Systematic review and meta-analysis of endometrial thickening during endocrine therapy combined with Chinese herbal medicine intervention after breast cancer surgery

Objective:To systematically evaluate the endometrial thickening and Chinese herbal medicine intervention effects during endocrine therapy following breast cancer surgery.Methods:Computerized searches were performed on CNKI,CBM,Wanfang,VIP,Pub Med,Embase,and Cochrane to gather randomized controlled trials(RCTs)of endometrial thickening combined with Chinese herbal medicine intervention during endocrine therapy after breast cancer surgery.The meta analysis is done using Rev Man 5.4,and the retrieval range is from the database's creation to January 2023.Results:There were 710 patients enrolled in a total of 12 RCTs.The results of Meta-analysis were as follows:combined with Chinese herbal medicine treatment for 3 months of endometrial thickness(MD=-1.12,95%CI[-1.47,0.77],P<0.00001);6 months endometrial thickness(MD=-1.90,95%CI[-2.38,-1.42],P<0.00001);endometrial thickness at 12 months(MD=-2.24,95%CI[-2.96,-1.52],P<0.00001);modified Kupperman score(MD=-10.45,95%CI[-19.10,-1.80],P=0.02);TCM syndrome score(SMD=-1.53,95%CI[-1.84,-1.22],P<0.00001);KPS score(MD=3.75,95%CI[2.81,4.68],P<0.00001);there was no significant difference in CA153,CEA,FSH and E2 between the two groups.Conclusion:After breast cancer surgery,endocrine therapy combined with Chinese herbal medicine can significantly lessen endometrial thickening and enhance patient quality of life.

Chinese Herbal Medicine for Lung Cancer:A Critical Literature Review

INTRODUCTIONLung cancer (LC) is one of the most prevalent malignancies with high mortality and poor progno-sis. In 1990, LC represented 12.8% of the total new cancer cases and 17. 8% of the total cancer deaths, while five-year survival was only 11%. Current management for LC includes surgery for localised tumours, and chemotherapy or radiotherapy for those at an advanced stage when tumours have spread to other organs. Patient resistance to these approaches, which is often based on concerns about adverse effects, may reduce the acceptance of these therapies by LC patients.

Use of Chinese Herbal Medicine as an Adjuvant for Cancer Treatment: A Randomized Controlled Dose-Finding Clinical Trial on Lung Cancer Patients

Background: Cancer has become a leading cause of death world-wide. In Hong Kong, cancer accounted for 24.8% of deaths in 1980, rising to 31.3% in 1998. The conventional treatment of cancer usually includes surgery, radiotherapy and chemotherapy. These conventional therapies do not guarantee not relapse and are often associated with serious side effects. Using Chinese Medicine (CM) as an adjunctive treatment is commonly practiced in Chinese Communities to support patients being treated with conventional modern medicine, with the aim of alleviating the side effects, and improving self-defense and their quality of life. Well-designed and conducted clinical trials could give evidence of the efficacy of CM. This study investigated the clinical efficacy through the well designed clinical trial, and the implementation of carrying out the trial, to assess the adjuvant and supportive effect on lung cancer patients. Methods: The clinical study was designed as a randomized controlled trial to investigate the dose-dependent effects. Primary endpoint was the difference of Functional Assessment of Cancer Therapy-General (FACT-G) score. Results: 41 eligible subjects were enrolled and randomly divided into 2 groups, 21 in high dose group and 20 in low dose group. Sub-domains of PWB (Physical well-being) and EWB (Emotional well-being) as well as FACT-G total score were significantly improved in high dose group when compared with low dose group after 12 weeks treatment (p = 0.015, 0.006 and 0.012, respectively). Conclusions: Holistic approach using quality of life as parameters to evaluate the efficacy of CM is an important compromise. Well-designed clinical trial can provide convincing evidence to support CM’s efficacy. The study demonstrated that quality of life of patients with lung cancer could be beneficial from the supportive care with CM.

Chinese Herbal Medicine for Lung Cancer——A Critical Literature Review(Continued)

CLINICAL STUDIES Clinical studies on Chinese herbal medicine(CHM)in lung cancer(LC)have largely been on anumber of basic formulae selected by syndrome(Zheng)differentiation,or specific formula basedon clinical experience.There have also been anumber of studies comparing combination ofCHMs with either chemotherapy or radiotherapywith chemotherapy or radiotherapy alone,to as-sess any additional benefits or synergistic outcomesof the combination.

Gemcitabine and cisplatin combined with the Chinese herbal medicine compound Fuzhenggubenfang improve quality of life and progression-free survival in patients with advanced non-small cell lung cancer

目的：评估化疗联合扶正固本方治疗晚期非小细胞肺癌的作用.方法：2013年10月至2016年7月共收治符合条件的患者84例.随机分配到接受化疗的对照组和化疗联合扶正固本方的实验组.研究的主要终点指标是生活质量（QOL）和无进展生存期（PFS）.次要终点指标是肿瘤反应率,化疗相关毒性,出组率,QOL和PFS临床病理因素的单因素和多因素分析.结果：实验组较对照组总体生活质量包括躯体功能、角色功能、情绪功能、认知功能、社会功能均有显著改善（均P〈0.001）,疲乏、恶心或呕吐、失眠、食欲减退、便秘亦显著改善（均P〈0.001）.实验组较对照组获得更好的PFS且有显著性差异（P=0.032）.两组肿瘤反应率无显著性差异.扶正固本方明显减少化疗引起的贫血,中性粒细胞减少、恶心、呕吐（均P〈0.001）,且只有轻微的副作用.本研究中影响QOL的临床病理因素包括：中药（P〈0.001）、体力状态评分（P=0.027）、临床分期（P=0.009）、性别（P=0.044）.影响PFS的临床病理因素包括中药（P=0.043）和既往化疗次数（P=0.003）.结论：扶正固本方可通过改善晚期非小细胞肺癌患者QOL,改善患者对治疗的治疗依从性,减轻化疗相关毒副反应,从而改善PFS,提高生存率,是晚期非小细胞肺癌治疗期间可选择的辅助用药.

The effect of long-term traditional Chinese medicine treatment on disease-free survival of postoperative stage I-III lung cancer patients:a retrospective cohort study

Objective:Traditional Chinese medicine(TCM)has been extensively used as one of popular alternative therapies for several cancers.However,it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients.In this study,we explored the effect of long-term TCM treatment on patients with different stages of lung cancer.Methods:All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study.Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group(control group).All patients were regularly followed up by clinic appointment or phone,and all survival data were collected from databases after the last follow-up in October 2017.Results:A total of 575 patients were included in this study,with 299 patients in the TCM group and 276 in the control group.For all patients,5-year disease-free survival(DFS)was 62.2% in TCM group and 42.1% in the control group,and 6-year DFSs were 51.8% and 35.4%,respectively(HR=0.51,95% CI:0.40 to 0.66,log-rank P≤0.001).For patients with stage I,5-year DFSs were 83.7%(TCM group)and 57.5%(control group)and 6-year DFSs were 73.7% and 51.9%,respectively(HR=0.30,95% CI:0.18 to 0.50,log-rank P≤0.001).For patients with stage II in the TCM group and the control group,5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%,respectively(HR=0.31,95% CI:0.19 to 0.52,log-rank P≤0.001),and for patients with stage III,5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group(HR=1.06,95% CI:0.72 to 1.56,log-rank P=0.76).Conclusions:This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients,especially in patients with stage I and II disease.However,these observational findings need being validated by large sample randomized controlled trials.

Use of Chinese Herbal Medicine Therapies in Comprehensive Hospitals in Central China: A Parallel Survey in Cancer Patients and Clinicians

Summary： Chinese herbal medicine （CHM）, as the largest application category of traditional Chinese medicine （TCM）, is widely accepted among cancer patients in China. Herbal slice （HS） and Chinese patent drug （CPD） are commonly used CHM in China. This study aimed to investigate the utilization of CHM among clinicians and cancer patients in central China. Five hundred and twenty-five patients and 165 clinicians in 35 comprehensive hospitals in central China were asked to complete an anonymous questionnaire that was designed to evaluate the use of CHM. The results showed that 90.74% clinicians and 72.24% cancer patients used CHM during cancer treatment. The educational backgrounds of the clinicians and the age, education level, annual income, and cancer stage of the cancer patients were re- lated to use of CHM. More than 90% clinicians and cancer patients had used CPD. Comparatively, the percentage of HS use was 10% lower than that of CPD use among clinicians and cancer patients. More clinicians preferred to use CHM after surgery than cancer patients did （20.41% vs. 5.37%）. Enhancing physical fitness and improving performance status were regarded as the most potential effect of CHM on cancer treatment （85.71% among clinicians and 94.07% among cancer patients）, in comparison with directly killing tumor cells （24.49% among clinicians and 31.36% among patients）. As for refusal rea- sons, imprecise efficacy was the unanimous （100%） reason for clinicians＇ rejection of CHM, and 95.58% patients objected to using CHM also for this reason. Furthermore, the side effects of CHM were more concerned by clinicians than by patients （33.33% vs. 15.81%）. In conclusion, our survey revealed that CHM was popularly accepted by clinicians and cancer patients in central China. The reasons of use and rejection of CHM were different between clinicians and cancer patients.

The application of traditional Chinese medicinesynthetic effect criteria in the late stage lung cancer

Objective To inspect the correlation of synthetic effect criteria to sensitivity,reliability of late stage lung cancer curative effect verdict and median survival time. Method Using size change of tumor,symptom change related to tumor,Karnofsky score,body weight etc.as synthetic effect criteria and instituting clinical synthetic effect criteria,to assess the curative effect of late stage lung cancer patients who received different treatment in department of tumor of Xiyuan Hospital between March 1997 and March 2000, to analysis medium survival time, and being compared with RR of tumor.Result 52 patients entered this experiment, in which 42 patients were assessable (follow-up), 13 patients were effective(30.95%),17 were patients stable(40.48%),12 patients deteriorated (28.57%).The result of tumor objective remission rate: CR is 0,PR is 16.67%(7 patients),NC is 64.29%(27 patients) and PD is 19.05% (8 patients).There was apparent difference between two effect criteria(P< 0.05).The mean survival time of this group is (9.3±1.6)months,median survival time is 10.5 months(2～28months),survival rate of one year is 33.33%(14 patients).In the patients who live longer than median survival time, most of them survive associated with tumor existence who are in NC of tumor objective remission rate, but also in the effective column of synthetic effect criteria. Compared with tumor objective remission rate,the synthetic effect criteria have more apparent correlation to survival time. Conclusion In the assessment of late stage lung cancer,synthetic effect criteria has better sensitivity and reliability,and emphasize survival quality,at same time it reflect the reaction of tumor and host to treatment,it reflect prognosis of tumor preferably and have better correlation to the survival time. It can be used as clinical effect criteria of late stage lung cancer after further consummation.

Thinking on the Treatment of Lung Cancer by Regulating Lung-Intestinal Axis Microecology by Traditional Chinese Medicine

The intestinal microecological disorder is closely related to the occurrence and development of lung cancer and the treatment response.This paper starts with the relationship between the lungintestinal axis,to discuss the possibility of TCM regulating the target of intestinal microecological treatment of lung cancer,so as to provide new research ideas for TCM treatment of lung cancer.

Exploration on Integrative Traditional Chinese and Western Medicine Strategy for Treating Patients of Lung Cancer over 80 Years Old

Lung cancer incidence and mortality are much higher among elderly patients over 80 years'old.However,surgery,chemo and radiotherapy,target therapy all are refined in treating this population.This article summarized 3 types of over 80 years'old elderly cancer patient in real world,which include:1.advanced non-small cell lung cancer that cannot be tolerated by targeted therapy;2.Suspected lung malignancies for which a clear pathological diagnosis cannot be obtained;3.Advanced lung cancer with distance metastasis at first diagnosis.The current paper summarized real cases from YANG Yu-fei at Xiyuan Hospital and her traditional Chinese medicine treatment methods and experiences to guide further clinical practice were discussed and shared.

Analysis of the law of traditional Chinese medicine in prevention and treatment of gastrointestinal reaction caused by lung cancer chemotherapy

Objective:To explore the law of traditional Chinese medicine in prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer.Methods:The literatures on prevention and treatment of gastrointestinal reaction after chemotherapy with Chinese medicine were searched from CNKI,Wanfang and VIP databases from the establishment of the database to September 2020.After screening,the database was established,and data mining was conducted by using IBM SPSS statistics 20.0 and IBM SPSS modeler 18.0 to summarize the medication rules of traditional Chinese medicine in the prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer.Results:(1)A total of 131 literatures involving 245 traditional Chinese medicines were included for data mining;(2)High frequency drugs include Astragalus membranaceus,liquorice,Poria cocos,Atractylodes macrocephala,Pinellia ternata,Codonopsis pilosula,Ophiopogon japonicus,coix seed,Pericarpium Citri Reticulatae,Radix Glehniae and so on;(3)The traditional Chinese medicine used is mainly tonifying deficiency medicine,resolving phlegm and relieving cough and asthma medicine,diuresis and dampness medicine,heat clearing medicine and antiphlogistic medicine.The medicine tastes bitter and sweet,and has cold and warm properties.The meridian tropism involves liver,lung,stomach,spleen and kidney;(4)Seven core TCM combinations were obtained by cluster analysis,and 24 drug pairs(groups)were obtained by association rule analysis.Conclusion:Through the data mining of traditional Chinese medicine for the prevention and treatment of gastrointestinal reaction after chemotherapy for lung cancer,we can find out the potential rules of traditional Chinese medicine prescription,and clarify the core Chinese medicine,which is helpful to provide certain reference for the development and research of drugs for the treatment of gastrointestinal reaction and modern clinical practice.

Nursing perspective of the expert consensus on diagnosis and treatment of integrated Chinese and Western medicine in lung cancer

Lung cancer is a malignant tumor with the highest incidence and mortality in China,which seriously affects the quality of life of patients.Traditional Chinese medicine(TCM)plays a unique advantage in the treatment and rehabilitation of lung cancer.In order to standardize TCM diagnosis and treatment and disease management of clinical medical workers,the Chinese Association of Integrative Medicine issued the“Expert Consensus on the Diagnosis and Treatment of Lung Cancer by Integrated Traditional Chinese and Western Medicine”in August 2021.Experts’recommendations were made on the clinical staging and syndrome differentiation and classification of lung cancer,characteristic TCM therapies,and nursing care of integrated traditional Chinese and Western medicine.This article interpreted the Consensus on the above aspects from a nursing perspective,hoping to provide references for clinical medical workers in the treatment and nursing care of lung cancer.

Progress in research of single-flavor Chinese medicine extracts in treatment of non-small cell lung cancer

Lung cancer is one of the diseases with high morbidity and mortality,and non-small cell lung cancer accounts for a large proportion of it.Traditional Chinese medicine has a long history in treating tumors.More and more researchers have paid more attention to it.At present,many studies have proved that traditional Chinese medicine extracts such as astragalus,turmeric,ginseng,coix seed,and gallbladder can inhibit tumor cell proliferation,and have synergistic effects when used in combination with radiotherapy and chemotherapy Its mechanism of action is mostly related to regulating the cell cycle,inhibiting the expression of cancer-related genes,and inducing apoptosis.It is believed that with the development of purification technology,Chinese medicine extracts will play a greater role.

Effects and safety of Chinese herbals containing Houttuynia cordata Thunb in the treatment of lung cancer:a systematic review

Objective:This study systematically evaluates the efficacy and safety of Houttuynia cordata in the treatment of lung cancer in order to provide clinical data support for better application of Houttuynia cordata.Methods:PubMed,EMbase,Web of Science,ScienceDirect,Scopus,CNKI,WanFang Data,VIP and SinoMed were used to retrieve clinical observations and clinical controlled studies of Houttuynia cordata in the treatment of lung cancer.The retrieval time ranges from database building to January 2019.Two researchers independently screened literature,extracted data and conducted computational analysis.Result:In the clinical observational study,12 literatures of pure Chinese medicine treatment(1473 patients)and 4 literatures of combined Chinese and Western medicine treatment(193 patients)were compared.The total effective rate and total stable rate of combined Chinese and Western medicine treatment for tumour control were better,but the total improvement rate of quality of life of combined Chinese and Western medicine treatment was lower than that of pure Chinese medicine,and the incidence of adverse reactions such as bone marrow suppression and gastrointestinal tract reaction was also higher than that of pure Chinese medicine.Chinese medicine In the clinical control study,8 articles(567 patients)in the treatment group were treated by Chinese medicine and 9 articles in the treatment group(530 patients)were treated by combination of Chinese and Western medicine.Compared with Chinese medicine group,the total effective rate and total stability rate in the control of tumor size were higher in the combination of Chinese and Western medicine;The survival rate of 0.5~2 years was higher,and the total effective rate of body weight gain was slightly higher in the combination of Chinese and Western medicine.At the same time,the incidence of side effects was significantly higher than that of pure Chinese medicine treatment group.In addition,compared with the control group,the incidence of all side effects in the pure Chinese medicine group was lower.Compared with the control group,besides"bleeding","oral reaction"and"skin reaction",the probability interval of side effects in the treatment group was less than that in the control group,and the degree of side effects was also less than that in the chemotherapy group.Conclusion:In the treatment of lung cancer,the use of herbs containing Houttuynia cordata combined with western medicine or radiotherapy and chemotherapy not only has good curative effect,but also reduces toxicity and side effects.Therefore,the combination of herbs with western medicine has unique advantages,which deserves further in-depth research and development.

Progress in diagnosis and treatment of small cell lung cancer with integrated traditional Chinese and Western medicine

Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.

An Expert Consensus of Integrated Chinese and Western Medicine Treatment on Lung Cancer

Lung cancer is a malignant tumor of the lung originating from the bronchial mucosa,glands or alveolar epithelium.With the population aging and environmental pollution getting increasingly severe,lung cancer has become the malignant tumor with the highest incidence and mortality rate in China,seriously endangering people’s life and health.However,there is no standardized guideline for the integrated Chinese and Western medicine treatment of lung cancer in China.In order to standardize and improve integrated Chinese and Western medicine diagnosis and treatment of lung cancer in China,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,together with oncologists from the Sun Yat-sen University Cancer Center,compiled this consensus under the coordination of the Medical Policy Department of the National Administration of Traditional Chinese Medicine,taking into account the main results of the pilot project of Chinese and Western Medicine Clinical Collaboration for Major Difficult Diseases(lung cancer).

Nano-formulated delivery of active ingredients from traditional Chinese herbal medicines for cancer immunotherapy

Cancer immunotherapy has garnered promise in tumor progression, invasion, and metastasis through establishing durable and memorable immunological activity. However, low response rates, adverse side effects, and high costs compromise the additional benefits for patients treated with current chemical and biological agents. Chinese herbal medicines (CHMs) are a potential treasure trove of natural medicines and are gaining momentum in cancer immunomodulation with multi-component, multi-target, and multi-pathway characteristics. The active ingredient extracted from CHMs benefit generalized patients through modulating immune response mechanisms. Additionally, the introduction of nanotechnology has greatly improved the pharmacological qualities of active ingredients through increasing the hydrophilicity, stability, permeability, and targeting characteristics, further enhancing anti-cancer immunity. In this review, we summarize the mechanism of active ingredients for cancer immunomodulation, highlight nano-formulated deliveries of active ingredients for cancer immunotherapy, and provide insights into the future applications in the emerging field of nano-formulated active ingredients of CHMs.

The roles of traditional Chinese herbal medications in regulating mitochondrial activity to reverse cancer

Cancer was gradually regarded as a metabolic disease,which might be linked to impairment of mitochondrial function.There are really some essential differences between the mitochondria of normal and cancer cells,which might become promising target for cancer chemotherapy.According to western pharmacology,a known target was needed for drug development.Unfortunately,the number of therapeutic agents relating to the mitochondrion are severely limited because of lacking of knowledge about mitochondrial biology.Unlike the“Western Medicine”,some traditional Chinese herbal medicine(TCHM)might be prone to targeting mitochondria despite the lack of precise molecular mechanisms.If it is the case,we might be able to screen and identify active anti-cancer drugs from traditional Chinese therapeutics by using mitochondrial functional assay.In this review,we would give an overview of the effect of TCHM on the mitochondrion,and the challenges and breakthroughs remaining in cancer treatment.

Efficacy and safety of Kang’ai injection adjunct with TP chemotherapy for the treatment of non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Background:Combination therapy with traditional Chinese medicine and chemotherapy was proposed as a therapeutic strategy for non-small cell lung cancer patients.Therefore,we performed a systematic review and metaanalysis of randomized controlled trials to assess effects of this combination therapy on non-small cell lung cancer.To evaluate the efficacy and safety of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the treatment of non-small cell lung cancer.Methods:A randomized controlled study of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the databases of China National Knowledge Infrastructure Database,WanFang Database,VIP Database,Sino-Med Database,PUBMED,EMBASE and Cochrane library was searched by computer.The literatures published from the database establishment to July 1,2020 were included in the search scope.After 2 evaluators independently evaluated and cross checked the quality of the study,Revman 5.3 was used to meta analyze the clinical effect of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy on patients with non-small cell lung cancer.Results:A total of 1,370 lung cancer patients were included in 20 RCTs.The results of meta-analysis showed that there were significant differences between the 2 groups in clinical efficacy(RR=1.32,95%CI(1.20,1.44)),quality of life(RR=1.44,95%CI(1.32,1.57)),immune function(MD=0.53,95%CI(0.23–0.83)),adverse reactions(RR=0.49,95%CI(0.41,0.58)).Conclusion:The Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy is effective and safe in the treatment of non-small cell lung cancer,and has great prospects for further development.However,the quality of evidence was very low-to-moderate.Considering the poor quality of evidence,we are not very confident in the results.We look forward to more research and update results in the future and improve the evidence quality.

Traditional Chinese medicines for non-small cell lung cancer: Therapies and mechanisms

The most common subtype of lung cancer is non-small cell lung cancer(NSCLC), which has a poor prognosis and seriously threatens the health of human beings. The multidisciplinary comprehensive treatment model has gradually become the mainstream of NSCLC treatment. Traditional Chinese medicine(TCM) can be used effectively either as an adjunctive therapy or alone throughout the NSCLC therapy,which has a significant impact on survival, quality of life, and reduction of toxicity. Therefore, this paper reviewed the theoretical basis, the latest clinical application, and combined treatment mechanisms in order to explore the advantage stage of TCM treatment and the synergistic therapeutic mechanisms.