Strategy of Using Herbal Extract Preparations for Stage IV Cancer in Palliative Care: an Enhanced and Maintenance Therapy.

89 Background: Palliative care is focused and seems as rationally anti-cancer way that have low systemic toxicity and acceptable effectiveness for stage IV cancer, especially herbal extracted medicines, which can regulate tumor microenviroment and body immune system. Our previous lab studies have indicated that TGF-beta, EGF, VEGF, IL-10 cytokines expression and mico-vessel density can be downgraded in tumor microenviroment by herbal extract preparation from Ginseng, Herba Agrimonia, Hairyvein and Arginine etc. Methods: 13 patients with unresectable pancreatic cancer, 31 patients with liver cancer, and 168 patients with stage IV lung cancer were studied. Herbal extract preparation, which was approved by the China Food and Drug Administration; hyperthermia; and psychological rehabilitation were initiated as alternative therapies. Survival time, quality of life and toxicity were evaluated during treatment. Results: The average ECOG score decreased from 3 to 2, and appetite and sleep improved in all three groups. According to CTCAE criteria, no severe hematology and digestion side-effect above grade 2 were observed. In pancreatic cancer group, the median and the average survival time were 5.1 and 6.5 months. The longest survival time was 16.7 months and patient still alive. The 3-, 6-, and 10-month survival rates were 92.3%, 46.2% and 30.8%, respectively. In liver cancer group, the average and median survival time were 12.48 and 5.03 months, respectively; the longest survival time was 84.17 months. The 3-, 6-, and 12-month survival time rates were 77.42%, 38.71%, and 29.03%, respectively. In lung cancer group, 31.58% patients suffered from pleural effusion. The 6 month, 1-, 2- and 5-year survival time rates were 33.93%, 19.05%, 14.29% and 4.17%, respectively. Furthermore, once the survival time was beyond 6 months, the average and median survival time reached 29.98 and 14.80 months; and the 1-, 2- and 5-year survival time rates were up to 56.14%, 42.11% and 12.28%, respectively. Conclusions: Herbal extract preparations, which are a part of palliative care, show acceptable effectiveness and toxicity. Thus, it may prove to be a considerable strategy and optional maintenance therapy for stage IV patients.