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

Sunhwi Bang; Youngju Yun; Junyong Choi; Changwoo Han; Soyeon Kim; Seongha Park; Jinwoo Hong; Jungnam Kwon; In Lee; Bang, Sunhwi; Yun, Youngju; Choi, Junyong; Han, Changwoo; Kim, Soyeon; Park, Seongha; Hong, Jinwoo; Kwon, Jungnam; Lee, In

doi:10.13048/jkm.21009

JKM > Volume 42(1); 2021 > Article

Bang, Yun, Choi, Han, Kim, Park, Hong, Kwon, and Lee: Case Report on Complete Response and 5 year Survival of Non-Small Cell Lung Cancer IIIB Patient Treated with Integrative Medicine

Case report

The Journal of Korean Medicine 2021; 42(1): 119-128.

Published online: March 01, 2021

DOI: https://doi.org/10.13048/jkm.21009

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

Sunhwi Bang¹

, Youngju Yun²^{, 3}

, Junyong Choi²^{, 3}

, Changwoo Han²^{, 3}

, Soyeon Kim²^{, 3}

, Seongha Park²^{, 3}

, Jinwoo Hong²^{, 3}

, Jungnam Kwon²^{, 3}

, In Lee²^{, 3}

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 January 18, 2021 Revised February 15, 2021 Accepted February 15, 2021

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.

Keywords: Non-Small Cell Lung Cancer, Concurrent Chemoradiotherapy, Traditional Korean Medicine, Integrative Medicine

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
2015.09.21~11.09. CCRT		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

참고문헌

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 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.