2016中医药治疗胰腺癌长期带瘤生存的作用及机制复旦大学肿瘤医院刘鲁明

QYHJ Formula-based Integrated Herbs and Western medicine Therapy in Elderly Patients with Pancreatic Cancer,Luming Liu Department of Integrative Oncology Fudan University Cancer Hospital Shanghai China,Stage distribution at diagnosis and 5-year relative survival rate among patients with pancreatic cancer US,1996-2003,5-year relative survival rate,Stage distribution at diagnosis,From Jemal, A. et al. CA Cancer J Clin 2008;58:71-96.,The 4th leading cause of cancer-related mortality in U.S.A.,Edwards BK et al. Annual report to the nation on the status of cancer, 19731999, featuring implications of age and aging on U.S. cancer burden. Cancer, 2002,41pancreatic cancer occurs over 75 years old,71pancreatic cancer occurs over 65 years old,Standardized Incidence of cancer in Shanghai City,Incidence of pancreatic cancer from1972-1999 increased 72.2 in male and 56.2 in female，2 or so increase every year.,A rapidly increasing trend in the incidence for PC:the 8th and 9th for men and women in Shanghai,LIU Jusi,et al. Tumor 2004,24(1)11-15,ca,CharacteristicsinElderly Patients with Cancers,Ageing and sickly;Cancer progression relatively slow;Cancer metastasis probably less;Multiple primary carcinoma increasing; Poor tolerance to Chem & RT（because of its losing physiological function inelderly patients）,A retrospective study on advanced pancreatic cancer treated by TCM Herbs - An analysis of 56 casesLiu LM, Wu LC, Lin SY,et al. Therapeutic Evaluation on Advanced Pancreatic Cancer Treated by Integrative Chinese and Western Medicine - Clinical Analysis of 56 Cases.,Chin J Integrative Med, 2003, 9(1): 39-43.,56 cases with advanced pancreatic cancer treated by chemotherapy alone or chemotherapy combined with TCM decoctionThe TCM+CHEMO group had a better survival over the CHEMO group （P0.04）There was a superiority of chemotherapy combined with TCM to chemotherapy in objective response (p=0.049) and in improvement of symptoms (P0.002）,Case 1 67y, F. Symptoms before operation: Jaundice, upper abdominal pain;Tumor size: 89cmOperation time: Oct.8,1997 ,Tumor unresected,1999,FENG Erbao Nov 2004 7-year birthday,Follow up in xinhua（新华 ） Hospital Hangzhou in March 18，2006,1,1,1,232 cases from May 1, 2002-Dec. 31, 2005 were reviewed, and 134 cases with advanced pancreatic cancer had pathological diagnosis were included in this analysis (94 no prior treatment, 40 had treatment).We excluded 98 cases (no pathology 64, not-proven by pathology 16, neuroendocrine carcinoma 2，no mass after pancreatic operation 7；clinical data incomplete 4；herbs treatment 1month 5, stage II 10 例、 stage III 15、 stage IV 109 with remote M).,A Retrospective Study on Advanced Pancreatic Cancer Treated with Integrated Western Medicine and Traditional Chinese herbs: Analysis of 134 Cases 2002-2005Shen Ye-hua, Liu Lu-ming, Meng Zhi-qiang, Chen Zhen, Lin Jun-hua, Zhou Zhen-hua, Chen Hao, Wang Kun, Fu Jie, Yu Er-xinDepartment of Integrated Oncology，FudanUniversity Cancer Hospital,Survival,Median Survival 5.7monsHalf yr survival 47.01-yr survival 17.52-yr survival 8.7%3-yr survival 7.2%,QYHJ Herbs P0.05,GI bleeding,Vomit,Norsea,3-4. Thrompenia,3-4. Leucopenia,ALP,AKP,Control,Prognostic analysis of 190 elderly patients with Pancreatic cancer treated by integrated Herbs and Western medicinePan Y, Liu LM, Chen Z, Meng ZQ, Lin JH, Chen H, Wang K, Shen YH, Zhu XYChinese J. Clin Hepatol. 2014, (30)4: 330333,190 elderly pancreatic cancer patients treated by integrated Herbs and Western medicine during Jan. ,2002Dec., 2008 . Proved by histopathology 63; cytology 127; Female:126，male:64，average age: 67.935.54（6083ys); UICC stage : 52(27.4%)， stage 138 (72.6%)。 distant metastasis 132 ( 69.5%),survival time of QYHJ formula to TNM-III Pancreatic cancer in elderly patientswith non-surgery,survival time of QYHJ formula to TNM-IV Pancreatic cancer in elderly patients with non-surgery,Conclusion,For elderly patients with advance pancreatic cancer, it is best to choose QYHJ-based formula without others.,F，41y，Anhui 和县 native;Diagnosis data: 01/04/2005;Diagnosis: Panc Ca(CT:02/2005) with liver metastasis(liver boispy:04/2005);Cytology: Adenocarcinoma,6,Case 6,Treatment 21/02/2005 CT：Cancer in pancreatic tail with liver M;11/03/2005 CT：Cancer in pancreatic tail with liver multi-M;04/04/2005 Liver boipsy:Adenocarcinoma;05/04/2005 1th liver TACE;28/04/2005 PC ERT+QYHJ;03/08/2005 MRI： No mass in pancreas； liver multi-M;10/08/2005 2th liver TACE;14/11/2006 3th TACE;07/07/2007 CT： PR in liver multi-M.31/12/2009 Survives 59 mons.,MRIMR after treatment,Before,After Treatment,Case 7 Chen xx,M，62y，Helongjiang大庆 native.Diagnosis data：21/03/2003Diagnosis：Pancreatic cancer resected（09/1999), Pathology: Adenocarcinoma with liver MLiver biopsy（12/2002）：metastatic poor differentiated AdenocarcinomaStomach Ca resected（09/1999), Pathology: Adenocarcinoma,Treatment,09/1999: Pancreatic cancer resected & Stomach Ca resected;12/2002: liver M;12/2002: Liver biopsy：metastatic poor differentiated Adenocarcinoma;03/2003: TACE;04/2003: Oxplatin+5-Fu+CF;04/2003; TACE;05/2003: Liver ERT;12/31/2009: Survives 6-year more.,2003.4.15,Case 8 Lin,M，53y，Zhejiang 瑞安 RuiAn nativeDiagnosis data： 21/03/2005Diagnosis ： Panc Ca(CT:03/2005) with liver metastasis(liver boispy:05/2005);Cytology: Liver biopsy (28/03/2005) poor differentiated carcinoma,long survival with cancer,(March, 2005 now). Dec. 30, 2009: Survives 58 mons,Treatment 31/03/2005 1th liver TACE19/07/2005 3th liver TACE;28/07/2005 HIFU for pancreatic mass; 12/06/2008 11th liver TACE;,8,Case 10 Zhang xx,F，51y，Shanghai Native1st Diagnosis：08/10/2004CT：mass in pancreatic head with liver metastasis Liver biopsy：AdenocarcinomaFollow up: 16/01/2010. Survival time:63 mons.,Jan.,2010,08/10/200416/01/2010,10,Fewer side-effects and toxicity than western medicine;Tolerated well for extended periods of time;Inexpensive.It is a suit