Case Report on Long Term Survival of Glioblastoma Patient Treated with Integrative Medicine

Article information

J Korean Med. 2018;39(1):75-85

Publication date (electronic) : 2018 March 31

doi : https://doi.org/10.13048/jkm.18008

Juno Yang ¹, Youngju Yun ²^,³, Jinwoo Hong ²^,³

, Changwoo Han ²^,³, Jungnam Kwon ²^,³

, In Lee ²^,³, Seongha Park ²^,³, Soyeon Kim ²^,³, Junyong Choi ²^,³

, Hyeyoon Lee ²

¹Kyungheeyedang Oriental Medical Clinic

²School of Korean Medicine, Pusan National University

³Department of Internal Medicine, Pusan National University Korean Medicine Hospital

Correspondence to: 윤영주 (Youngju Yun), 경남 양산시물금읍 금오로 20, 부산대학교 한의학전문대학원, Tel: +82-55-360-5955, Fax: +82-55-360-5909, E-mail: mdkmdyun@pusan.ac.kr

Received 2017 December 29; Revised 2018 March 7; Accepted 2018 March 12.

Abstract

Objectives: This is a long-term survival case report about glioblastoma treated with western medicine and traditional Korean medicine. 28 year-old man diagnosed glioblastoma in 2003 went through 2 year’s chemotherapy first. After emergency brain surgery he took acupuncture and Korean herbal medication including Dohongsamul-tang and Boan-Manyeongdan in addition to conventional radiotherapy and chemotherapy for 3 years. Since May 2008, he was exclusively treated with traditional Korean medicine except taking antiplatelets only for 9 years. Though he has sequelae of tumor necrosis such as facial palsy and hemiparesis, he has survived without recurrence more than 14 years. We suggest that integrative approach including traditional Korean medicine can be a meaningful treatment option for malignant brain tumor. Further studies with more cases should be performed to establish proper treatment protocol of integrative medicine for brain tumor.

Keywords: Glioblastoma; Traditional Korean Medicine; Integrative Medicine

Fig 1

Brain MRI before and after the First Surgery (2005.05.19)

Lt: before (2005.05.15), Rt: after (2005.05.20)

Fig. 3

Brain MRI (2006. 06.27)

Fig. 5

Brain MRI Suspicious of Tumor Progression (2006.11.21)

Table 1

Contents of treatment and results between 2005-05-30 and 2008-05-21.

Table 2

Contents of treatment and results between 2008-05-22 and 2017-08.

References

1. Louis DN, Perry A, Reifenberger G, Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016;10.1007/s00401-016-1545-1.

2. Nicholas S, Mathios D, Ruzevick J, Jackson C, Yang I, Lim M. Current Trends in Glioblastoma Multiforme Treatment: Radiation Therapy and Immune Checkpoint Inhibitors. Brain Tumor Res Treat 2013;1:2–8.

3. Jung KW, Yoo H, Kong HJ, Won YJ, Park S, Lee SH. Population-based survival data for brain tumors in Korea. J neurooncol 2012;109:301–307.

4. Jeong JS, Park JW, Yoon SW. A Case of Metastatic Brain Tumor Patient with Nausea and Vomiting Treated with Gamibokryungbanha-tang. Korean J Orient Int Med 2007;28(4):956–962.

5. Jeong UM, Kim HM, Jeong JS, Lee JS, Kim KS, Yoon SW. A Case Report of Regressed Metastatic Brain Tumors and Prolongation of Life with Allergen Removed Rhus verniciflua Stokes after Gamma Knife Radiosurgery. J Korean Med 2009;30(5):157–162.

6. Kang Th, Won JH. Clinical Study on 1 Case of Patient with Astrocytoma. J Korea Oriental Oncology 2000;6(1):181–188.

7. Wang Z, Chen S, Wang L. A Comprehensive Curative Effect of Malignant Brain Tumors Treated With VM26+MeCCNU and TCM. Cancer Prev Treat Res 2000;27(2):152–153.

8. Zhou J, Liu H, Zhao M. Clinical research on Naoliu (Brain Tumor) powder in treating brain gliomas. Tianjin J Trad Chinese Med 2008;25(4):277–280.

9. Fan Y, Hu Y, Li Y. Antifebrile Effect of Naoreqing oral Liquid on Post-operational Fever of Glioma or Meningioma Patients. Cninese J Int Med 2001;21(6):406–408.

10. Zhang J. Analysis of Application of High Doses of Aconite Treatment of Typical Cases of Brain Tumor. Systems Med 2016;1(4):60–63.

11. Sun W, Cui J, Zhu Y, Cao Y, Sun Y, Wang Z. Discussion and Analysis of Contemporary Famous Chinese Medicine Experts’ Clinical ExPeriences in Treating Brain Tumors. J Liaoning Univ TCM 2014;16(4):59–60.

12. Guo C, Zhu G. Summary of the Features of Qian Bowen’s Thoughts on Clinical Treatment of Brain tumor. World Chinese Med 2015;10(10):1552–1554.

13. Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report:primary brain and central nervous tumors diagnosed in the United States in 2005–2009. Neuro Oncol 2012;14(suppl5):v1–v49.

14. Do YS, Jung KW, Ha J, Seo Y, Park CK, Won YJ, et al. An Updated Nationwide Epidemiology of Primary Brain Tumors in Republic of Korea, 2013. Brain Tumor Res Treat 2017;5(1):16–23.

15. Omuro A, DeAngelis LM. Glioblastoma and Other Malignant Gliomas: A Clinical Review. JAMA 2013;310(17):1842–1850.

16. Chung MJ, Park JY, Bang S, Park SW, Chung JB, Song SY. Phase II clinical trial to evaluate the efficacy and safety of activated T-lymphocyte cell therapy in gemcitabine refractory advanced pancreatic cancer. Pancreatology 2013;13(4):S45.

17. Shin YS, Lee JA, Bae SH, Lee SY, Jang MK. Investigation into the Use of Complementary and Alternative Medicine and Factors Affecting Use in Korean Patients with Brain Tumors. J Korean Acad Fundam Nurs 2013;20(2):147–156.

18. Lee JK, Song YK, Lim HH. Analgesic and anti-inflammatory effect of Scutellaria baicalensis. J Korean Med 2007;28(4):124–135.

19. Lee HY, Kim JE, Kim M, Kim JH. A review of traditional Korean medical treatment for cancer-related cognitive impairment. J Korean Med 2016;37(3):74–86.

20. Verlut C, Mouillet G, Magnin E, Buffet-Miny J, Viennet G, Cattin F, et al. Age, Neurological Status MRC scale, and Postoperative Morbidity are Prognostic Factors in Patients with Glioblastoma Treated by Chemoradiotherapy. Clinical Med Insight: Oncology 2016;:1077–1082.

Article information Continued

Fig 1

Brain MRI before and after the First Surgery (2005.05.19)

Lt: before (2005.05.15), Rt: after (2005.05.20)

Fig. 2

Brain MRI Suspicious of Recurrence (2005. 11.17)

Fig. 3

Brain MRI (2006. 06.27)

Fig. 4

Brain MRI after the Second Surgery (2006.07.06)

Fig. 5

Brain MRI Suspicious of Tumor Progression (2006.11.21)

Fig. 6

Brain MRI (2009.01.08)

Fig. 7

Brain MRI of Hemorrhage (2010.04.13)

Fig. 8

Brain MRI (2015.06.11.)

Table 1

Contents of treatment and results between 2005-05-30 and 2008-05-21.

Period	2005.05.30~2005.06.21	2005.06.21~2006.03.29	2006.03.30~2008.05.21
Western medicine	Status post right temporal craniotomy & gross total resection of tumor with temporal lobectomy Depakin, Medilac DS, Gliatilin, Ascorbic acid, Levopride	Radiotherapy 30 times (05.06.09~08.04) dendritic cell implantation 3 times (05.09.07~10.21) Radioitherapy (05.12.08~12.21) Temodal 4 times (05.11.17~06.02.23)	PCV (06.03.30) Subtotal resection of tumor (06.07.05) PCV (3 times), Temodal (6 times) (06.03.30.~07.02.12) Embolectomy of left iliac vein (stent insertion), Warfarin sodium 5mg (06.08.30) Nolvadex 10mg 1Tab twice/day -> 5Tab twice/day Embolectomy of left iliac vein (07.07.14)
Clinically important events	-	Brain edema & compression of cerebral ventricle (05.12.08~12 21)	Right facial paralysis and left side hemiparesis (06.05.02) Progress in Facial paralysis and hemiparesis (06.06.27) appetite hyperactivity, body weight gain (07.08.23)
Brain MRI	-	suspicion of recurrence at primary site (05.11.17. Fig. 2)	Brain edema. No progression in brain tumor. Necrosis of most tumor tissue (06.07.05 Fig. 4) tumor progressioin (07.11.21)
Herbal medication	半夏白朮天麻湯(for 3weeks)	桃紅四物湯加味方I 保安萬靈丹小柴胡湯加味方	桃紅四物湯加味方II 加人蔘桃紅四物湯加味方II 加人蔘, 鹿茸右歸飮加人蔘, 鹿茸
Targets for herbal medicatioin	Protection of normal brain tissue Prevention of brain edema Promotion of thrombus absorption	桃紅四物湯加味方I: prevention of tumor recurrence 保安萬靈丹: hemiparesis 小柴胡湯加味方: fever due to radiotherapy	桃紅四物湯加味方II 加人蔘: tumor and general weakness 桃紅四物湯加味方II 加鹿茸: bone marrow dysfunction 右歸飮加人蔘, 鹿茸: severer bone marrow dysfunction
Acupuncture	風池, 風府, 啞門, 曲池, 三陰交

PVC: Procarbazine, Lomustine (CCNU), Vincristine

Table 2

Contents of treatment and results between 2008-05-22 and 2017-08.

Period	2008.05.22~2010.04.12	2010.04.13
Herbal medication	桃紅四物湯加味方II 保安萬靈丹	桃紅四物湯加味方 II 加牧丹皮, 三七根
Targets for herbal medication	桃紅四物湯加味方II: prevention of tumor recurrence 保安萬靈丹: prevention of tumor recurrence, alleviation of paralysis	Absorption of hemorrhage
Brain MRI	Improvement in enhancing lesion (09.01.08. Fig. 6)	Cerebral hemorrhage (10.04.13. Fig 7) No specific findings (15.06.11. Fig 8)
Clinically important event	Hiccup (10.04.13)	aPTT=3.08, (11.07 19.) Warfarin sodium 5mg stop aPTT=1.8, (11.07.22.) Warfarin sodium 2.5mg start
Acupuncture	Acupuncture on the paralyzed region to reduce spasticity and muscle stiffness, and to promote improvement by sensory stimulation

aPTT: activated partial thromboplastin time