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      Partial response to Chinese patent medicine Kangliu pill for adult glioblastoma: A case report and review of the literature

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          Abstract

          BACKGROUND

          Glioblastoma is the most common type of brain tumor and is invariably fatal, with a mean survival time of 8-15 mo for recently diagnosed tumors, and a 5-year survival rate of only 7.2%. The standard treatment for newly diagnosed glioblastoma includes surgery followed by concurrent chemoradiotherapy and further adjuvant temozolomide. However, the prognosis remains poor and long-term survival is rare. This report aimed to demonstrate a new therapeutic strategy for the treatment of glioblastoma.

          CASE SUMMARY

          A patient was referred to the Department of Neurosurgery with an intracranial space-occupying lesion with a maximum diameter of approximately 5 cm. The tumor was compressing functional areas, and the patient accordingly underwent partial resection and concurrent chemoradiotherapy. The imaging and pathological findings were consistent with a diagnosis of glioblastoma with oligodendroglioma differentiation (World Health Organization IV). The patient was finally diagnosed with glioblastoma. However, the patient discontinued treatment due to intolerable side effects, and was prescribed Kangliu pill (KLP) 7.5 g three times/d, which he has continued to date. Significant shrinkage of the tumor (maximum diameter reduced from about 3.5 to about 2 cm) was found after 3 mo of KLP therapy, and the tumor was further reduced to about 1 cm after 3 years. The patient’s symptoms of headache, limb weakness, and left hemiplegia were relieved, with no side effects.

          CONCLUSION

          KLP has been a successful intervention for glioblastoma, and the current case indicates that traditional Chinese medicine may offer effective alternative therapies for glioblastoma.

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          Most cited references31

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          Effect of Tumor-Treating Fields Plus Maintenance Temozolomide vs Maintenance Temozolomide Alone on Survival in Patients With Glioblastoma

          Tumor-treating fields (TTFields) is an antimitotic treatment modality that interferes with glioblastoma cell division and organelle assembly by delivering low-intensity alternating electric fields to the tumor.
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            CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013–2017

            The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control (CDC) and National Cancer Institute (NCI), is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors (malignant and non-malignant) and supersedes all previous CBTRUS reports in terms of completeness and accuracy. All rates (incidence and mortality) are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 23.79 (Malignant AAAIR=7.08, non-Malignant AAAIR=16.71). This rate was higher in females compared to males (26.31 versus 21.09), Blacks compared to Whites (23.88 versus 23.83), and non-Hispanics compared to Hispanics (24.23 versus 21.48). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.5% of all tumors), and the most common non-malignant tumor was meningioma (38.3% of all tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.14. An estimated 83,830 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US in 2020 (24,970 malignant and 58,860 non-malignant). There were 81,246 deaths attributed to malignant brain and other CNS tumors between 2013 and 2017. This represents an average annual mortality rate of 4.42. The 5-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 36.0% and for a non-malignant brain and other CNS tumor was 91.7%.
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              CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2011–2015

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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                26 April 2021
                26 April 2021
                : 9
                : 12
                : 2845-2853
                Affiliations
                Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
                Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
                Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
                Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
                Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
                Department of Traditional Chinese Medicine, School of Medicine and Cancer Research Center, Xiamen University, Xiamen 361102, Fujian Province, China
                Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing 100053, China. xllin83@ 123456163.com
                Author notes

                Author contributions: Sun G, Zhuang W and Lin QT were responsible for the study design, data collection, data analysis and interpretation; Sun G was responsible for composing the manuscript; Wang LM was responsible for pathological data collection, analysis, and interpretation; Zhen YH analyzed and interpreted the neuroimaging findings; Xi SY was responsible for English and grammar corrections, critical revisions, and approved the final version; Xi SY and Lin XL were responsible for acquisition, analysis, or interpretation of data, revision for important intellectual content, final approval of the version for publication, and agreed to be accountable for all aspects of the work related to its accuracy and integrity. All authors contributed to the article and approved the submitted version.

                Supported by the Foundation for Beijing Science and Technology Development of TCM, No. JJ2016-10; and the National Traditional Chinese Medicine Innovative Talents Training Project from Beijing Municipal Science and Technology Commission , No. Z171100001717006.

                Corresponding author: Xiao-Lan Lin, Chief Pharmacist, Reader (Associate Professor), Department of Pharmacy, Xuanwu Hospital of Capital Medical University, No. 45 Changchun Street, Beijing 100053, China. xllin83@ 123456163.com

                Article
                jWJCC.v9.i12.pg2845
                10.12998/wjcc.v9.i12.2845
                8058673
                8e8c8220-8cd2-497a-b35c-0fba72e775c0
                ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 16 November 2020
                : 13 January 2021
                : 22 February 2021
                Categories
                Case Report

                glioblastoma,kangliu pill,traditional chinese medicine,therapeutic effect,adjunct therapy,chinese patent medicine,case report

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