Case Report on Complete Response and 5 year Survival of Non-Small Cell Lung Cancer IIIB Patient Treated with Integrative Medicine

Article information

J Korean Med. 2021;42(1):119-128
Publication date (electronic) : 2021 March 01
doi : https://doi.org/10.13048/jkm.21009
1Hwirim Korean Medicine Hospital
2School of Korean Medicine, Pusan National University
3Department of Internal Medicine, Pusan University Korean Medicine Hospital
Correspondence to: 윤영주 경남 양산시 물금읍 금오로 20, 부산대학교 한의학전문대학원 Tel: +82-55-360-5955, Fax: +82-55-360-5909, E-mail: mdkmdyun@pusan.ac.kr
Received 2021 January 18; Revised 2021 February 15; Accepted 2021 February 15.

Abstract

Objectives

This is a five-year survival case report on non-small cell lung cancer (NSCLC) treated with western medicine and traditional Korean medicine. 44-year old man diagnosed NSCLC IIIB in 2015 went through two months’ concurrent chemoradiotherapy (CCRT) first, however the cancer did not response. After CCRT he began to take intensive integrative therapy including acupuncture, abdominal moxibustion, wild ginseng pharmacopuncture, herbal medicinal product of ginseng, hyperthermia, Thymosin α1, and mega vitamin C injection for 4 years and 9 months. After three months of intensive treatment, the state of cancer changed first to partial response and then complete response. He finally succeeded in five-year survival without any recurrence or complication in 2020, We suggest that integrative approach including traditional Korean medicine can be a meaningful treatment option for nonoperable NSCLC. Further studies with more cases should be performed to establish proper treatment protocol of integrative medicine for lung cancer.

Fig. 1

Change of Chest CT

1-1) first diagnosis(2015.09.01) - Lymph Node(LN) Enlargement(long→subcarinal, short→left interlobar)

1-2) stable disease(2015.10.24), 1-3) partial response(2015.12.14) – decreased size of LN

1-4) complete response(2016.03.15) – nomal size of LN. 1-5) no change(2016.07.19), 1-6) 5 year survival(2020.08.25)

Fig. 2

Change of PET/CT

2-1) first diagnosis(2015.09.09)- abnormal hyper metabolic lesion

2-2) partial response(2015.12.18)-marked decrease of hypermetabolism

Western Medicine Treatment and Results between 2015-09-21 and 2015-12-07

Integrative Treatment and Results between 2015-12-08 and 2020-08-31

References

1. Annual Report of national cancer statistics in Korea in 2017 National Cancer Center; 2019.
2. Jeong SH, Jung JH, Lee HW, Kang SY, choi YW, Ahn MS, et al. Concurrent Chemoradiotherapy with Weekly Paclitaxel for Locally Advanced Non-small Cell Lung Cancer. J Lung Cancer 2009;8(1):8–12.
3. Wu X, Chung VC, Lu P, Poon SK, Hui EP, Lau AY, et al. Chinese Herbal Medicine for Improving Quality of Life Among Nonsmall Cell Lung Cancer Patients: Overvies of Systematic Reviews and Network Meta-Analysis. Medicine 2016;95(1):e2410.
4. Liu J, Lin HS, Hou W, Hua BJ, Zhang PT, Li J, et al. Comprehensive treatment with Chinese medicine in patients with advanced non-small cell lung cancer: A multicenter, prospective, cohort study. Chin J Integr Med 2017;23(10):733–739.
5. Han GJ, Cho MJ, Park EJ, Seong S, Kim SS, Kim KI, et al. Analysis of existing guidelines and randomized, controlled, clinical trials for development of [guideline of clinical trial with herbal medicinal product for lung cancer]. J Korean Med 2019;40(1):153–173.
6. Jung HJ, Kim JD. The Role of Korean Medicine for Treatment and Management for Lung Cancer. J Kor Trad Oncol 2015;20(1):45–54.
7. Kin KS. Case Study: Regression of a residual tumor and prolongation of overall survival with allergen-removed Rhus Verniciflua stokes after chemoradiotherapy in locally advanced non-small cell lung cancer. J Int Korean Med 2015;36(2):200–206.
8. Park SJ, Kang HJ, Park JH, Cho CK, Yoo HS. A case report of a clinically diagnosed advanced lung cancer patient after treatment with Gunchilgyebok-Jung. J Kor Trad Oncol 2015;20(1):23–29.
9. Zheng HM, Yoon JW, Lee YW, Cho CK, Ph DS, Yoo HS. Case Series of advanced non-small cell lung cancer patients treated with Hang-am Plus. J Int Korean Med 2011;32(1):113–120.
10. Park SJ, Kim SY, Cho CK, Jung IC, Yoo HS. Preliminary study to develop the instrument of oriental medical evaluation for lung cancer. J Korean Med 2015;36(3):53–64.
11. Park JG, Bang YJ, Ha SH. Oncology 2nd rev edth ed. Seoul: Iljogak; 2012. p. 224–239.
12. NCCN clinical practice guidelines in oncology (ver.8) National Comprehensive cancer network; 2020.
13. Costa GJ, Ferreira CG, Thuler CS. Concurrent chemoradiotherapy for stage III non-small cell lung cancer: corredt clinical management as the basis to move beyond. Ann Transl Med 2018;6(Suppl 1):S65.
14. Lee JC, Yun HY, Yoo HS, Bang SH. A case report of complete response of advanced gastric carcinoma patient treated with Korean medicine treatment in conjuction with chemoradiation therapy. J Kor Trad Oncol 2014;19(1):25–32.
15. Wust P, Hildebrandt B, Sreenivasa G, Rau B, Gellermann J, Riess H, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol 2002;3(8):487–497.
16. Garaci E, Pica F, Matteucci C, Gaziano R, D’Agostini C, Miele MT, et al. Historical review on thymosin α1 in oncology: preclinical and clinical experiences. Expert Opin Biol Ther 2015;15(Suppl 1):S31–9.
17. Fritz H, Flower G, Weeks L, Cooley K, Callachan M, McGowan J, et al. Intravenous Vitamin C and Cancer: A Systematic Review. Integr Cancer Ther 2014;Jul. 13(4):280–300.
18. Kwon KR, Kim HD, Kim JS, Yoo HS, Cho CK. Case series of Non-small cell Lung cancer treated with mountain Ginseng pharmacopuncture. J Acupunct Meridian Stud 2011;4(11):61–68.
19. Dai D, Zhang CF, Williams S, Yuan CS, Wang CZ. Ginseng on Cancer: Potential Role in Modulating Inflammation-Mediated Angiogenesis. Am J Chin Med 2017;45(1):13–22.

Article information Continued

Fig. 1

Change of Chest CT

1-1) first diagnosis(2015.09.01) - Lymph Node(LN) Enlargement(long→subcarinal, short→left interlobar)

1-2) stable disease(2015.10.24), 1-3) partial response(2015.12.14) – decreased size of LN

1-4) complete response(2016.03.15) – nomal size of LN. 1-5) no change(2016.07.19), 1-6) 5 year survival(2020.08.25)

Fig. 2

Change of PET/CT

2-1) first diagnosis(2015.09.09)- abnormal hyper metabolic lesion

2-2) partial response(2015.12.18)-marked decrease of hypermetabolism

Table 1

Western Medicine Treatment and Results between 2015-09-21 and 2015-12-07

Period Diagnosis and Follow up Result Treatment
2015.09.21~11.09.
CCRT
2015.10.24. chest CT. (after CTx#2, RTx#20) No gross interval change in size of the multiple LNs enlargement
→ Stable Disease
CTx #1(09.21) #2(10.12) #3 (11.03)
Monotaxel (docetaxel) 100mg + Unistin (Cisplastin) 100mg
RTx 09.21.~11.09.
RTx#30 (60Gy)
2015.10.20.~12.01.
Treatment for radiation esophagitis
10.01. (after RTx#7) mild pain in swallowing. discomfort in eating
10.15. (after RTx#16) mild dysphagia.
10.20. pain in swallowing.
10.20 Medication
(Talimephin, Ulcerimin, Menisolon, Ranix)
10.22.(after RTx#20) diagnosed as radiation esophagitis
Grade II–III.
Durogesic patch
10.26~12.01. pain in swallowing, dysphagia. Durogesic patch, Talimephin, Ulcerimin, Menisolon, Ranix

Table 2

Integrative Treatment and Results between 2015-12-08 and 2020-08-31

western medicine treatment Korean medicine treatment Follow up Result
  • - Hyperthermia (Celsius TCS®) on chest for 50min, three times a week.

  • - Thymosin α1 1.6mg injection (SQ or IM). twice a week.

  • - Mega vitamin C IV injection. twice a week. (normal saline 750ml + vitamin 60g + ginkobal 1 ample + B-comhexa 1 ample)

  • - Viscum Album 20mg/mL SQ injection, twice a week.

  • - Glutathione IV injection. twice a week.(Glutathione 600mg + normal saline 100ml)

  • - Acupuncture bid 15 min. (LI4, LI6, ST42, ST40, PC7, HT7, LR3, KI3, LU8)

  • - Moxibustion qd 60min (around CV8)

  • - Pharmacopuncture :Cultivated wild Ginseng 5ml qd (ST 25, CV12)

  • - Ginsenopil (wild ginseng powder 3g+honey 2g) 1T qd

  • - RGS 50ml (boiled decoction including wild ginseng powder 6.6g) qd

  • - Anti-cancer Plus 500mg tid

2015.12.14. chest CT. Decreased size of multiple LNs enlargement at both lower paratracheal, subcarinal, and left interlobar areas
2015.12.18. PET/CT. Decreased size and glucose metabolism of metastatic lymphadenopathies
→ Partial Response
2016.03.15. chest CT. More decrease in size of the residual LNs enlargement at both lower paratracheal and subcarinal areas
→ Complete Response
2016.07.19. chest CT. No change
2017.03.22. ~2020.03.17 chest CT every 6 months
No change
2020.08.25. chest CT. No change
→ 5 year survival.

CT: computed tomography, LN; lymph node, PET; positron emission tomography, SQ: subqutaneous, IM; intramuscular, IV; intravenous