Kidney cancer treatment, drug treatment

1, the basic treatment program
The main treatment for kidney cancer with surgery. Effect of radical resection of renal cell carcinoma is better than simple nephrectomy, if they are of regional lymph node dissection, the survival rate even higher. Radiation therapy, chemotherapy, immune therapy result is not satisfactory and is not sure, but as adjuvant therapy before and after surgery, the application may then have better results. Because radiation therapy, chemotherapy, immune therapy more than the result is not satisfactory, so the role of traditional Chinese medicine treatment of kidney cancer is particularly important in reducing the symptoms and prolong life, has good results.
Second, Chinese medicine treatment
(A) Differentiation and Treatment
In accordance with various types of clinical manifestations of renal cell carcinoma can refer to hematuria, flank pain, disease and other permits Differential Treatment of the plot. Most of their patients to this virtual real standard-based, the virtual, such as kidney, spleen deficiency, yin and yang deficiency; standard real multi-drug by the hot and humid evil, phlegm congestion infestation.
1. Spleen deficiency type
Syndromes: low back pain, abdominal distention, hematuria, or waist abdominal mass, anorexia, nausea, vomiting, body weight loss, weakness anemia, pale tongue, thin white tongue fur, pulse weak or weak Shen thin.
Governing law: Jianpiyishenfang, Ruanjian Sanjie.
Recipe: Four-Wu-Tang co-Youguiyin addition and subtraction. Atractylodes, Codonopsis, Astragalus, Eucommia, psoralen each 10g, Chinese angelica, dried tangerine peel, palm charcoal, red peony each 12g, verbena, Hedyotis diffusa, Dianthus superbus, grass and river vehicles, Health plantago-jen of 30g, Huang Jing 15g, cornus 15g.
2. Kidney weak form
Syndrome: a short red blood urine, hot flushes and night sweats, Kouzao throat, Yaoxisuanruan, low back pain, abdominal mass, red tongue, pulse breakdown.
Governing law: Yin Qingreliangxue.
Recipe: Zhi Bai Di Huang decoction. Anemarrhena, yams, paeonol, Alisma, Eclipta prostrata each 10g, habitat, Daji, thistle, raw Cacumen Platycladi the 30g, Phellodendron, cornus the 5g, blood over charcoal, Oujie each 15g.
3. Humid Yun-kidney-type
Syndrome: back pain, bulge discomfort, hematuria, low-grade fever, body Shen difficulties, poor diet, waist and abdomen mass, fur Baini in yellow, tongue body fat, pulse a few slippery.
Governing law: heat Lishi, Jieduhuayu.
Recipe: eight addition and subtraction are scattered. Akebia, rhubarb, Gardenia, Atractylodes each 10g, talcum, Polygonum aviculare, verbena, Hedyotis diffusa, Dianthus superbus, grass and river vehicles, Health plantago-jen of 30g, plantain seed, red peony each 15g, rush 5g. Hot-Sheng who added Mr Wong, gentian 10g.
4. Ecchymosis resistance-type
Syndrome: looking unlucky dim, blood urinary frequency hair, waist dull, waist and abdomen tumor gradually increased, inflation does not hold back kidney area, and parched, tongue purple dim or ecchymoses, thin yellow tongue fur, pulse string, or astringent or a knot on behalf of.
Governing law: promoting blood circulation of qi Sanjie.
Recipe: Taohongsiwutang addition and subtraction. Peach kernel, safflower, Yuan Hu, Cyperus rotundus, Citrus aurantium each 10g, Salvia, Verbena, Hedyotis diffusa, Dianthus superbus, grass and river vehicles, Health plantago-jen of 30g, red peony, Sichuan Fritillaria, Prunella each 15g. Low back pain, hematuria plus 37 powder 3g (blunt), size of the thistle of 15g.
5. Firelight Kang Sheng-type
Syndrome: urine red hot red blood, urinating or when there is light, hot burning feeling upset thirst, sore tongue, night sleep soundly rocked, back pain and swelling, tongue red, pulse a few Hong Dayong and powerful.
Governing law: Qingxin Xiehuo, cooling blood to stop bleeding.
Recipe: thistle Yin Zi, guided red powder addition and subtraction. Thistle, raw land, talcum each 30g, light bamboo leaves, Puhuang, mountain Gardenia each 10g, licorice root 5g, Akebia 5g, Oujie 15g, rhubarb 5g (post below).
Repeatedly made by, to talc, wood-pass, etc. Tom Lee of goods, plus serving two to Pill; if lost Shuxie liver, gall bladder inflammation Sheng and hematuria who use flavored Xiaoyaosan; such as Qi stagnation blood stasis, hematuria who have pieces, plus with peach kernel, Salvia.
6. Cancer drug taking channeling, qi and blood deficiency type
Syndrome: disease to late, distant metastasis, fatigue, weakness, spontaneous perspiration sweating, looking minimalist, when hematuria, lower back pain abdominal distension, anemia, weight loss, action shortness of breath, cough and sometimes accompanied by low-heat, dry mouth and not like it, tongue red or dark red, dusky purple with ecchymosis, pulse thin and delicate or large and several.
Governing Law: Two-fill qi and blood, righting tumor suppressor.
Recipe: Bazhen Decoction. Health Astragalus 25g, Taizishen 15g, Ligustrum lucidum, aspartame, Ophiopogon japonicus, rhizome, Poria, Atractylodes each 15g, licorice root 5g, Health Rehmannia, wolfberry fruit, honeysuckle all 10g, Gynostemma 15g, white peony root 5g.
7. Carcinoma of evil is attacked, vestiges of outstanding type
Syndrome: surgery, radiotherapy, chemotherapy, Yaoxisuanruan frail weakness, lack of energy, occasional low-grade fever or hematuria, pale, anorexia, pale red tongue, thin white fur, or Bai Ni, pulse weak or thin soft number.
Governing law: kidney and spleen, rousing.
Recipe: Four Gentlemen Decoction. Codonopsis, Scutellaria barbata, Shude, Taizishen the 15g, Atractylodes, Poria, Ophiopogon japonicus, Zhuling the 15g, licorice root 5g, medlar, Bodhisattva of 10g, Astragalus, Agrimony each 20g. Insomnia by Canadian Polygalaceae, Flos Albiziae each 15g.
In patients with early stage renal cell carcinoma is true, the hot and humid Yun kidney, or hot and humid block connections, or hot and humid Accumulation If it persists into the sputum into pieces, resulting in low back pain hematuria. The medium-term spleen and kidney damage, hot and humid Accumulation, Qi stagnation blood stasis, blood heat Wang Xing, to efforts Kang Sheng, bleeding resistance prevalent; late upright wasting, qi and blood deficiency, drugs, channeling cancer walk, cancer is evil offensive, and residual poison outstanding, multi-Qi Yin qi and blood manifested as two others. But the development of the disease, especially kidney cancer, once discovered, is already in the late phases of clinical symptom complex and overlapping, clinical medicine, when the main dialectical. Traditional Chinese medicine treatment period applicable to all patients, is expected to improve the curative effect.
(B) unilateral prescription
1. Dianthus 120g, Shuijianbi.
2. Oujie 50g, Shuijianbi.
3. Health-jobi jen 120g, Shuijianbi.
4. Cyamophila 30 ~ 60g, Shuijianbi.
5. Renal cell carcinoma after surgery Prescriptions for Health and Rehmannia the 12g, Bodhisattva, Ligustrum lucidum each 15g, wolfberry fruit, psoralen, Atractylodes, cloud-ling of 10g, Astragalus, banzhilian the 30g, heterophylla, Dianthus superbus, soil Fuling The 20g, Shuijianbi.
6. Pancreas, kidney, renal pelvis cancer in the late, or after those herbs Dianthus superbus compound 20g, bittersweet, Solanum nigrum, Indian strawberry, Daji, thistle, Agrimony, soil Fuling, banzhilian the 30g, Treats 15g, yuan Hu, Zhuru, bamboo each 10g, Shuijianbi.
(C) The acupuncture treatment of
1. Acupuncture therapeutic apparatus for treatment with the HANS device, the electrode plate connected to the pain and Service to the negative connected to the pain and contralateral outside, to the low-frequency stimulation applied to oncology and pain throughout.
2. Acupuncture and Point Injection acupoints Sanyinjiao, Kunlun, full three years, and to compound Danshen injection 2ml diluted in 5ml normal saline each were injected with 1ml, once a day or every other day for 10 days for a course of treatment. 5 days rest before starting another course of treatment. For cancer pain, and hematuria was found in cord-like blood clots, difficulty urinating person.
(D) Massage Therapy
Acupoints Qu pool, Hegu, Shenshu Sanyinjiao and other points, using brush, take, shake, beat, strike and other practices, righting strengthen our foundation, Qi and blood circulation for renal tumor of low back pain and poor air-hematuria embolism.
(E) external application of drugs
Pain Powder: kaempferol, frankincense, myrrh, turmeric, Gardenia, Angelica, baicalin the 20g, cumin, public clove, red peony, costas, Phellodendron the 15g, castor-jen 20. On the drug total to fine, with egg and mix thoroughly topical kidney points, 6 ~ 8 hours to replace one. Those who applied to kidney cancer pain.
(6) diet to restore
1. A pre-operative diet renal tumors found, mostly in the late surgery before entering easier digestion, absorption, nutritious food, vegetables, lean meat, eggs, etc., in order to maintain human nutrition, enhance the body's resistance to diseases, for surgery create the conditions for treatment.
2. Kidney cancer surgery diet after surgery because of injury righteousness, Shenqi major injuries, wounds gas consumption of blood, blood two injuries, should qi nourishing. Eat protein-rich food such as milk, soy milk, mashed potatoes, green mud, spinach mud, Yu Geng, etc. can also be used wolfberry fruit ף ¬ consumption. However, note that too much fullness of food unfit for human consumption.
3. Radiotherapy radiotherapy when the diet period, the kidney yin loss, should Zishen nourishing Yin Sheng Jin of goods, selection of fresh fruit, fresh vegetables such as spinach, apples, Yamanashi, longan meat, walnut kernel, medlar, white fungus soup.
4. Chemotherapy diet because of blood in patients with chemotherapy two injuries, coupled with drug side effects Yinyehaoshang, gas and injury of blood consumption, they should eat Ziyin qi food such as Yu Geng, turtle soup, turtle soup, mushrooms soup, white fungus soup, bird's nest, apple juice, gingko, meat soup, chicken soup, etc., can choose food. There are Outu Zhe, available health ginger.
5. Advanced tumors with advanced cancer diet blood were injured, yin and yang imbalance, should adjust the yin and yang, nourishing Qi. The discretion to consume the food, the people can choose Peach Ginseng, white fungus soup, nuts ointment. Fasting shrimp, crabs and other food products made objects.
3, surgical treatment
(A) surgery for patients
As long as the patient's body conditions permit and can tolerate surgery, the period should be the preferred surgical treatment in patients with renal cell carcinoma. According to the patients in different disease stages are different and can be taken to a different surgery.
(B) surgical options
1. Radical nephrectomy for early stage in most patients, is the most basic methods of treatment include surgical removal of kidney disease, perirenal fat, kidney and the surrounding fascia and ipsilateral adrenal gland. 5-year and 10-year survival rates were 52% and 49%.
2. Simple nephrectomy for advanced kidney cancer palliative resection can alleviate local symptoms such as pain, bleeding, control the fever and so on. As well as the general condition is poor, can not tolerate radical surgery. Sometimes, better results. 5-year and 10-year survival rates were 33% and 7.1% respectively.
3. Regional lymph node dissection radical nephrectomy at the same time for the regional lymph node dissection, helping correct clinical staging, to reduce the rate of local tumor recurrence and improve survival. Radical nephrectomy plus regional lymph node dissection, postoperative 5-year survival rate in stage Ⅰ of 87.4%, Ⅱ a period of 60.6%, Ⅲ period of 41%, without lymph node dissection for the 5-year survival rate of only 33 %.
4. Renal artery embolization for larger tumors before surgery to percutaneous stab selective renal artery catheterization, injection-induced bolt of material, so that arterial occlusion of tumor blood flow reduction in shrinkage can decrease surgical bleeding and improve tumor resection rate. At the same time, suitable for patients with unresectable advanced, using palliative embolization can control and mitigate the patient's symptoms, such as the bleeding stopped, the pain reduced symptom improvement.
5. Special cases of surgical options with bilateral renal cell carcinoma (rare about 1% ~ 2%), and solitary kidney renal cell carcinoma. Right side of the larger radical tumor resection, compared to the smaller side of the line part of the nephrectomy, local tumor resection or enucleation, were considerably smaller than is possible if both sides of bilateral enucleation. Solitary kidney renal cell carcinoma, early tumor enucleation should be taken, is located in a great part of those lines nephrectomy. For the multiple renal cell carcinoma and the tumor is located in the central viable integrated treatment or radical resection, blood dialysis to maintain a year later in kidney transplant. Root statistical applications, the above-mentioned surgical treatment, 5-year survival rate of T1, 100%, T2 period of 83%, T3 ~ 4 Qi 34%.
6. Surgical treatment of metastatic renal cell carcinoma, 20% to 30% of kidney cancer patients have been diagnosed when the transfer. A single transfer of 1% ~ 3.2%, mostly multiple metastases, the most common for lung metastasis. A single metastasis in patients suffering from renal conditions should seek the same time, and metastasis resection, postoperative radiotherapy, chemotherapy and immunotherapy. Solitary pulmonary metastasis should line lobectomy or wedge resection. 5-year survival rate was 25% ~ 35%. For multiple transfers renal cell carcinoma, where conditions permit, should also be given after the resection of the primary lesion combined therapy may be stable or to relieve symptoms, with occasional reports of metastatic lesions disappear on their own. So for metastatic renal cell carcinoma should first consider the surgery.
4, radiation therapy
Radiation therapy on the treatment of kidney cancer is no important role. Most scholars do not advocate radiation therapy for kidney cancer, only can be used as adjuvant therapy before and after surgery. Short-term fast-growing tumor, toxic symptoms were, preoperative radiotherapy can reduce the tumor size, reduce the proliferation of cancer surgery is beneficial operative. Pairs of stage Ⅱ, Ⅲ, or kidney disease has spread to nearby organs, or cases of incomplete tumor resection, postoperative radiotherapy reduce local recurrence. At the same time for unresectable advanced kidney cancer, radiotherapy reduces bone metastases localized pain, hematuria, and ease symptoms of toxicity.
5, immune therapy
Immunotherapy is divided into non-specific immunity and specific immunity, but a variety of immune therapy are in the experimental stage, although a certain effect, but still need further observation and study.
(A) non-specific immunity is the most commonly used Bacillus Calmette-Guerin (BCG), can be immune cells to expand the cellular and antibody immune response effects, which enhance the body's immune system and anti-tumor capabilities. Usage: BCG 5mg, inner thighs intradermal injection, 1 week, sharing of 6 weeks. Can be used alone can also be used in conjunction with other drugs.
(B)-specific immune
1. Immune ribonucleic acid (IRNA) with advanced kidney cancer can reduce the effective rate was 22%. Side effects and adverse reactions very rare.
2. Interferon is currently the treatment of cancer more effective drugs. Major regulator of immune function and induction to activate the T-lymphocyte production and release of lymphokines, thereby activating macrophages to enhance anti-tumor effect. Because of drug sources, clinical а major application of recombinant interferon therapy. Efficiency 20%. The main side effects were flu-like symptoms such as fever, chills, muscle pain, loss of appetite and vomiting.
3. Interleukin -2 (IL-2) is also non-specific immunotherapy can induce anti-tumor activity of LAK cells, dissolved a variety of tumor cells, resulting in degeneration and necrosis of tumor cells. If the IL-2 with LAK cells, should also be constituted adoptive immune therapy, can enhance the LAK cells and T cell immune activity and enhance anti-tumor effects, treatment efficiency of 15% ~ 25%. IL-2 together with the chemotherapy drugs when the use of synergies.
6, hormone therapy
Renal cell carcinoma significantly dependent on the hormone, in patients with advanced kidney cancer can relieve symptoms and prolong life, and even make a small number of tumor regression, efficiency of 15%. In patients with symptom improvement in up to 50%. Hormones with the immune agents and chemotherapy drug combination, there are synergies that can increase the efficacy of advanced kidney cancer. Clinical applications in order to medroxyprogesterone acetate as first choice, the other can be applied testosterone propionate, hydroxy progesterone, prednisolone and so on.
7, the chemical treatment
Kidney cancer chemotherapy less effective, but in combination with interferon may be a synergistic effect. Such as 5-FU combination therapy with interferon renal cell carcinoma. Specific programs are:
5-FU 0.75/m2, intravenous infusion, the first 1-5 days;
Interferon-α 200 Wan IU/m2, intramuscular injection, the first 1-5 days.
28-day repeat cycle of shared 3. Attention to protecting the mouth, to prevent ulcers.
Commonly used chemotherapy drugs vinblastine (VLB), mitomycin C (MMC), hydroxyurea (HU), UFT (UFT), bleomycin (BLM), adriamycin (AMD), fluorouracil (5 -FU), cyclophosphamide (CTX), Lomustine (CCNU), cisplatin (DDP) and so on.
(A) single-agent chemotherapy
Individual drug use is less than 15 percent remission rate, but more effective drugs for the VLB, efficiency up to 25%.
(B) combination chemotherapy
Combined with chemotherapy is superior to monotherapy. As with Chinese medicine treatment and endocrine therapy, efficacy can be increased.
1.HFM Program
HU 1 ~ 1.5g, oral, the first 1,4 days a week, and even serving 6 weeks;
5-FU 500mg, intravenous injection, the first 3,6 days per week applied for 6 weeks;
Megestrol acetate (MA) 400mg / times, 4 times / day, orally qd for 6 weeks.
6 weeks for a course of treatment, interval of 2 ~ 4 weeks.
2.CH Program
CCNU 100mg, oral, every week day 1;
HU 2 ~ 3g, taken orally, 2 times / week
6 weeks as one cycle.
3.VHF Program
VLB 10mg, intravenous injection, one time per week.
HU 2g, orally, 2 times per week;
5-FU 300mg/m2, intravenous drip, week 1.
Medication 2 weeks rest for a period 1 week. A total of 2 ~ 3 cycles for a course of treatment.
4.MVB program (with efficiency of about 36%)
VLB 4mg/m2, intravenous injection, four hours later to;
MTX 500 ~ 1000mg/m2, intravenous drip, drip 2 hours after completion to the;
CF 15mg, intramuscular injection, every 6 hours to once a total of 3 days;
BLM 15mg/m2, intravenous drip, week 1.
Note: CF with MTX, in addition to the rescue, the same time, diuretic and alkalization of urine.