The Clinical Observation Of Xiaoji Decotion Combined With Erlotinib In The Treatment Of Non-small Cell Lung Cancer Harboring EGFR Mutation

ObjectivesTo retrospectively analyze the clinical efficacy of Xiaoji decoction combined with Erlotinib in the treatment of advanced non-small cell lung cancer,and to explore whether this combination as a first-line treatment for advanced non-small cell lung cancer(stage IIIb or IV)with EGFR mutations could prolong survival time,improve the quality of life and reduce side effects.MethodsThe method of retrospective single arm clinical observation was applied in this study.Patients who were hospitalized or outpatient for treatment and met the inclusion criteria from July 2011 to July 2017 were enrolled in this study.A retrospective analysis and follow-up were performed,and the patients were observed or followed up until disease progression,the occurrence of intolerant toxic and side effects,or death.The main observation outcome was progression-free survival(PFS),and secondary observation outcomes were overall survival(OS),median survival time,objective response rate,disease control rate,1-year survival rate,5-year survival rate and toxic reaction.The objective response rate and disease control rate were used as short-term curative effect indexes,and the PFS,OS and median survival time were used as long-term curative effect indexes.ResultsTotally 143 cases were collected in this study.In the aspects of short-term curative effect,the ORR and DCR of Xiaoji decoction combined with Erlotinib was 68.5% and 96.5%,respectively.No obvious difference was found between the exon 19 mutation group and the exon 21 mutation group.And there was no obvious difference between the first-line treatment and the second-line treatment.The ORR of the first-line treatment was slightly lower than that of the second-line treatment,but the difference was not significant.In terms of long-term curative effect,the median PFS was 15 months and the median OS was 23 months.In the whole case samples,the one year survival rate was 87.2%,two year survival rate was 57.1%,three year survival rate was 40.1%,five year survival rate was 2.7%.In terms of the subgroup analysises for survival,there was no obvious difference between the exon 19 mutation group and the exon 21 mutation group,so were between the first-line treatment and the second-line treatment.The PS score and the number of metastases were factors for PFS and OS.In terms of the curative effect of traditional Chinese Medicine,Traditional Chinese medicine is effective.Each type was associated with the curative effect,and overall efficiency of the type of heat toxin syndrome and the type of Qi deficiency and blood stasis was high,which reached 100%.Rash and diarrhea were common adverse reactions of the Erlotinib target therapy.The rash total incidence rate was 26.6%,the rash total incidence rate of diarrhea was 16.1%,the liver injury total incidence rate was 3.5%.Most of the adverse reactions occurred at grade I,which could be relieved after symptomatic treatment,and there was no treatment-related death.Conclusion1.In the treatment of advanced non-small cell lung cancer with EGFR mutation,Xiaoji decoction combined with Erlotinib has no significant differences in efficacy between patients with the exon 19 mutation and the exon 21 mutation and the first-line and second-line treatment.2.In the treatment of Xiaoji decoction combined with Erlotinib for treating EGFR mutated advanced non-small cell lung cancer,the PS score and the number of metastases could be used as an independent factors for survival.3.In the treatment of advanced non-small cell lung cancer with EGFR mutation,Xiaoji decoction combined with Erlotinib could achieved better clinical efficiency ?disease control rate and longer survival time,with which reducing the incidence of adverse reactions.