대한한의학회지 (The Journal of Korean Medicine)

  • 제44권4호
  • /
  • Pages.26-40
  • /
  • 2023
  • /
  • 1010-0695(pISSN)
  • /
  • 2288-3339(eISSN)
대한한의학회 (The Society of Korean Medicine)
권호 표지
DOI QR코드

DOI QR Code

Bojungikgi-tang for Anorexia in Lung Cancer Patients with Treated with Chemotherapy: A Single-arm, Open-label, Single-center Trial

  • Im-Hak Cho (Department of Korean Medicine, The Graduate School, Pusan National University) ;
  • Seong-Hoon Yoon (Department of Internal Medicine, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital) ;
  • So-Yeon Kim (Department of Korean Medicine, The Graduate School, Pusan National University) ;
  • Byoung-Kab Kang (Korea Institute of Oriental Medicine) ;
  • Chang-Seob Seo (Korea Institute of Oriental Medicine) ;
  • Young-Eun Choi (Korea Institute of Oriental Medicine) ;
  • Hyeun Kyoo Shin (Korea Institute of Oriental Medicine) ;
  • Jun-Yong Choi (Department of Korean Medicine, The Graduate School, Pusan National University)
  • 투고 : 2023.09.26
  • 심사 : 2023.11.09
  • 발행 : 2023.12.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: This study was to evaluate the effectiveness and safety of Bojungikgi-tang for lung cancer patients with anorexia. Methods: This was a single-arm, open-label, and single-center trial, and suitable participants took Bojungikgi-tang (Buzhongyiqi-tang in Chinese, Hochuekki-to in Japanese) three times a day before or between meals for six weeks (42 days). After registration of clinical trials (visit 2), they visited the hospital every three weeks (visits 3 and 4) and measured or tested the effectiveness or safety evaluation variables to analyze the results. The primary outcome was the anorexia/cachexia subscale (A/CS) of functional assessment of anorexia/cachexia therapy (FAACT) score. Results: Seventeen lung cancer patients were included in the intention-to-treat (ITT) analysis. Lung cancer patients had higher A/CS of FAACT scores after six weeks of Bojungikgi-tang administration compared to that at the baseline. This was not significant four lung cancer (p=0.1668). In the secondary outcomes, the visual analog scale (VAS) score of anorexia decreased significantly (p=0.0009), and the CD4/CD8 ratio (p=0.0396) and CD4 levels (p=0.0345) significantly increased after six weeks of treatment. No serious adverse events were reported with Bojungikgi-tang in lung cancer patients. Conclusions: Bojungikgi-tang can be an effective and safe treatment for anorexia in lung cancer patients undergoing chemotherapy.

키워드

과제정보

This research was supported by grants from the Korea Institute of Oriental Medicine (KIOM) (grant numbers: KSN1812240, KSN2013310, and KSN2021310).

참고문헌

  1. World Cancer Research Fund International. Lung cancer statistics. Available from: URL:, https://www.wcrf.org/cancer-trends/lung-cancer-statistics/1.
  2. Griesinger F, Korol EE, Kayaniyil S, Varol N, Ebner T, Goring SM. Efficacy and safety of first-line carboplatin-versus cisplatin-based chemotherapy for non-small cell lung cancer: A meta-analysis. Lung Cancer 2019;135:196-204. 10.1016/j.lungcan.2019.07.010
  3. Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman JR, Bharat A, et al. Non-Small Cell Lung Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022;20(5):497-530.10.6004/jnccn.2022.0025
  4. Ryu HJ, Kim YN, Gyeong SY, Park SH, An CH, Bang SM, et al. Original Articles : Carboplatin, ifosfamide, and etoposide chemotherapy for extensive-disease small cell lung cancer. Korean J Med 2006;70(6):688-694. http://www.ekjm.org/journal/view.php?number=15822
  5. Ganti AKP, Loo BW, Bassetti M, Blakely C, Chiang A, D'Amico TA, et al. Small Cell Lung Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2021;19(12):1441-1464. 10.6004/jnccn.2021.0058
  6. Hattori T, Yakabi K, Takeda H. Cisplatin-induced anorexia and ghrelin. Vitam Horm 2013;92:301-317. 10.1016/b978-0-12-410473-0.00012-x
  7. Yoshiya T, Mimae T, Ito M, Sasada S, Tsutani Y, Satoh K, et al. Prospective, randomized, cross-over pilot study of the effects of Rikkunshito, a Japanese traditional herbal medicine, on anorexia and plasma-acylated ghrelin levels in lung cancer patients undergoing cisplatin-based chemotherapy. Invest New Drugs 2020;38(2):485-492. 10.1007/s10637-019-00836-x
  8. Seonkyeong Y, and Hyunah K. Pharmacologic Therapy for Cancer Anorexia-Cachexia Syndrome. J Clin Nutr 2015;7(2):36-41. 10.15747/jcn.2015.7.2.36
  9. Ruiz Garcia V, Lopez-Briz E, Carbonell Sanchis R, Gonzalvez Perales JL, Bort-Marti S. Megestrol acetate for treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev 2013;2013(3):Cd004310. 10.1002/14651858.CD004310.pub3
  10. Zhang X, Qiu H, Li C, Cai P, Qi F. The positive role of traditional Chinese medicine as an adjunctive therapy for cancer. Biosci Trends 2021;15(5):283-298. 10.5582/bst.2021.01318
  11. Akita S, Namiki T, Kawasaki Y, Rikihisa N, Ogata H, Tokumoto H, et al. The beneficial effect of traditional Japanese herbal (Kampo) medicine, Hochu-ekki-to (Bu-Zhong-Yi-Qi-Tang), for patients with chronic wounds refractory to conventional therapies: A prospective, randomized trial. Wound Repair Regen 2019;27(6):672-679. 10.1111/wrr.12753
  12. Na D. Clinical Effect and Pharmacological Analysis of Buzhongyiqi Decoction Combined with Chemotherapy on Nonsmall Cell Lung Cancer. Clinical journal of traditional chinese medicine 2019;31(1): 145-148. 10.16448/j.cjtcm.2019.0041
  13. Ming-Hua C, Bao-Hua Z, Lei Y. Mechanisms of Anorexia Cancer Cachexia Syndrome and Potential Benefits of Traditional Medicine and Natural Herbs. Curr Pharm Biotechnol 2016;17(13):1147-1152. 10.2174/1389201017666161018123311
  14. Cheon C, Yoo J-E, Yoo H-S, Cho C-K, Kang S, Kim M, et al. Efficacy and Safety of Sipjeondaebo-Tang for Anorexia in Patients with Cancer: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial. Evidence-Based Complementary and Alternative Medicine 2017;2017:8780325. 10.1155/2017/8780325
  15. Seo C, Kim J, Shin H. Simultaneous determination of liquiritin, nodakenin, hesperidin and glycyrrhizin in Bojungikgi-tang using HPLC-PDA. Yakhak Hoeji 2013;57(3):187-193. http://www.yakhak.org/journal/view.html?spage=187&volume=57&number=3
  16. Lemjabbar-Alaoui H, Hassan OU, Yang YW, Buchanan P. Lung cancer: Biology and treatment options. Biochim Biophys Acta 2015;1856(2):189-210. 10.1016/j.bbcan.2015.08.002
  17. Sun LL, Lai HZ, Chen ZZ, Zhu XS, Lin LZ. Modified Liujunzi Decoction () Alleviates Chemotherapy-Induced Anorexia in Advanced Non-Small Cell Lung Cancer: A Propensity Score Matched Case-Control Study. Chin J Integr Med 2020;26(4): 256-262. 10.1007/s11655-020-3185-5
  18. Oun R, Moussa YE, Wheate NJ. The side effects of platinum-based chemotherapy drugs: a review for chemists. Dalton Trans 2018;47(19):6645-6653. 10.1039/c8dt00838h
  19. Davis MP. The emerging role of palliative medicine in the treatment of lung cancer patients. Cleve Clin J Med 2012;79 Electronic Suppl 1:eS51-55. 10.3949/ccjm.79.s2.11
  20. Temel JS, Pirl WF, Lynch TJ. Comprehensive symptom management in patients with advanced-stage non-small-cell lung cancer. Clin Lung Cancer 2006;7(4):241-249. 10.3816/CLC.2006.n.001
  21. Kuroiwa A, Liou S, Yan H, Eshita A, Naitoh S, Nagayama A. Effect of a traditional Japanese herbal medicine, hochu-ekki-to (Bu-Zhong-Yi-Qi Tang), on immunity in elderly persons. Int Immunopharmacol 2004;4(2):317-324. 10.1016/j.intimp.2003.12.004
  22. QIAN Jia-nan, SUN Bo-yun, Hong-yi H. Clinical and Basic Research Progress of Buzhong Yiqi Decoction in Treatment of Malignant Tumor Diseases. Journal of Hebei Traditional Chinese Medicine and Pharmacology 2021;36(5):59-64. 10.16370/j.cnki.13-1214/r.2021.05.017
  23. Li TM, Yu YH, Tsai FJ, Cheng CF, Wu YC, Ho TJ, et al. Characteristics of Chinese herbal medicine usage and its effect on survival of lung cancer patients in Taiwan. J Ethnopharmacol 2018;213:92-100. 10.1016/j.jep.2017.10.031
  24. Yu N, Xiong Y, Wang C. Bu-Zhong-Yi-Qi Decoction, the Water Extract of Chinese Traditional Herbal Medicine, Enhances Cisplatin Cytotoxicity in A549/DDP Cells through Induction of Apoptosis and Autophagy. Biomed Res Int 2017;2017:3692797. 10.1155/2017/3692797
  25. Ribaudo JM, Cella D, Hahn EA, Lloyd SR, Tchekmedyian NS, Von Roenn J, et al. Re-validation and shortening of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire. Qual Life Res 2000;9(10):1137-1146. 10.1023/a:1016670403148
  26. Turcott JG, Onate-Ocana LF, Soca-Chafre G, Ramirez-Tirado L-A, Flores-Estrada D, Zatarain-Barron ZL, et al. FAACT-Anorexia Cachexia Scale: Cutoff Value for Anorexia Diagnosis in Advanced Non-Small Cell Lung Cancer Patients. Nutrition & Cancer 2019;71(3):409-417. 10.1080/01635581.2018.1506488
  27. Jeon H, Eo W, Shim B, Kim S, Lee S. Prognostic Value of Functional Assessment of Cancer Therapy-General (FACT-G) in Advanced Non-Small-Cell Lung Cancer Treated with Korean Medicine. Evid Based Complement Alternat Med 2020;2020:2845401. 10.1155/2020/2845401
  28. Yoo H, Suh C, Kim S, Eremenco S, Kim H, Kim S. Korean translation and validation of the functional assessment of cancer therapy-lung (FACT-L) version 4. Qual Life Res 2006;15(1):161-166.10.1007/s11136-005- 8752-x
  29. Xiao Z, Chen Z, Han R, Lu L, Li Z, Lin J, et al. Comprehensive TCM treatments combined with chemotherapy for advanced non-small cell lung cancer: A randomized, controlled trial. Medicine (Baltimore) 2021;100(18):e25690. 10.1097/md.0000000000025690
  30. Rebe C, Demontoux L, Pilot T, Ghiringhelli F. Platinum Derivatives Effects on Anticancer Immune Response. Biomolecules 2019;10(1). 10.3390/biom10010013
  31. Yan Y, Wang X, Liu C, Jia J. Association of lymphocyte subsets with efficacy and prognosis of immune checkpoint inhibitor therapy in advanced non-small cell lung carcinoma: a retrospective study. BMC Pulm Med 2022;22(1):166. 10.1186/s12890-022-01951-x
  32. Tay RE, Richardson EK, Toh HC. Revisiting the role of CD4+ T cells in cancer immunotherapy-new insights into old paradigms. Cancer Gene Therapy 2021;28(1):5-17. 10.1038/s41417-020-0183-x
  33. Zhao Z, Liao H, Ju Y. Effect of compound Kushen injection on T-cell subgroups and natural killer cells in patients with locally advanced non-small-cell lung cancer treated with concomitant radiochemotherapy. J Tradit Chin Med 2016;36(1):14-18. 10.1016/s0254-6272(16)30002-4
  34. Zu-yi Y, Xue-mei W, Ya-long O, Ping Y, Jie L, Xiu-yun S. Effect of TCM combined with chemotherapy on immune function and quality of life of patients with non-small cell lung cancer in stage III-IV. Chinese Journal of Integrative Medicine 2004;10(3):181-186. 10.1007/BF02836403
  35. Zhang S, Chen W, Wang Y, Wu J, Xu L, Yu Y, et al. Chinese Herbal Prescription Fu-Zheng-Qu-Xie Prevents Recurrence and Metastasis of Postoperative Early-Stage Lung Adenocarcinoma: A Prospective Cohort Study Followed with Potential Mechanism Exploration. Oxidative Medicine and Cellular Longevity 2021;2021:6673828. 10.1155/2021/ 6673828
  36. Xu R, Wu J, Zhang X, Zou X, Li C, Wang H, et al. Modified Bu-zhong-yi-qi decoction synergies with 5 fluorouracile to inhibits gastric cancer progress via PD-1/PD- L1-dependent T cell immunization. Pharmacol Res 2020;152:104623. 10.1016/ j.phrs.2019.104623
  37. Jiao L, Dong C, Liu J, Chen Z, Zhang L, Xu J, et al. Effects of Chinese Medicine as Adjunct Medication for Adjuvant Chemotherapy Treatments of Non-Small Cell Lung Cancer Patients. Sci Rep 2017;7:46524. 10.1038/srep46524
  38. Kwon CY, Lee B, Kong M, Lee SH, Jung HJ, Kim KI, et al. Effectiveness and safety of herbal medicine for cancer-related fatigue in lung cancer survivors: A systematic review and meta-analysis. Phytother Res 2021;35(2):751-770. 10.1002/ptr.6860