Clinical Research On The Treatment Of Locally Advanced Nonsmall-cell Lung Cancer By Concurrent Radiochemotherapy Combined With Fuzheng Traditional Chinese Medicine Prescription Of Lung Cancer

Objective:Through clinical observation and analysis of the different results in scores of TCM syndromes,quality of life,KPS,the recent efficacy,survival,immune function and adverse reactions by treating the locally advanced nonsmall-cell lung cancer by concurrent radiochemotherapy combined with Fuzheng traditional Chinese medicine prescription of lung cancer and simple concurrent radiochemotherapy,we can research the role of traditional Chinese medicine during radiotherapy and chemotherapy,and explore new directions for future combination therapy for locally advanced non-small cell lung cancer.Methods:All 68 cases of lung cancer patients were selected from the Fifth Hospital Oncology of Wuhan,from November 2013 to March 2015,were all diagnosed with ?a or ?b of NSCLC.According to admission order,numbered the patients with odd and even numbers.Odd number was treatment group(concurrent radio-chemotherapy combined with Fuzheng traditional Chinese medicine prescription of lung cancer);even numbers as the control group(simple concurrent radiochemotherapy).There were 34 patients for each group(There was one case excluded observation in treatment group).Treatment Method: Two groups of patients were treated with concurrent chemoradiotherapy,Intensity modulated radiation therapy using radiotherapy.Using 7-9 generally intensity-modulated radiation field to making 90% to 95% isodose curve planning target volume(PTV),splitting dose 2Gy / times,5 times / week,total dose of 60 ~ 70 Gy.Using DP(docetaxel + cisplatin)chemotherapy,Docetaxel 75 mg / m2,ivgtt,d1;cisplatin 25 mg / m2,ivgtt,d1-d3,21 days for a period.Treatment group started to oral the him for the medical of Fuzheng traditional Chinese medicine prescription of lung cancer before the week prior to chemotherapy,and continued to take Traditional Chinese medicine for 3 months after completion of radiation and chemotherapy.The control group did not take Traditional Chinese medicine.Results:33 cases in treatment group had finished the experiment while 34 cases in control group.Before treatment,the general situation of the two groups were comparable,and there were no significant differences in gender,age,KPS score,pathological classification,clinical stage,clinical symptoms(P > 0.05).(1)After the end of treatment in the two groups clinical syndromes,treatment group,rate were 36.4%(12 / 33)and 11.8%(4 / 34)in the control group improved significantly,part of the improvement rate were 45.5%(15 / 33),38.2%(13 / 34),no improvement rate of 18.2%(6 / 33),50%(17 / 34)respectively.The effective rates of the two groups were 81.8% and 50.0%.The effective rate of the two groups was statistically analyzed,P=0.01 < 0.05,there was statistical significance.(2)After the end of treatment,the treatment group KPS score was 75.8% patients improved,18.2% remained stable,decreased approximately 6.0% of patients before the treatment;control group KPS score was 41.2% of the patients improved,32.3% remained stable,about 26.5% of patients compared with those before treatment,the decline.Compared with the two groups,the KPS score of the treatment group was significantly higher than that of the control group(P < 0.05).(3)In the treatment group and the control group,complete remission rate(CR)were 21.2%,14.7%;partial remission(PR)rate were 69.7%,70.6%;stable(SD)rate of 6.1% and 8.8%,respectively;progress(PD)rates were 3.0%,5.8%,the total effective rate were 90.9%,85.3%.Comparison of the two groups,P=0.877 > 0.05,there was no statistical significance.(4)Treatment group and control group after 6 months survival rate were 96.7% and 94.1%,two groups,P = 1.00 > 0.05,no statistical difference;1 year survival rates were 87.9%,82.4%,but there was no statistical difference in the two groups.(5)The treatment group and control group before treatment of CD3 +,CD4 +,CD8 +,CD4 + / CD8 + level had no difference(P > 0.05).After treatment,the CD3 +,CD4 +,CD4 + / CD8 + in control group decreased significantly(P < 0.05),while in treatment group after treatment were not change significantly(P > 0.05);the CD3 +,CD4 +,CD4 + / CD8 + in control group before and after treatment decreased significantly compared with before treatment(P < 0.05),and CD8 + increased.After treatment,the IgA and IgM levels in control group were compared with those before treatment decreased(P < 0.05).The treatment group of IgG,IgA and IgM levels were compared with those before treatment(P > 0.05);treatment group compared with the control group,IgG,IgA and IgM levels were significantly increased(P < 0.05).(6)Treatment group and control group ?-? grade incidence of bone marrow suppression were 72.7%?76.5%;The treatment group appeared 3 cases grade ? myelosuppression,the control group had 4 cases of grade ? myelosuppression.The myelosuppression in the two groups had no significant difference.The gastrointestinal reactions of the two groups were all grade ?-?,the incidence of Treatment group and control group were 63.6%?85.3%,P<0.05,two groups has significant differences.Treatment group had 39.4% occurred ?-? level radiation pneumonitis,and no patients occurred radiation pneumonitis above ?.The control group had 52.9%occurred ?-? level radiation pneumonitis,also had 5.9%occurred radiation pneumonitis ?.The incidence of radiation pneumonitis groups,The treatment group was significantly lower than the control group(P=0.019).The incidence of treatment group and control group radiation esophagitis were 30.3%?35.3%,all were grade ?-?,had no statistically significance.Conclusion:The therapy with Concurrent radiochemotherapy combined with Fuzheng prescription of Lung cancer for locally advanced non-small cell lung cancer,can improve immune function in patients,reduce the toxicity,improve the quality of life of patients.It provides a new direction for the combination therapy of locally advanced non-small cell lung cancer.