Clinical Application of the Jianpi Shengjin Prescription as an Adjuvant to 3D Conformal Radiotherapy in Patients with Locally Advanced Nasopharyngeal Carcinoma

Abstract

Background

This study investigates the clinical application of the Jianpi Shengjin prescription as an adjuvant to 3D conformal radiotherapy in patients with locally advanced nasopharyngeal carcinoma (LANC).

Methods

A total of 140 patients with LANC were recruited from our hospitals between January 2022 and December 2023. These patients were randomly assigned to either the control group, which received the three-dimensional conformal radiotherapy, or the experimental group, which was treated with the Jianpi Shengjin prescription combined with three-dimensional conformal radiotherapy. Both groups provided general data and blood samples for further analysis.

Results

No significant differences in demographics or clinical benefit rates were observed between the groups. Posttreatment, two groups were compared for clinical efficacy, with the experimental group showing a clinical benefit rate of 92%, significantly higher than the control group's clinical benefit rate of 61% (P < 0.05). EGFR, PD-L1, and VEGF protein and mRNA levels in the experimental group were significantly decreased compared to the control group (P < 0.05). Furthermore, logistic regression analysis revealed that EGFR (OR = 1.025, 95% CI 1.011–1.039, P < 0.01) had a positive association with LANC, indicating its role as a predictive factor for LANC development. Similarly, the analysis demonstrated that PD-L1 (OR = 1.164, 95% CI 1.065–1.272, P < 0.01) was positively related to LANC, suggesting PD-L1 as a predictive marker. Additionally, VEGF (OR = 1.013, 95% CI 1.007–1.019, P < 0.01) showed a positive correlation with LANC, serving as another predictive factor for the condition.

Conclusions

The Jianpi Shengjin prescription adjunctive treatment significantly improves the clinical efficacy in LANC patients undergoing 3D conformal radiotherapy, and EGFR, PD-L1, and VEGF served as predictive factors for LANC development.

Keywords

locally advanced nasopharyngeal carcinoma three-dimensional conformal radiotherapy Jianpi Shengjin prescription

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References

Cai

Zhong

Huang

(2023). Meta-analysis of efficacy of Chinese medicine compound combined with concurrent radiotherapy and chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma. American Journal of Translational Research, 15(7), 4439–4453.

Chen

Liang

Zhu

(2020). Anti-EGFR therapies in nasopharyngeal carcinoma. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, 131, 110649. https://doi.org/10.1016/j.biopha.2020.110649

Doshi

Kamal

K. H.

Murat

, et al. (2023). Artificial intelligence’s significance in diseases with malignant tumours. Mesopotamian Journal of Artificial Intelligence in Healthcare, 2023, 35–39. https://doi.org/10.58496/MJAIH/2023/007

Fang

Zhang

Hong

, et al. (2014). EBV-driven LMP1 and IFN-γ up-regulate PD-L1 in nasopharyngeal carcinoma. Implications for oncotargeted therapy. Oncotarget, 5(23), 12189. https://doi.org/10.18632/oncotarget.2608

Wang

Xiong

, et al. (2021). Epstein-Barr virus-encoded circular RNA CircBART2.2 promotes immune escape of nasopharyngeal carcinoma by regulating PD-L1. Cancer Research, 81(19), 5074–5088. https://doi.org/10.1158/0008-5472.CAN-20-4321

Guo

Mao

Y. P.

Tang

L. L.

, et al. (2019). The evolution of nasopharyngeal carcinoma staging. The British Journal Of Radiology, 92(1102), 20190244. https://doi.org/10.1259/bjr.20190244

Huang

Yao

Deng

, et al. (2023). Immunotherapy for nasopharyngeal carcinoma. Current status and prospects (Review). International journal of oncology, 63(2), 97. https://doi.org/10.3892/ijo.2023.5545

Johnson

B. B. Y.

(2021). Targeting the PD-1/ PD-L1 interaction in nasopharyngeal carcinoma. Oral Oncology, 113, 105127. https://doi.org/10.1016/j.oraloncology.2020.105127

Lee

A. W. M.

W. T.

Chan

J. Y. W.

, et al. (2019). Management of locally recurrent nasopharyngeal carcinoma. Cancer Treatment Reviews, 79, 101890. https://doi.org/10.1016/j.ctrv.2019.101890

10.

Zhu

Zhang

, et al. (2023). Incidence and risk factors for radiotherapy-induced oral mucositis among patients with nasopharyngeal carcinoma: A meta-analysis. Asian Nursing Research, 17(2), 70–82. https://doi.org/10.1016/j.anr.2023.04.002

11.

Lin

Guo

, et al. (2022). Stereotactic body radiotherapy extends the clinical benefit of PD-1 inhibitors in refractory recurrent/metastatic nasopharyngeal carcinoma. Radiation Oncology (London, England), 17(1), 117. https://doi.org/10.1186/s13014-022-02073-8

12.

Linder

L. A.

Hooke

M. C.

(2019). Symptoms in children receiving treatment for cancer-part II: Pain, sadness, and symptom clusters. Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses, 36(4), 262–279. https://doi.org/10.1177/1043454219849578

13.

Liu

Zheng

(2018). Effect of strengthening spleen and promoting fluid with Chinese medicine assisted three-dimensional conformal radiotherapy on local advanced nasopharyngeal carcinoma and its influence on T lymphocyte subsets, vascular endothelial growth factor and bone alkaline phosphatase levels. Modern Journal of Integrated Traditional Chinese and Western Medicine, 27(9), 950–953. + 1023. https://doi.org/10.3969/j.issn.1008-8849.2018.09.010

14.

Liu

Tang

, et al. (2024). Nasopharyngeal carcinoma: Current views on the tumor microenvironment's impact on drug resistance and clinical outcomes. Molecular Cancer, 23(1), 20. https://doi.org/10.1186/s12943-023-01928-2

15.

Ren

Zhao

, et al. (2020). Can self-pain sensitivity quantify empathy for others’ pain?. Psychophysiology, 57(10), e13637. https://doi.org/10.1111/psyp.13637

16.

Song

Y. C.

Hung

K. F.

Liang

K. L.

, et al. (2019). Adjunctive Chinese herbal medicine therapy for nasopharyngeal carcinoma: Clinical evidence and experimental validation. Head & Neck, 41(9), 2860–2872. https://doi.org/10.1002/hed.25766

17.

Tambe-Jagtap

S. N.

Jaaz

Z. A.

(2023). Integrative genomic and proteomic profiling for personalized oncological treatments: Enhancing therapeutic efficacy and reducing adverse effects in breast cancer patients. SHIFAA, 2023, 1–9. https://doi.org/10.70470/SHIFAA/2023/001

18.

Tang

L. L.

Chen

Y. P.

Chen

C. B.

, et al. (2021). The Chinese Society of Clinical Oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma. Cancer Communications (London, England), 41(11), 1195–1227. https://doi.org/10.1002/cac2.12218

19.

Tang

L. L.

Guo

Zhang

, et al. (2022). Effect of radiotherapy alone vs radiotherapy with concurrent chemoradiotherapy on survival without disease relapse in patients with low-risk nasopharyngeal carcinoma: A randomized clinical trial. Jama, 328(8), 728–736. https://doi.org/10.1001/jama.2022.13997

20.

Tian

Liu

Han

S. M.

, et al. (2023). The mechanism and relevant mediators associated with neuronal apoptosis and potential therapeutic targets in subarachnoid hemorrhage. Neural Regeneration Research, 18(2), 244–252. https://doi.org/10.4103/1673-5374.346457

21.

Wang

Zhang

Chen

, et al. (2020). Antitumor effects of immunity-enhancing traditional Chinese medicine. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, 121, 109570. https://doi.org/10.1016/j.biopha.2019.109570

22.

Wei

Jiang

Zhang

, et al. (2019). Neoadjuvant three-dimensional conformal radiotherapy for resectable hepatocellular carcinoma with portal vein tumor thrombus: A randomized, open-label, multicenter controlled study. Journal of Clinical Oncology: Official Journal Of The American Society of Clinical Oncology, 37(24), 2141–2151. https://doi.org/10.1200/JCO.18.02184

23.

Xue

Song

Zhu

, et al. (2022). The efficacy and safety of VEGF/VEGFR inhibitors in patients with recurrent or metastatic nasopharyngeal carcinoma: A meta-analysis. Oral Oncology, 135, 106231. https://doi.org/10.1016/j.oraloncology.2022.106231

24.

Zhou

(2022). Intensity-Modulated radiotherapy and three-dimensional conformal radiotherapy combined with intracavitary posterior radiotherapy for the treatment of medium-term and advanced cervical cancer: Efficacy, safety and prognostic factors. Frontiers in Surgery, 9, 906117. https://doi.org/10.3389/fsurg.2022.906117

25.

Zhang

Chen

G.-Q.

, et al. (2019). Gemcitabine and cisplatin induction chemotherapy in nasopharyngeal carcinoma. New England Journal of Medicine, 381(12), 1124–1135. https://doi.org/10.1056/NEJMoa1905287

26.

Zhang

Yang

, et al. (2023). Survival rate prediction of nasopharyngeal carcinoma patients based on MRI and gene expression using a deep neural network. Cancer Science, 114(4), 1596–1605. https://doi.org/10.1111/cas.15704