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QYHJFormula-basedIntegratedHerbsandWesternmedicineTherapyinElderlyPatients

with

PancreaticCancerLumingLiu

DepartmentofIntegrativeOncology

FudanUniversityCancerHospitalShanghaiChinaStagedistributionatdiagnosisand5-yearrelativesurvivalrateamongpatientswithpancreaticcancerUS,1996-20035-yearrelativesurvivalrateStagedistributionatdiagnosisFromJemal,A.etal.CACancerJClin2008;58:71-96.The4thleadingcauseofcancer-relatedmortalityinU.S.A.EdwardsBKetal.Annualreporttothenationonthestatusofcancer,1973–1999,featuringimplicationsofageandagingonU.S.cancerburden.

Cancer,200241%pancreaticcanceroccursover75yearsold71%pancreaticcanceroccursover65yearsoldStandardizedIncidenceofcancerinShanghaiCity

Incidenceofpancreaticcancerfrom1972-1999increased72.2%inmaleand56.2%infemale,2%orsoincreaseeveryyear.ArapidlyincreasingtrendintheincidenceforPC:the8thand9thformenandwomeninShanghaiLIUJusi,etal.Tumor2004,24(1)11-15caCharacteristics

in

ElderlyPatientswithCancersAgeingandsickly;Cancerprogressionrelativelyslow;Cancermetastasisprobablyless;Multipleprimarycarcinomaincreasing;PoortolerancetoChem&RT(becauseofitslosingphysiologicalfunctionin

elderlypatients)Aretrospectivestudyon

advancedpancreaticcancertreatedbyTCMHerbs---Ananalysisof56cases

LiuLM,WuLC,LinSY,etal.

TherapeuticEvaluationonAdvancedPancreaticCancerTreatedbyIntegrativeChineseandWesternMedicine-ClinicalAnalysisof56Cases.

ChinJIntegrativeMed,2003,9(1):39-43.

56caseswithadvancedpancreaticcancertreatedbychemotherapyaloneorchemotherapycombinedwithTCMdecoctionTheTCM+CHEMOgrouphadabettersurvivalovertheCHEMOgroup(P=0.04)TherewasasuperiorityofchemotherapycombinedwithTCMtochemotherapyinobjectiveresponse(p=0.049)andinimprovementofsymptoms(P=0.002)

Survivalrate(%)Mediansurvival(month)1year2year3year5yearTCM+CHEMO(31)55.37±3.2434.61±16.3125.96±24.6425.96±24.6416.3CHEMO(25)21.95±27.547.31±27.54007.5Case167y,F.

Symptomsbeforeoperation:Jaundice,upperabdominalpain;

Tumorsize:89cm

Operationtime:Oct.8,1997,Tumorunresected1999FENGErbao

Nov2004

7-yearbirthdayFollowup

inxinhua(新华)HospitalHangzhou

inMarch18,2006111232casesfromMay1,2002-Dec.31,2005werereviewed, and134caseswithadvancedpancreaticcancerhadpathologicaldiagnosiswereincludedinthisanalysis(94nopriortreatment,40hadtreatment).Weexcluded98cases(nopathology64,not-provenbypathology16,neuroendocrinecarcinoma2,nomassafterpancreaticoperation7;clinicaldataincomplete4;herbstreatment<1month5,stageII10例、stageIII15、stageIV109

withremoteM).ARetrospectiveStudyonAdvancedPancreaticCancerTreatedwithIntegratedWesternMedicineandTraditionalChineseherbs:Analysisof134Cases2002-2005

ShenYe-hua,LiuLu-ming,MengZhi-qiang,ChenZhen,LinJun-hua,ZhouZhen-hua,ChenHao,WangKun,FuJie,YuEr-xin

DepartmentofIntegratedOncology,FudanUniversityCancerHospitalSurvivalMedianSurvival5.7monsHalfyrsurvival47.0%1-yrsurvival17.5%2-yrsurvival8.7%3-yrsurvival

7.2%QYHJHerbsP<0.001monsQYHJHerbsOthersHerbs20062004200520072008Case2BeforeTreatment

2002-7-25AfterTreatment2003-6-6Case3Xingxx;18/07/2002Admission,2010.1.1.Follow-upCase32011Case4

WuJianpingxxF,44yrs,JiangsunativeDiagnoseddata:May2003CT:PCMass10cm,twoloberlivermultimasses,biggestoneis9cm;Case4Liverbiopsy:metastasispoordifferentiatedadenocarcinoma;Treatment

:May28,2003:Gemcitabine(1.4g/m2),Oxalipatin(150mg/m2),THP60mg+Lipiodol

13mlin1stcycleTAIforlivermetastasis;June25,2003~July23,2003

3DCRT6MVX-ray3160cGy/20FxforPC;Aug11,2003:Gemcitabine1.4g,Oxalipatin200mg,THP60mg+LP10mlin2ndcycleTAI;

HerbstreatmentJuly31,2003-7-31Aftertreatment——intrahepaticmetastasismassesregression,andmassnotclearMay22,2003BeforeTreatment

May2003PCMassBeforetreatmentOct.2003PCmassnotclearJuly2003aftertreatmentPCmassregressionCase5Yangxx

longsurvivalwithcancerbefore(13/10/2004)after(17/04/2008)F,43y,ShanghainativeDiagnoseddata:31/08/2004Diagnosis:PancreaticCawithLM(09/2004),bothlungM(09/2004),post-peritoneumLNm(09/2004),multi-bone(11/2006);Cytology:denocarcinomaFollow-up:31/12/2009Survives86monsCase5MultimodalityTreatmentofPancreaticCancerWithLiverMetastasesUsingChemotherapy,RadiationTherapy,and/orChineseHerbalMedicine

---Analysisof164Cases

Huaqiang

Ouyang,PengWang,MD,Zhiqiang

Meng,MD,ZhenChen,Er’xinYu,HuanJin,DavidZ.Chang,ZhongxingLiao,LorenzoCohen,PhD,andLumingLiuPancreas,2011;40(1):120~126,IF:2.607RESULTSFrom2002to2007,164casesofpancreaticcancerpatientswithlivermetastasisdiagnosedbypathologyQYHJFormulaisindependentprognosticfactors

YESNOmOS5.4m3.9m1yearsurvival21.9%4.8%QingyihuajiFormula(QYHJ)AmorphophallusrivieriDurieu蛇六谷

Oldenlandiadiffusa(Willd)

Roxb白花蛇舌草ScutellariabarbataD.Don半支莲清热解毒、利湿消肿、活血止痛为臣AmomumcardamomumL.白豆蔻化湿和胃、行气宽中为使Gynostemmapentaphyllum(Thunb.)Mak.绞股兰扶助正气、清热解毒为佐Liuetal.ChinJIntegrMed.2005Shenetal.TraditChinMed.2006Shenetal.CJBMTCM.2006Shenetal.ChinaOncology.2006Clinical&experimentalstudyshowedthat:QYHJisoftheeffectsonanti-pancreaticcancer.

Aprospectiverandomizedcontrolled

PhaseIIclinicaltrial

IntegrativetherapyofQYHJ+Gemcitabine-

basedchemotherapyorwith3DCRTforadvancedpancreaticcancer

ShenYehua,LiuLuming,ChenZhen,MengZhiqiang,

LinJunhua,ZhouZhenhua,ChengWenwu,YuErxin,JiangGuoliang.

IntegrativeMedicineProgramofLiver,GallbladderandPancreaticCancer,FudanUniversityCancerHospital

JournalofTraditionalChineseMedicine

2010,51(12)

:1093-1097StudyDesign

PrimaryObjective:Response,MedianSurvival,OverallSurvivalSecondaryobjective:ClinicalBenefits,AdverseEffectsRGEMd1+3DCRTd15+QYHJherbsfor4monsGEMd1+3DCRTd15+Placebofor4monsTAI:Gem1.0g/m2,Oxaplatin135mg/m2orCisplatin40mg/m23DCRT:6MVXray,36~40Gy/1.8~2GyAdvancedPCResearchsubjects(participants)83caseswereenrolledintothisstudyduringMarch,2004~2009;1pathologicdiagnosischanged;2notreatment: 1(QYHJ)obstructivejaundice; 1(Control)bowelobstruction;80receivedtreatmentandincludedinthestudy:QYHJ41cases,control39.ComparisonofControlandQYHJGroupControl(n=39)QYHJ(n=41)PvalueSexM21290.119F1812Age59[42~74]60[41~78]0.950Massofpancreasminus8160.090body,tail3125TumorSize(cm)4.6[1.5~9.0]4.7[1.5~10.0]0.304stageLocaladvanced7120.234metastasis3229KPS<8015150.863≥802426ComparisonofControlandQYHJGroupTreatControl(n=39)QYHJ(n=41)PvalueGEM-based129290.391TAItimes2109302401ChemodrugsCDDP990.904Oxaplatin3032TACEYes21170.268No1824ERTYes27330.245No128CompletedERTYes20280.121No1913ResponseCRPRSDPDPvalueQYXJ(n=36)0512190.067Control(n=36)001323

Of80,72isvaluableassesment. 5casesarePRinQYHJgroup,noCRorPRincontrol.

Survival

1y%3y%

OS(mo)

QYHJControl5.104.3Lastestfollow-up:nolostonDec.1,2009;3cases(allinQYHJ)stillsurvive.P=0.046GroupControlQYHJAdverseEffectsP>0.05GIbleedingVomitNorsea

3-4.Thrompenia

3-4.LeucopeniaALPAKPControlPrognosticanalysisof190elderlypatientswithPancreaticcancertreatedbyintegratedHerbsandWesternmedicine

PanY,LiuLM,ChenZ,MengZQ,LinJH,ChenH,

WangK,ShenYH,ZhuXY

ChineseJ.Clin

Hepatol.2014,(30)4:330~333190elderlypancreaticcancerpatientstreatedbyintegratedHerbsandWesternmedicineduringJan.,2002~Dec.,2008.

Provedbyhistopathology63;cytology127;

Female:126,male:64,averageage:67.93±5.54(60~83ys);

UICC

stageⅢ:52(27.4%),stageⅣ138(72.6%)。

distantmetastasis132(69.5%)

survivaltimeofQYHJformulatoTNM-IIIPancreaticcancerinelderlypatientswithnon-surgery

survivaltimeofQYHJformulatoTNM-IVPancreaticcancerinelderlypatientswithnon-surgeryConclusion

Forelderlypatientswithadvancepancreaticcancer,itisbesttochooseQYHJ-basedformulawithoutothers.F,41y,Anhui和县native;Diagnosisdata:01/04/2005;Diagnosis:PancCa(CT:02/2005)withlivermetastasis(liverboispy:04/2005);Cytology:Adenocarcinoma6Case6Treatment

21/02/2005CT:CancerinpancreatictailwithliverM;11/03/2005CT:Cancerinpancreatictailwithlivermulti-M;04/04/2005Liverboipsy:Adenocarcinoma;05/04/20051thliverTACE;28/04/2005PCERT+QYHJ;03/08/2005MRI:Nomassinpancreas;livermulti-M;10/08/20052thliverTACE;14/11/20063thTACE;07/07/2007CT:PRinlivermulti-M.31/12/2009Survives59mons.MRI——MRaftertreatmentBeforeAfterTreatmentCase7ChenxxM,62y,Helongjiang大庆native.Diagnosisdata:21/03/2003Diagnosis:Pancreaticcancerresected(09/1999),Pathology:AdenocarcinomawithliverMLiverbiopsy(12/2002):metastaticpoordifferentiatedAdenocarcinomaStomachCaresected(09/1999),Pathology:AdenocarcinomaTreatment09/1999:Pancreaticcancerresected&StomachCaresected;12/2002:liverM;12/2002:Liverbiopsy:metastaticpoordifferentiatedAdenocarcinoma;03/2003:TACE;04/2003:Oxplatin+5-Fu+CF;04/2003;TACE;05/2003:LiverERT;12/31/2009:Survives6-yearmore.2003.4.15

Case8LinM,53y,Zhejiang瑞安RuiAnnativeDiagnosisdata:

21/03/2005Diagnosis

:PancCa(CT:03/2005)withlivermetastasis(liverboispy:05/2005);Cytology:Liverbiopsy(28/03/2005)poordifferentiatedcarcinomalongsurvivalwithcancer(March,2005~now).Dec.30,2009:

Survives58monsTreatment

31

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