rates,cellular immune function,toxic reaction before and after treatment and follow-up of patients regularly, record the lifetime, put all the data for statistical analysis. Results :The number of two groups to complete treatment were 38 and 37 cases. Evaluating the clinical syndrome score after treatment of two groups,the cure rates were 0%(0/38) and 0%(0/37),the significant effective rates were 13.16%(5/38) and 5.41%(2/37),the effective rates were 60.53%(23/38) and 37.84%(14/37),the no effective rates were 26.32%(10/38) and 56.76%(21/37),the total effective rate were 73.69%(28/38) and 43.24%(16/37),P was 0.007 after statistics analysis,there was no statistical significance. The complete remission rates of two groups were 0%(0/38) and 0%(0/37),the partial remission rates of two groups were 7.89%(3/38) and 5.41%(2/37),the no change rates of two groups were 71.05%(27/38) and 72.97%(27/37),the progressive disease rates of two groups were 21.05%(8/38) and 21.62%(8/37),the total effective rates of two groups were 78.95%(30/38)and 78.38%(29/37), the comparision showed no statistically significant,P was 0.815.The three months,six months and one year survival rates of two groups were 92.11%(35/38)and 89.19%(33/37), 47.37%(18/38)and 40.54%(15/37),18.42%(7/38)and 2.7%(1/37),the comparision of three months and six months survival rates showed no statistically significant,P was 0.664 and 0.551 respectively.But the one year survival rate showed statistically significant,P was 0.027.The CD3+,CD4+,CD8+ and CD4+/CD8+ levels of two group were fairly before treatment(P were 0.967,0.244,0.890 and 0.882 respectively).The levels of CD3+,CD4+ and CD4+/CD8+ were relatively higher(P for group A were 0.000,0.000,0.000 and for group B were 0.000,0.034,0.000) and the level of CD8+ was lower(P for two groups were 0.000 and 0.000 respectively) after treatment than before treatment.The comparision of CD3+,CD4+,CD8+ and CD4+/CD8+ between two groups after treatment also showed statistically significant(P were 0.028, 0.046,0.038 and 0.006 respectively).The toxic reactions of treament were mainly gastrointestinal reaction,radioactive liver damage and myelosuppression.The incidence rates of I- II degree of gastrointestinal reaction were 34.21%(13/38)and 40.54%(15/37) in two groups; I-II level of radioactive liver damage were 21.05%(8/38)and 43.24%(16/37); I-II degree of myelosuppression were 44.74%(17/38) and 67.57%(25/37) respectively.The comparsion of gastrointestinal reaction showed no statistically significant(P was 0.571) and the radioactive liver damage,myelosuppression showed statistically significant(P was 0.039 and 0.046). Conclusion:Semi-liver alternating and Intensity Modulated Radiation Therapy combined with Zhangshikang’ai powder can improve clinical syndrome for patients with liver cancer,can improve life quality and enhance immune function, prolong living time, reduce the occurrence of side effects and provides a new direction to combine traditional Chinese and western medicine treatment for primary diffuse liver cancer. |
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