| Background:Somatostatin analogues(SSA)are first-line treatment of advanced gastroenteropancreatic neuroendocrine tumor(GEP-NET).At present,there are few reports on the treatment of GEP-NET with traditional Chinese medicine.The purpose of this study is to observe the efficacy of traditional Chinese medicine combined with SSA in the treatment of advanced GEP-NET and to summarize the experience and basic prescriptions of Professor Tan Huangying in the treatment of traditional Chinese medicine.so as to lay a good foundation for further research.Methods:From June 2012 to January 2019,50 patients with advanced GEP-NET who were treated regularly by traditional Chinese medicine combined with SSA in Chin-Japan Friendship Hospital were retrospectively analyzed,including 26 males and 24 females,with a median age of 53 years(20-81 years).Fifteen patients received first-line treatment with traditional Chinese medicine combined with SSA,and 35 patients received other therapy before.The primary site included 23 cases of pancreas,23 cases of gastrointestinal tract,and 4 cases with unknown primary site.Fourty-four cases were nonfunctional tumors and 6 cases were functional.According to the Chinese Consensus of Pathological Diagnosis of Gastrointestinal Pancreatic Neuroendocrine tumours(2013 version),7 cases were NET G1,37 cases were NET G2,5 cases were NET G3,and 1 case was of unknown tumor grade.All patients were treated with traditional Chinese medicine according to the syndrome differentiation prescription of Professor Tan Huangying.They were also treated with octreotide LAR 20-40mg every 21-28 days,or lanreotide LAR 40 mg every 10-14 days.RESIST 1.1 standard was used to evaluate the tumor response every 2-4 months.The main research end point was progression-free survival(PFS).The traditional Chinese medicine prescriptions taken during the treatment were collected and analyzed through hospital information system.Results:As of February 28,2019,only 6 of 50 patients died,with a median follow-up period of 29.0 months(5.6-86.5).The median OS and PFS were not reached.Thirty-two patients received SSA combined with traditional Chinese medicine only,and the other 18 patients received other treatments.A total of 14 patients in this group developed disease progression,11 patients turned to other treatment after stable disease,the remaining 25 patients with stable disease still receiving SSA combined with traditional Chinese medicine treatment.No complete response(CR)or partial response(PR)was observed during the treatment,with an objective response rate of 0%.44 patients had stable disease(SD),and the SD rate was 88.0%.The duration of stabilization was not related to gender,primary site,tumor grade,functional,whether other treatments had been taken or whether other therapy had been combined(P=0.319,0.189,0.393,0.167,0.154,0.503).According to the statistics of the hospital information center,Professor Tan Huangying wrote 642 prescriptions for the patients in the group.According to the frequency statistics,there were 889 raw/fried Baizhu,880 Dangshen/Taizishen/(Bei)Shashen,802 fried/raw Gancao,802 Baihuasheshecao,759 Jineijin,672 fried/charred Maiya,661 Danggui,595 Fuling,506 Baishao,478 Cuchaihu/Chaihu,472 fried/deep-fired Shanzha,455 fried/raw Yimi,444 fried/raw Huangqi,290 Yuanhu.,259 Chenpi,253 Nizhenzi,248 Gouqizi,240 danshen,240 Muxiang,228 fried Zhiqiao,219 Zhibiejia.CONCLUSION:Compared with SSA alone,traditional Chinese medicine combined with SSA can significantly prolong PFS in patients with advanced GEP-NET.Professor Tan Huangying’s basic prescription for patients with advanced GEP-NET was summarized as:Cuchaihu/Chaihu 10g,Baishao 10g,Danggui 15g,fried/raw Baizhu 15g,Dangshen/Taizishen/(Bei)Shashen 15g,Fuling 15g,fried/raw Gancaop 10g,fried/deep-fried Maiya 20-30g,fired/deep-fried Shanzha 15-20-20g,Jineijin/raw Jineijin 15-30g,fried/raw Huangqi 20-30g,fried/raw Yimi 20-30g and Baihuasheshecao 15-30g.Further prospective studies can be carried out on this basis in the future. |
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