1.Clinical Observation on 45 Cases of Chronic Obstructive Pulmonary Disease in the Stable Phase with Qi Deficiency,Blood Stasis and Phlegm Obstruction Syndrome with Auxiliary Treated with Jinwei Guben Decoction (金卫固本汤) Combined with Bailing Capsule (百令胶囊)
Deyu KONG ; Xudong ZHENG ; Huimin ZHOU ; Ruitao WANG ; Benzhang ZHAO ; Jianjun WU
Journal of Traditional Chinese Medicine 2025;66(4):367-375
ObjectiveTo observe the clinical efficacy of modified Jinwei Guben Decoction (金卫固本汤, MJGD) combined with Bailing Capsule (百令胶囊, BC) in the treatment of chronic obstructive pulmonary disease (COPD) patients in the stable stage with qi deficiency, blood stasis and phlegm obstruction syndrome, in addition to conventional western medicine treatment. MethodsA total of 102 patients with stable COPD and qi deficiency, blood stasis, and phlegm obstruction syndrome were included in the study. According to the patients'preferences, they were divided into treatment group (49 cases) and control group (53 cases). The control group received conventional western medicine treatment, while the treatment group was given MJGD (1 dose daily) combined with BC (2.0 g each time, three times a day) additionally. The treatment period was 3 months, and the patients were followed up for 1 year after the treatment. The acute exacerbation frequency (mild, moderate, severe) before treatment, during treatment, at 6-month follow-up, and at 1-year follow-up was compared between groups. Additionally, the lung function indicators such as FEV1, FEV1%pred, FVC, and FEV1/FVC ratio, traditional Chinese medicine (TCM) syndrome scores, modified British Medical Research Council (mMRC) dyspnea scale, and the COPD Assessment Test (CAT) scores before and after treatment were compared. A logistic regression model was constructed to analyze the impact of MJGD combined with BC on clinical efficacy. ResultsFour patients dropped out from the treatment group and eight from the control group, leaving 45 patients of each group for statistical analysis. The number of mild and moderate acute exacerbations in the treatment group was lower than that in the control group during the treatment period, at 6-month follow-up and within 1 year of follow-up (P<0.05) .The number of severe acute exacerbations was only lower in the treatment group than in the control group at 6-month follow-up (P<0.05). Compared with that before treatment, the number of acute exacerbations of all degrees in the treatment group was significantly reduced within 1 year of follow-up (P<0.05),while only the number of mild acute exacerbations in the control group was significantly reduced within 1 year of follow-up (P<0.05). The treatment group showed significant improvement in FEV1 and FEV1%pred and FEV1/FEV, while the control group showed a significant decline in FEV1 and FVC (P<0.05). After treatment, both groups showed significant reductions in TCM syndrome scores, including coughing, sputum, wheezing, chest tightness, shortness of breath, and fatigue, as well as mMRC and CAT scores (P<0.05), with the treatment group having significantly lower scores than the control group (P<0.05). The overall clinical effective rate of in the treatment group was 93.33% (42/45), significantly higher than that of the control group, 75.56% (34/45, P<0.05). Multivariate logistic regression analysis showed that the use of MJGD combined with BC (OR = 4.68, 95%CI: 1.15 - 19.09, P = 0.03) was positively correlated with clinical efficacy. ConclusionsIn addition to conventional western medicine treatment, the combination of MJGD and BC can reduce the frequency of acute exacerbations, delay the decline of lung function, improve clinical symptoms, and significantly enhance the clinical efficacy in patients with stable COPD and qi deficiency, blood stasis, and phlegm obstruction syndrome.
2.Clinical Efficacy of Jinwei Pingchuan Decoction in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Phlegm-heat Obstruction in Lung Syndrome
Xudong ZHENG ; Deyu KONG ; Benzhang ZHAO ; Huimin ZHOU ; Ruitao WANG ; Jianjun WU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):125-133
ObjectiveTo study the effect of Jinwei Pingchuan decoction combined with conventional Western medicine on the number of acute exacerbations, lung function, and clinical symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) with phlegm-heat obstruction in lung syndrome. MethodsA non-randomized controlled trial was conducted to include 60 patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. Patients were divided into a treatment group and a control group based on whether they received Jinwei Pingchuan decoction, with 30 patients in each group. The treatment group received Jinwei Pingchuan decoction combined with conventional Western medicine therapy, while the control group received conventional Western medicine therapy alone. Both groups received treatment for 7 days. The number of acute exacerbations and lung function indices were followed up and recorded before treatment and three months after treatment. The following outcomes were observed before and after treatment: the number of acute exacerbations, lung function indices (forced expiratory volume in one second [FEV1], percentage of predicted value [FEV1%pred], forced vital capacity [FVC], and FEV1/FVC ratio), the degree of acute exacerbation, TCM syndrome score, COPD assessment test (CAT) score, modified British Medical Research Council Dyspnea Questionnaire (mMRC) score, C-reactive protein (CRP), and white blood cell (WBC) count. ResultsAfter 3 months of follow-up, the treatment group showed a significant reduction in the number of acute exacerbations compared with the pre-treatment values (P<0.05). After treatment, the treatment group had fewer acute exacerbations than the control group (P<0.05). The degree of acute exacerbation in the treatment group improved significantly compared with the pre-treatment values (P<0.05). After treatment, the degree of acute exacerbation in the treatment group was improved compared to the control group (P<0.05). Regarding lung function, FEV1, FEV1%pred, FVC, and FEV1/FVC ratio increased significantly in the treatment group compared with the pre-treatment values (P<0.05), and similar improvements were observed in the control group (P<0.05). After treatment, FEV1 and FVC were higher in the treatment group than the control group (P<0.05). Regarding TCM syndrome scores, the scores for individual symptoms such as wheezing, cough, expectoration, chest tightness, shortness of breath, and fatigue, as well as the total score, decreased significantly in the treatment group compared with the pre-treatment values (P<0.05). In the control group, the scores for cough, expectoration, chest tightness, fatigue, and palpitation, as well as the total score, also decreased (P<0.05). After treatment, the treatment group showed significantly lower scores for wheezing, cough, chest tightness, shortness of breath, and the total score than the control group (P<0.05). Regarding the CAT score, the scores for cough, expectoration, chest tightness, climbing stairs, going out, activity, and energy, as well as the total score, decreased significantly in the treatment group compared with the pre-treatment values (P<0.05). In the control group, the scores for cough, expectoration, chest tightness, sleep, energy, and the total score decreased (P<0.05). After treatment, the treatment group showed significantly lower scores for cough, expectoration, chest tightness, activity, and going out than the control group (P<0.05). Regarding the mMRC score, CRP level, and WBC count, all these parameters decreased significantly in the treatment group compared with the pre-treatment values (P<0.05), and similar reductions were observed in the control group (P<0.05). ConclusionJinwei Pingchuan decoction can reduce the number of acute exacerbations and the degree of acute exacerbation in patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. It also improves lung function and symptoms such as cough and chest tightness, thereby enhancing the quality of life of patients.
3.Clinical Efficacy of Jinwei Pingchuan Decoction in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Phlegm-heat Obstruction in Lung Syndrome
Xudong ZHENG ; Deyu KONG ; Benzhang ZHAO ; Huimin ZHOU ; Ruitao WANG ; Jianjun WU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):125-133
ObjectiveTo study the effect of Jinwei Pingchuan decoction combined with conventional Western medicine on the number of acute exacerbations, lung function, and clinical symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) with phlegm-heat obstruction in lung syndrome. MethodsA non-randomized controlled trial was conducted to include 60 patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. Patients were divided into a treatment group and a control group based on whether they received Jinwei Pingchuan decoction, with 30 patients in each group. The treatment group received Jinwei Pingchuan decoction combined with conventional Western medicine therapy, while the control group received conventional Western medicine therapy alone. Both groups received treatment for 7 days. The number of acute exacerbations and lung function indices were followed up and recorded before treatment and three months after treatment. The following outcomes were observed before and after treatment: the number of acute exacerbations, lung function indices (forced expiratory volume in one second [FEV1], percentage of predicted value [FEV1%pred], forced vital capacity [FVC], and FEV1/FVC ratio), the degree of acute exacerbation, TCM syndrome score, COPD assessment test (CAT) score, modified British Medical Research Council Dyspnea Questionnaire (mMRC) score, C-reactive protein (CRP), and white blood cell (WBC) count. ResultsAfter 3 months of follow-up, the treatment group showed a significant reduction in the number of acute exacerbations compared with the pre-treatment values (P<0.05). After treatment, the treatment group had fewer acute exacerbations than the control group (P<0.05). The degree of acute exacerbation in the treatment group improved significantly compared with the pre-treatment values (P<0.05). After treatment, the degree of acute exacerbation in the treatment group was improved compared to the control group (P<0.05). Regarding lung function, FEV1, FEV1%pred, FVC, and FEV1/FVC ratio increased significantly in the treatment group compared with the pre-treatment values (P<0.05), and similar improvements were observed in the control group (P<0.05). After treatment, FEV1 and FVC were higher in the treatment group than the control group (P<0.05). Regarding TCM syndrome scores, the scores for individual symptoms such as wheezing, cough, expectoration, chest tightness, shortness of breath, and fatigue, as well as the total score, decreased significantly in the treatment group compared with the pre-treatment values (P<0.05). In the control group, the scores for cough, expectoration, chest tightness, fatigue, and palpitation, as well as the total score, also decreased (P<0.05). After treatment, the treatment group showed significantly lower scores for wheezing, cough, chest tightness, shortness of breath, and the total score than the control group (P<0.05). Regarding the CAT score, the scores for cough, expectoration, chest tightness, climbing stairs, going out, activity, and energy, as well as the total score, decreased significantly in the treatment group compared with the pre-treatment values (P<0.05). In the control group, the scores for cough, expectoration, chest tightness, sleep, energy, and the total score decreased (P<0.05). After treatment, the treatment group showed significantly lower scores for cough, expectoration, chest tightness, activity, and going out than the control group (P<0.05). Regarding the mMRC score, CRP level, and WBC count, all these parameters decreased significantly in the treatment group compared with the pre-treatment values (P<0.05), and similar reductions were observed in the control group (P<0.05). ConclusionJinwei Pingchuan decoction can reduce the number of acute exacerbations and the degree of acute exacerbation in patients with acute exacerbation of COPD with phlegm-heat obstruction in lung syndrome. It also improves lung function and symptoms such as cough and chest tightness, thereby enhancing the quality of life of patients.
4.Improvement effect of metformin on liver injury in non-alcoholic steatohepatitis rats
Shuang WU ; Hailin CHENG ; Dan LIU ; Ting XIAO ; Xingbang WU ; Huadong LI ; Xudong HU
China Pharmacy 2025;36(7):837-842
OBJECTIVE To investigate the effects of metformin (Met) on liver injury in non-alcoholic steatohepatitis (NASH) rats by regulating the PI3K/AKT/PDGF signaling pathway. METHODS NASH model was constructed by feeding rats with a high- glucose and high-fat diet, and assigned into Model group, Met low-dose group (Met-L group, 100 mg/kg), Met medium-dose group (Met-M group, 200 mg/kg), Met high-dose group (Met-H group, 400 mg/kg), and high dose of Met+PI3K activator group (Met-H+740 Y-P group, 400 mg/kg Met+50 mg/kg 740 Y-P), with 12 rats in each group. Another 12 rats were regarded as the Control group. Each group of rats was orally administered/injected with the corresponding medication once a day for 6 consecutive weeks. The changes in body weight and liver index of rats were recorded and analyzed. The pathological damage [evaluation of non-alcoholic fatty liver disease activity score (NAS)], lipid deposition (calculation of the proportion of oil red O-positive staining area), and fibrosis (calculation of collagen deposition score) were observed in liver tissue of rats. The levels of inflammatory factors [interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] in serum and liver tissue, the levels of serum lipid metabolism indicators [total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C)] and liver function indicators [aspartate aminotransferase (AST) and alanine Δ 基金项目 武汉市知识创新专项项目(No.2022020801010588); aminotransferase (ALT)] were measured. The expression levels of PI3K/AKT/PDGF signaling pathway-related proteins and Caspase-3 in liver tissue of rats were determined. RESULTS Compared with the Control group, body weight, liver index, the levels of serum lipid metabolism indicators and liver function indicators, the levels of IL-6 and TNF-α in serum and liver tissue, the NAS, the proportion of oil red O-positive staining area, the collagen deposition fraction, and the levels of phosphorylated PI3K and AKT proteins, as well as the expression levels of PDGF and Caspase-3 proteins in liver tissue, were all significantly increased (P<0.05). The liver tissue showed severe pathological damage, characterized by an abundance of lipid droplets and pronounced collagen deposition. After the intervention with Met, the aforementioned quantitative indicators and pathological changes in rats were significantly improved in a dose- dependent manner (P<0.05). 740 Y-P could reverse the improvement effects of high dose of Met on the above indexes of rats (P< 0.05). CONCLUSIONS Met can improve liver damage, and alleviate inflammatory reactions and liver fibrosis of NASH rats, the mechanism of which may be associated with inhibiting PI3K/AKT/PDGF signaling pathway.
5.Individualized treatment and pharmaceutical care for breast cancer complicated with chronic kidney disease
Lu YU ; Xudong WU ; Ming ZHANG
China Pharmacy 2025;36(7):853-857
OBJECTIVE To provide a reference for individualized treatment and pharmaceutical care for patients with breast cancer complicated with chronic kidney disease (CKD). METHODS Clinical pharmacists participated in the anti-tumor treatment and pharmaceutical care for a breast cancer patient with CKD. Clinical pharmacists reviewed guidelines and literature to assist the clinical physician in formulating the initial neoadjuvant treatment plan (docetaxel+trastuzumab+paltuzumab) and provided monitoring recommendations for potential adverse drug reactions, such as vomiting, myelosuppression, renal impairment, cardiotoxicity. In response to the patient’s acute kidney injury after treatment, clinical pharmacists assisted the physician in analyzing the cause of the adverse reaction through causality assessment. Taking into account the patient’s preferences, docetaxel was substituted with paclitaxel (which did not require dose adjustment based on renal function). The clinical pharmacists collaborated with the physician to establish a postoperative targeted therapy regimen (trastuzumab+pertuzumab). Taking into account the patient’s positive estrogen receptor status, the clinical pharmacists recommended to initiate regular anastrozole administration after the completion of radiotherapy and undergo periodic bone density assessments. RESULTS The clinical physician accepted the suggestions from the clinical pharmacists. The patient successfully completed preoperative neoadjuvant chemotherapy and postoperative targeted therapy, and was discharged with medication (anastrozole). During the treatment process, the patient did not experience adverse reactions such as myelosuppression, cardiotoxicity, or the occurrence of osteoporosis. CONCLUSIONS Clinical pharmacists analyzed and adjusted the preoperative and postoperative antitumor treatment plans based on the patient’s renal function. They promptly assessed the correlation between antitumor drugs and acute kidney injury, and actively implemented comprehensive pharmaceutical care to ensure medication safety for breast cancer patients with CKD.
6.Rapid Analysis of the Chemical Composition of Zhangbang Nine Steaming Nine Sun-dying Rehmanniae Radix Based on UPLC-Q-TOF-MS Technique and Study on the Function of Solid Excipiemts in Alleviating the "Nourishing and Spleen-impairing" in Rehmanniae Radix
Xudong ZHU ; Wei YAO ; Feixia YAN ; Dong HUANG ; Song WANG ; Na ZHU ; Mingming YUAN ; Liping HUANG ; Yi WU
Chinese Journal of Modern Applied Pharmacy 2024;41(10):1332-1342
OBJECTIVE
To study the chemical composition and the function of solid excipients in relieving the "nourishing and spleen-impairing" effect of Zhangbang nine steaming nine sun-dying Rehmanniae Radix(RR) by using UPLC-Q-TOF-MS technique.
METHODS
UPLC-Q-TOF-MS was used to collect the data of Zhangbang nine steaming nine sun-dying RR, and UNIFI platform and self-built database were used for the rapid qualitative analysis and identification of the chemical components of Zhangbang nine steaming nine sun-dying RR. The effect of solid excipients on the function of RR "nourishing and spleen-impairing" was investigated by establishing a mouse model of low gastric motility and measuring its gastric residual rate and small intestine propulsion rate.
RESULTS
The UPLC-Q-TOF-MS and UNFI platforms identified 76 chemical components in nine steaming nine sun-dying RR, including 9 iridoid glycosides, 11 phenylethyl glycosides, 31 flavonoids, 6 saccharides and 19 other compounds; the results of gastric emptying and small intestinal propulsion experiments on mice showed that Zhangbang nine steaming nine sun-dying RR had gastric emptying and intestinal propulsion effects.
CONCLUSION
This method can be used for the rapid identification and analysis of nine steaming nine sun-dying RR, which has solid excipients Citri Reticulatae Pericarpium and Amomi Fructus to alleviate the "nourishing and spleen-impairing" function of RR. This study can provide a reference for quality control and elucidation of the material basis of the medicinal effects of specialty beverage of Zhangbang nine steaming nine sun-dying RR.
7.Phase Ⅱ clinical trial of PD-1 inhibitor combined with chemotherapy for locally advanced resectable oral squamous cell carcinoma
Hongling WANG ; Kai YUE ; Yansheng WU ; Yuansheng DUAN ; Chao JING ; Xudong WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2024;59(4):335-342
Objective:To explore the effectiveness and safety of programmed death 1(PD-1) inhibitory combined with chemotherapy as a neoadjuvant therapy for locally advanced resectable oral squamous cell carcinoma.Methods:This study was a randomized controlled phase Ⅱ trial. Patients recruited from Tianjin Medical University Cancer Institute and Hospital from July 2021 to February 2023 were randomly divided into two groups in a 1∶1 ratio: the experimental group (Toripalimab combined with albumin paclitaxel and cisplatin) and the control group (albumin paclitaxel and cisplatin); patients in both groups underwent three cycles of neoadjuvant therapy. After completion of neoadjuvant therapy, patients were evaluated and subsequent surgical treatment was performed. According to the completion of treatment, the analysis was conducted on both the full analysis set and the protocol set. The effectiveness and safety of treatments were evaluated. SPSS 20.0 software was used for statistical analysis.Results:A total of 41 cases with oral cancer were enrolled, including 26 males and 15 females, aged between 34 and 74 years old. There were 23 cases in the experimental group and 18 cases in the control group. A total of 23 cases completed neoadjuvant therapy and surgery according to the protocol. Experimental group and control group showed respectively the complete response rates of 1/19 and 0/17, the partial response rates of 13/19 and 8/17, the stage-down rates of 4/19 and 3/17, the pathologic complete response rate of 8/14 and 2/9, with no statistically significant differences in individual rates between two groups ( P>0.05). The major pathological response rate of 13/14 in experimental group was higher than that of 2/9 in control group ( P<0.05). The incidence of grade 3-4 adverse reactions related to treatment was low in both groups (4/23 vs. 3/18, χ 2=0.13, P=0.72), and the most common serious adverse reactions in the experimental group were granulocyte deficiency and electrolyte disorder. There were no adverse reactions that affected subsequent surgical treatment or caused death, and the safety and tolerability were good. The median follow-up time was 15 months, and the one-year disease-free survival rate of the experimental group was higher than that of control group (92.86% vs. 77.78%, χ 2=0.62, P=0.42), with a relative decrease of 87% in the risk of disease progression or death ( P=0.029). For patients with programmed death-ligand 1(PD-L1) protein expression combined positive score≥20, the experimental group showed higher major pathological response rate than control group (5/5 vs. 0/4, P=0.03). Conclusion:The neoadjuvant therapy of immunotherapy combined with chemotherapy can improve the pathological remission of oral squamous cell carcinoma and the long-term survival benefits and the prognosis of patients.
8.Application value of MEX3A,CDX2,MUC2 and MUC5AC in judging cancerous gastric mucosal intestinal metaplasia
Mengyuan ZHANG ; Jiarui LIU ; Zhong ZHANG ; Lanlan JIAO ; Min ZHANG ; Wei BO ; Jiayu GOU ; Chengcheng WU ; Xudong YANG ; Xuguang WANG
China Modern Doctor 2024;62(10):1-5
Objective To investigate the correlation between MEX3A and differentiation characteristics of gastric cancer and intestinal metaplasia,and its combination with caudal-related homeobox transcription factor 2(CDX2)and mucin 2(MUC2)and mucin 5AC(MUC5AC)to determine the role of carcinogenic intestinal metaplasia.Methods From January 2010 to December 2014,a total of 410 cases of gastric cancer and paracarcinoma paraffin-embedded tissue samples were selected from the Central Hospital Affiliated to Shenyang Medical College and the Second Hospital Affiliated to Shenyang Medical College.According to pathological diagnosis,they were divided into control group(mild superficial gastritis,79 cases),intestinal metaplasia group(149 cases)and gastric cancer group(182 cases).The expressions of MEX3A,CDX2,MUC2 and MUC5AC were detected by immunohistochemistry.Results MEX3A was highly expressed in gastric cancer group and intestinal metaplasia group,especially diffuse gastric cancer,poorly differentiated gastric cancer and type Ⅲ intestinal metaplasia(P<0.05).CDX2 and MUC2 were highly expressed in gastric cancer group and intestinal metaplasia group,especially intestinal type gastric cancer,highly and moderately differentiated gastric cancer,type Ⅰ and type Ⅱ intestinal metaplasia(P<0.05).The expression of MUC5AC was high in control group and low in gastric cancer group and intestinal metaplasia group,especially in intestinal type gastric cancer,type Ⅰ and type Ⅲ intestinal metaplasia(P<0.05).Gastric cancer and intestinal metaplasia differentiation were negatively correlated with MEX3A and MUC5AC expression,but positively correlated with CDX2 and MUC2 expression(P<0.05).MEX3A was negatively correlated with the expression of CDX2 and MUC2,and positively correlated with the expression of MUC5AC in gastric cancer(P<0.05).MEX3A was negatively correlated with the expression of CDX2 and MUC2 in intestinal metaplasia(P<0.05),while CDX2 was positively correlated with the expression of MUC2(P<0.05).Conclusion MEX3A is negatively correlated with gastric cancer and intestinal metaplasia differentiation.Gastric cancer is characterized by high MEX3A expression and low CDX2 and MUC2 expression.
9.Sinensetin protects against periodontitis through binding to Bach1 enhancing its ubiquitination degradation and improving oxidative stress
Yuan ZHIYAO ; Li JUNJIE ; Xiao FUYU ; Wu YU ; Zhang ZHITING ; Shi JIAHONG ; Qian JUN ; Wu XUDONG ; Yan FUHUA
International Journal of Oral Science 2024;16(3):553-562
Periodontitis is a chronic inflammatory and immune reactive disease induced by the subgingival biofilm.The therapeutic effect for susceptible patients is often unsatisfactory due to excessive inflammatory response and oxidative stress.Sinensetin(Sin)is a nature polymethoxylated flavonoid with anti-inflammatory and antioxidant activities.Our study aimed to explore the beneficial effect of Sin on periodontitis and the specific molecular mechanisms.We found that Sin attenuated oxidative stress and inflammatory levels of periodontal ligament cells(PDLCs)under inflammatory conditions.Administered Sin to rats with ligation-induced periodontitis models exhibited a protective effect against periodontitis in vivo.By molecular docking,we identified Bach1 as a strong binding target of Sin,and this binding was further verified by cellular thermal displacement assay and immunofluorescence assays.Chromatin immunoprecipitation-quantitative polymerase chain reaction results also revealed that Sin obstructed the binding of Bach1 to the HMOX1 promoter,subsequently upregulating the expression of the key antioxidant factor HO-1.Further functional experiments with Bach1 knocked down and overexpressed verified Bach1 as a key target for Sin to exert its antioxidant effects.Additionally,we demonstrated that Sin prompted the reduction of Bach1 by potentiating the ubiquitination degradation of Bach1,thereby inducing HO-1 expression and inhibiting oxidative stress.Overall,Sin could be a promising drug candidate for the treatment of periodontitis by targeting binding to Bach1.
10.Clinical efficacy and safety analysis of helical tomotherapy for esophageal cancer
Hao YIN ; Xudong WU ; Lei WANG
Journal of International Oncology 2024;51(9):578-584
Objective:To compare the clinical efficacy of helical tomotherapy in the treatment of esophageal cancer, explore its influence on nutrition status, blood routine indexes, inflammatory factors and immune function, and analyze its safety.Methods:A total of 124 patients with esophageal cancer treated in Liyang People's Hospital of Jiangsu Province from May 2021 to April 2023 were selected as the study objects, and the patients were divided into the helical tomotherapy group ( n=62) and the modulated arc therapy group ( n=62) according to random number table method. The clinical efficacy, nutritional status [transferrin (TRF), prealbumin (PAB), serum albumin (ALB) ], blood routine indexes [hemoglobin (HGB), neutrophils count, white blood cells (WBC) count, platelets count], the inflammatory factors [C-reactive protein (CRP), interleukin (IL) -6, IL-18, tumor necrosis factor-α (TNF-α) ], immune function indexes [CD3 + T cells, CD4 + T cells, CD4 + T cells/CD8 + T cells ratio, natural killer (NK) cells], and the rate of adverse reactions were statistically analyzed. Results:The disease control rate of treatment in the helical tomotherapy group (88.71%, 55/62) was significantly higher than that in the modulated arc therapy group (74.19%, 46/62), with a statistically significant difference ( χ2=4.32, P=0.038). After treatment, TRF [(178.42±19.24) μg/dl vs. (171.27±18.19) μg/dl, t=2.13, P=0.035], PAB [(0.37±0.11) g/L vs. (0.31±0.09) g/L, t=3.32, P=0.001], ALB [(4.25±0.52) g/dl vs. (4.01±0.58) g/dl, t=2.43, P=0.017] in the helical tomotherapy group were higher than those in the modulated arc therapy group, with statistically significant differences. After treatment, HGB [(125.49±13.87) g/dl vs. (112.37±14.49) g/dl, t=5.21, P<0.001] in the helical tomotherapy group were higher than those in the modulated arc therapy group; neutrophils count [(4.91±0.75) ×10 9/L vs. (5.37±0.84) ×10 9/L, t=3.22, P=0.002], WBC count [(4.96±0.52) ×10 9/L vs. (5.26±0.61) ×10 9/L, t=2.95, P=0.004], platelets count [(227.15±25.38) ×10 9/L vs. (241.37±26.91) ×10 9/L, t=3.03, P=0.003] in the helical tomotherapy group were lower than those in the modulated arc therapy group, with statistically significant differences. After treatment, CRP [(7.76±0.84) mg/dl vs. (8.11±1.01) mg/dl, t=2.10, P=0.038], IL-6 [(6.47±0.81) μg/L vs. (7.16±0.93) μg/L, t=4.41, P<0.001], IL-18 [(191.01±23.14) μg/L vs. (201.62±22.96) μg/L, t=2.56, P=0.012, ) and TNF-α [(3.65±0.41) μg/L vs. (3.82±0.43) μg/L, t=2.25, P=0.026] in the helical tomotherapy group were lower than those in the modulated arc therapy group, with statistically significant differences. After treatment, the proportion of CD3 + T cells [(41.27±5.45) % vs. (35.48±5.17) %, t=6.07, P<0.001], the proportion of CD4 + T cells [(36.11±4.49) % vs. (29.24±9.52) %, t=9.48, P<0.001], CD4 + T cells/CD8 + T cells ratio (1.35±0.19 vs. 1.21±0.13, t=4.79, P<0.001), the proportion of NK cells [(14.68±2.79) % vs. (12.37±1.86) %, t=5.42, P<0.001] in the helical tomotherapy group were higher than those in the modulated arc therapy group, with statistically significant differences. The rate of adverse reactions in the helical tomotherapy group (80.65%, 50/62) was significantly lower than that in the modulated arc therapy group (93.55%, 58/62), with a statistically significant difference ( χ2=4.59, P=0.032) . Conclusion:Helical tomotherapy is more effective than modulated arc therapy in the treatment of esophageal cancer, which can improve nutrition levels, reduce immunity decline, and has high safety.


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