Effect of traditional Chinese medicine treatment as maintenance therapy on regulating the serum concentration of sCTLA-4 in patients with advanced non-small-cell lung cancer and its relationship with prognosis
10.3760/cma.j.issn.0253-3766.2016.10.009
- VernacularTitle:中医综合维持治疗方案对晚期非小细胞肺癌患者血清中可溶性细胞毒T淋巴细胞相关抗原4的影响及其与预后的关系
- Author:
Yi JIANG
1
;
Libo WU
;
Liping SHEN
;
Peng ZHANG
;
Weijie JIANG
;
Jianhui TIAN
;
Lingshuang LIU
Author Information
1. 200032上海中医药大学附属龙华医院肿瘤科
- Keywords:
Carcinoma,non-small-cell lung;
CTLA-4 antigen;
Time to progression;
Traditional Chinese medicine treatment;
Treatment outcome
- From:
Chinese Journal of Oncology
2016;38(10):757-762
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of traditional Chinese medicine ( TCM) treatment as maintenance therapy on regulating the serum concentration of soluble cytotoxic T lymphocyte associated antigen?4 ( sCTLA?4) in patients with advanced non?small?cell lung cancer ( NSCLC) and the relationship between sCTLA?4 and time to progression ( TTP ) . Methods This study was conducted as a prospective, randomized, controlled trial. 64 non?progressive patients who responded to initial therapy were randomized 1 ∶ 1 to the TCM arm ( treated with cinobufacini injection, herbal decoction and Chinese acupoint application, n=32) or to the chemotherapy arm (n=32). Each cycle was 21 days. Cycles were repeated until disease progression, unacceptable toxicity, or until the patient requested therapy discontinuation. The serum concentration of sCTLA?4 was detected by enzyme linked immunosorbent assay ( ELISA ) in the 64 patients with advanced NSCLC before and after two cycles of maintenance treatment. Cox regression was used to analyze the relative ratio for the risk of disease progression. Results After 2 cycles of maintenance TCM treatment, the serum concentration of sCTLA?4 in patients with advanced NSCLC was (12.77±2.37 pg/ml), significantly lower than that before treatment (40.30±10.75)(P=0.013). After 2 cycles of maintenance chemotherapy, the serum concentration of sCTLA?4 was higher than that before treatment, but was not significantly different (44.48±10.12 vs. 46.64±11.21 pg/ml, P=0.612). After 2 cycles of maintenance treatment, TCM treatment can significantly bring down the serum concentration of sCTLA?4 compared to chemotherapy (12.77±2.37 vs. 46.64±11.21 pg/ml, P=0.004). The multivariate analysis indicated that sCTLA?4 levels and treatment regimen were independent prognostic factors for TTP ( P<0. 05 for both ) . Conclusions Regulating the serum concentration of sCTLA?4 may be one of the mechanisms of TCM maintenance treatment of NSCLC. Trial registration Chinese Clinical Trial Register, ChiCTR?TRC?10001017.
