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2TMR Integrative Medicine  2019, 3: e19005.       DOI: 10.12032/TMRIM201903005
    
Chinese herbal protocol anti-fibrosis 1 improves radiation induced fibrosis and its related dysfunctions
Dong-Mei Jiang1, Ying-Ying Jin1, Liu-Hua Long1, Li-Jue Zhang1, Si-Hai Tan1, Pei-Pei Song1, Long Zhang1, Tai Zhang1, Wen-Hua Zhang1, Feng-Wei Wang1,*()
1Department of Oncology, Tianjin People’s Hospital, Tianjin 300180, China.
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Highlights:

In this study, TCM was used to treat the local fibrosis and the corresponding dysfunction was significantly improved. It shows that TCM has a good prospect in the treatment of radiation injury.

Abstract

Objective: Radiotherapy is the main modality for treatment of malignancies, but radiation fibrosis is a severe side effect of radiotherapy which may cause severe dysfunction of patients. We design a new traditional Chinese herbal protocol, which is named as Anti-fibrosis 1, and use it in patients with severe radiation fibrosis. Methods: From Feb 2013 to Feb 2014, 23 patients with severe radiation fibrosis and apparent dysfunction were treated with anti-fibrosis 1. There were 7 patients with nasopharyngeal carcinoma, 7 with oral cavity and oral pharyngeal carcinoma, 2 with pharyngeal carcinoma, 2 with breast carcinoma, 2 with esophageal carcinoma and 3 patients with pelvic malignancies. All patients received radiotherapy at least 0.5-8 years ago, and 22 patients with complete response, but all patients suffered with severe radiation fibrosis. The radiation dosage was among 50-74Gy/25-37f/35-70d. Patients status of fibrosis and recovery of tissue and organ were evaluated after 0.5, 1.5 and 3 months of herbal treatment. Results: 22 of 23 patients were head and neck carcinoma, 20 patients had got partial relief after 15 days medication with anti-fibrosis 1, nearly all patients had got apparent relief after 1.5 month of medication. But, there was no apparent difference between 1.5 month and 3 months group. There were no apparent side effects after the herbal treatment. Conclusions: The traditional Chinese herbal protocol anti-fibrosis 1 is an effective and safe modality for radiation fibrosis. And the apparent effect occurred after 1.5 month of herbal medication.



Key wordsKey Words: Radiation fibrosis      TCM      Side effects      Cancer     
Published: 09 March 2019
Corresponding Authors: Wang Feng-Wei   
E-mail: wfengwei2004@tom.com
Cite this article:

Dong-Mei Jiang, Ying-Ying Jin, Liu-Hua Long, Li-Jue Zhang, Si-Hai Tan, Pei-Pei Song, Long Zhang, Tai Zhang, Wen-Hua Zhang, Feng-Wei Wang. Chinese herbal protocol anti-fibrosis 1 improves radiation induced fibrosis and its related dysfunctions. 2TMR Integrative Medicine, 2019, 3: e19005.  

URL:

https://www.tmrjournals.com/im/EN/10.12032/TMRIM201903005     OR     https://www.tmrjournals.com/im/EN/Y2019/V3/IVolume 3/88888

Number Age Sex Location Pathological type Treatment type/dose Treatment time Degree of fibrosis
1 65 Female NPC SCC R/70Gy/7w 2009
2 62 Female NPC SCC R/70Gy/7w
复发二程放疗60 Gy/6w
2005
2012
3 55 Male NPC SCC R/70Gy/7w 2010
4 64 Male NPC SCC R/70Gy/7w 2007
5 52 Male NPC SCC R/70Gy/7w 2008
6 66 Male NPC SCC R/70Gy/7w 2008
7 52 Female NPC SCC R/70Gy/7w 2010
8 59 Male TC SCC R54Gy/6w 2009
9 63 Male TAC SCC R/70Gy/7w 2012
10 62 Male OPC SCC R/70Gy/7w
R/64 Gy/7w
2010
2012
11 64 Male PC PCa R/70Gy/7w 2010
2012
12 76 Male LC SCC R/64Gy/7w 2009
13 71 Male LC SCC R/70Gy/7w 2012
14 77 Male TC SCC R/70Gy/7w 2009
2010
15 61 Male OFC SCC R/70Gy/7w 2010
16 62 Female TC SCC R/54Gy/6w 2009
17 35 Female BC PCa R/50Gy/5w 2007
18 41 Female BC PCa R/64Gy/7w 2011
2013
19 66 Male EC SCC R/60Gy/6w 2010
20 78 Female EC SCC R/60Gy/6w 2008
21 48 Female CVC SCC R/50Gy/5w & R/24 Gy/4f 2011
22 58 Female PVC PCa R/50Gy/5w
R/40Gy/4w
2011
2012
23 52 Female CVC SCC R50Gy/5w & R/24 Gy/4f 2012
Table 1 Detailed clinical data of the patient
N Age Sex Dysfunction caused by Fibrosis Efficacy for 0.5 months Efficacy for 1.5 months Efficacy for 3 months AR
1 65 F (1) TC 1.1cm
(2) ETAN 0.8cm
(3) HA 65°
(4) HLA 120°
(1) TC 1.5cm
(2) ETAN 1.5cm
(3) HA 68°
(4) HLA 130°
(1) TC 2.1cm
(2) ETAN 2.3cm
(3) HA 73°
(4) HLA 135°
(1) TC 2.3cm
(2) ETAN 2.3cm
(3) HA 73°
(4) HLA 136°
Non
2 62 F (1) TC 0.5cm
(2) ETAN 0.3cm
(3) HA 35°
(4) HLA 110°
(1) TC 1.1cm
(2) ETAN 1.8cm
(3) HA 52°
(4) HLA 130°
(1) TC 1.5cm
(2) ETAN 2.7cm
(3) HA 60°
(4) HLA 135°
(1) TC 1.7cm
(2) ETAN 3.0cm
(3) HA 62°
(4) HLA 135°
Non
3 55 M (1) TC 2.6cm
(2) ETAN 2.5cm
(3) HA-R 40°
HA-L 50°
(4) HLA 120°
(1) TC 2.8cm
(2) ETAN 3.0cm
(3) HA-R50°
HA-L60°
(4) HLA 125°
(1) TC 3.0cm
(2) ETAN 3.0cm
(3) HA 62°
HA-L70°
(4) HLA 135°
(1) TC 3.0cm
(2) ETAN 3.0cm
(3) HA 65°, HA-L70°
(4) HLA 136°
Non
4 64 M (1) TC 2.0cm
(2) ETAN 1.5cm
(3) HA-R45°
HA-L50°
(4) HLA 125°
(1) TC 3.0cm
(2) ETAN 2.2cm
(3) HA-R65°
HA-L70°
(4) HLA 140°
(1) TC 3.1cm
(2) ETAN 2.5cm
(3) HA-R65°
HA-L70°
(4) HLA 140°
(1) TC 3.1cm
(2) ETAN 2.5cm
(3) HA-R65°
HA-L70°
(4) HLA 140°
MD
5 52 M (1) TC 2.0cm
(2) ETAN 1.0cm
(3) HA 55°
(4) HLA 120°
(1) TC 2.5cm
(2) ETAN 2.0cm
(3) HA 64°
(4) HLA 130°
(1) TC 2.8cm
(2) ETAN 2.2cm
(3) HA 65°
(4) HLA 130°
(1) TC 2.8cm
(2) ETAN 2.3cm
(3) HA 66°
(4) HLA 130°
Non
6 66 M (1) TC 1.0cm
(2) ETAN 0.5cm
(3) HA 45°
(4) HLA 115°
(1) TC 1.5cm
(2) ETAN 1.5cm
(3) HA 58°
(4) HLA 123°
(1) TC 1.8cm
(2) ETAN 2.0cm
(3) HA 62°
(4) HLA 130°
(1) TC 2.0cm
(2) ETAN 2.1cm
(3) HA 63°
(4) HLA 130°
Non
7 52 F (1) TC 1.4cm
(2) ETAN 1.3cm
(3) HA 25°
(4) HLA 110°
(1) TC 2.1cm
(2) ETAN 1.8cm
(3) HA 42°
(4) HLA 120°
(1) TC 2.5cm
(2) ETAN 2.4cm
(3) HA 50°
(4) HLA 125°
(1) TC 2.5cm
(2) ETAN 2.5cm
(3) HA 52°
(4) HLA 126°
MDZ
8 59 M (1) TC 2.5cm
(2) ETAN 0.7cm
(3) HA-R45°
HA-L70°
(4) HLA 120°
(1) TC 2.6cm
(2) ETAN 1.7cm
(3) HA-R55°
HA-L75°
(4) HLA 130°
(1) TC 2.6cm
(2) ETAN 2.2cm
(3) HA-R60°
HA-L75°
(4) HLA 132°
(1) TC 2.6cm
(2) ETAN 2.3cm
(3) HA-R60°
HA-L75°
(4) HLA 134°
Non
9 63 M (1) TC 1.5cm
(2) ETAN 1.5cm
(3) HA-R60°
HA-L70°
(4) HLA 110°
(1) TC 2.2cm
(2) ETAN 2.1cm
(3) HA-R65°
HA-L70°
(4) HLA 125°
(1) TC 2.6cm
(2) ETAN 2.6cm
(3) HA-R70°
HA-L75°
(4) HLA 130°
(1) TC 2.6cm
(2) ETAN 2.6cm
(3) HA-R70°
HA-L75°
(4) HLA 131°
Non
10 62 M (1) TC 1.8cm
(2) ETAN 2.0cm
(3) HA-R60°
HA-L60°
(4) HLA 130°
(1) TC 2.0cm
(2) ETAN 2.5cm
(3) HA-R65°
HA-L70°
(4) HLA 135°
(1) TC 3.0cm
(2) ETAN 3.1cm
(3) HA-R65°
HA-L70°
(4) HLA 135°
(1) TC 3.0cm
(2) ETAN 3.1cm
(3) HA-R65°
HA-L70°
(4) HLA 135°
MD
11 64 M (1) TC 0.5cm
(2) ETAN 0.5cm
(3) HA 55°
(4) HLA 120°
(1) TC 1.1cm
(2) ETAN 1.0cm
(3) HA 65°
(4) HLA 125°
(1) TC 1.5cm
(2) ETAN 1.5cm
(3) HA 78°
(4) HLA 130°
(1) TC 1.6cm
(2) ETAN 2.0cm
(3) HA 80°
(4) HLA 132°
Non
12 76 M (1) TC 2.5cm
(2) ETAN 2.5cm
(3) HA 35°
(4) HLA 120°
(1) TC 2.5cm
(2) ETAN 2.5cm
(3) HA 52°
(4) HLA 130°
(1) TC 2.7cm
(2) ETAN 2.8cm
(3) HA 65°
(4) HLA 135°
(1) TC 2.7cm
(2) ETAN 2.8cm
(3) HA 73°
(4) HLA 135°
Non
13 71 M (1) TC 3.0cm
(2) ETAN 2.8cm
(3) HA 40°
(4) HLA 110°
(1) TC 3.1cm
(2) ETAN 3.0cm
(3) HA 60°
(4) HLA 125°
(1) TC 3.1cm
(2) ETAN 3.0cm
(3) HA 70°
(4) HLA 130°
(1) TC 3.3cm
(2) ETAN 3.1cm
(3) HA 70°
(4) HLA 135°
Non
14 77 M (1) TC 0.3cm
(2) ETAN 0.2cm
(3) HA 15°
(4) HLA 100°
(1) TC 0.8cm
(2) ETAN 1.0cm
(3) HA 28°
(4) HLA 115°
(1) TC 1.5cm
(2) ETAN 1.3cm
(3) HA 40°
(4) HLA 120°
(1) TC 1.6cm
(2) ETAN 1.6cm
(3) HA 45°
(4) HLA 120°
Non
15 61 M (1) TC 1.8cm
(2) ETAN 0.2cm
(3) HA 35°
(4) HLA 115°
(1) TC 1.8cm
(2) ETAN 1.0cm
(3) HA 38°
(4) HLA 120°
(1) TC 2.1cm
(2) ETAN 2.0cm
(3) HA 45°
(4) HLA 130°
(1) TC 2.1cm
(2) ETAN 2.1cm
(3) HA 45°
(4) HLA 130°
Non
16 62 F (1) TC 2.1cm
(2) ETAN 0.3cm
(3) HA 45°
(4) HLA 120°
(1) TC 2.5cm
(2) ETAN 1.2cm
(3) HA 55°
(4) HLA 130°
(1) TC 2.5cm
(2) ETAN 1.6cm
(3) HA 60°
(4) HLA 130°
(1) TC 2.5cm
(2) ETAN 1.6cm
(3) HA 60°
(4) HLA 130°
MD
17 35 F (1) MCU 40cm
(2) AD 35°
UF 95°
(1) MCU 31cm
(2) AD 45°
UF 100°
(1) MCU 29cm
(2) AD 55°
UF 120°
(1) MCU 28cm
(2) AD 60°
UF 120°
Non
18 41 F (1) MCU 42cm
(2) AD 10°
UF 90°
(1) MCU 38cm
(2) AD 35°
UF 100°
(1) MCU 34cm
(2) AD 40°
UF 120°
(1) MCU 33cm
(2) AD 45°
UF 120°
Non
19 66 M (1) EL 100ml/0.5h
(2) TT 1/W
(1) EL 300ml/0.5h
(2)TT 1/2W
(1) ESL 300ml/0.5h
(2) TT 1/M
(1) ESL 300ml/0.5h
(2) TT 1/M
Non
20 78 F (1) EL 150ml/0.5h
(2) TT 1/W
(1) ESL 200ml/0.5h
(2) TT 1/2W
(1) ESL 300ml/0.5h
(2) TT 1/M
(1) ESL 300ml/0.5h
(2) TT 1/M
Non
21 48 F (1) C-60 cm
(2) LR 20°
(1) C-55 cm
(2) LR 40°
(1) C-46 cm
(2) LR 60°
(1) C-45 cm
(2) LR 65°
MD
22 58 F (1) C-64 cm
(2) LR 5°
(1) C-58 cm
(2) LR 25°
(1) C-55 cm
(2) LR 42°
(1) C-53 cm
(2) LR 45°
MSD
23 52 F (1) C-52 cm
(2) LR 45°
(1) C-45 cm
(2) LR 60°
(1) C-42 cm
(2) LR 70°
(1) C-42 cm
(2) LR 75°
Non
Table 2 Therapeutic efficacy and adverse reactions
1.   Wang Q, Hu WG, Song QB, et al. Current situation of clinical intervention and the prospect of targeted therapy for radioactive fibrosis. Chin Cancer 2014, 23: 765-772.
2.   Clark RE, Tenorio LM, Hussey JL, et al. Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial with long term follow-up. Int J Radiat Biol Phys 2008, 72: 134-143.
3.   Brennan S, Salib O, O’shea C, et al. A randomized prospective study of extended tocopherol and pentoxiphilline therapy, in addition to carbogen, in the treatment of radiation late effects. Ecancermedicalsciense 2008, 2: 81.
4.   Jacboson G, Bhatia S, Smith BJ, et al. Randomized trial of pentoxiphilline and vitamin E vs standard follow up after breast irradiation to prevent breast fibrosis, evaluated by tissue compliance meter. Int J Radiat Biol Phys 2013, 85: 604-608.
5.   Horton JA, Chuang EG, Hudak KE, et al. Inhibition of radiation induced fibrosis with Imatinib. Int J Radiat Biol Phys 2013, 89: 162-170.
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