大腸がん手術とＭＭＣ・ＦＴ‐２０７併用補助化学療法の成績

Purpose: To report a Taiwanese female with extensive conjunctival squamous cell carcinoma significantly reduced by radiotherapy and adjuvant topical mitomycin C. Methods: Case report Result: A 79-year-old Taiwanese woman with a history of lymphoma visited our uveitis service due to suspected ocular metastasis. On examination, an extensive papilliform conjunctival mass (24 mm×19mm×11 mm) with periorbital region involvement was observed over the left eye. Orbital computed tomography (CT) scan and positron emission tomography (PET) demonstrated a massive suspected malignant mass lesion over the peribulbar region without intraocular invasion. Under impression of conjunctival lymphoma, incisional biopsy was performed, revealing squamous cell carcinoma. Focal radiotherapy was applied but showed limited response. Therefore, adjuvant topical 0.04% mitomycin C was prescribed. Dramatic tumor reduction was observed with visual acuity of 6/20 achieved after radiation and adjuvant topical chemotherapy. Conclusions: Radiotherapy with adjuvant topical chemotherapy shows potential in the management of extensive conjunctival squamous cell carcinoma.

Special AT-rich sequence-binding protein 2 (SATB2) is a novel, diagnostically useful, and highly sensitive immunohistochemical marker for both primary and metastatic colorectal or appendiceal tumors. In the present study, we aimed to assess the impact of neoadjuvant chemotherapy on SATB2 expression in primary colorectal carcinomas and their corresponding liver metastases. Forty-four patients with colorectal carcinomas who received neoadjuvant chemotherapy were included. SATB2 expression in specimens of biopsy, resected primary colorectal carcinomas, and resected metastatic foci were examined by immunohistochemistry and compared to caudal-type homeobox transcription factor 2 (CDX2). Using a modified H-score, expressions were scored semiquantitatively for both staining intensity and tumor cell proportion with nuclear staining. SATB2 was positive in 43/44 cases (98%) in biopsy specimens, 42/44 cases (96%) in resected colorectal carcinomas with neoadjuvant chemotherapy, and 9/9 cases (100%) with liver metastases. However, these expressions were variably decreased, and the H-score was lower in resected colorectal carcinomas (158 ± 69) than in biopsy specimens (174 ± 60) (p < 0.01). The proportion of SATB2-positive area of colorectal carcinoma was 93% in metastatic foci, while the CDX2-positive area was 78%. When categorized by histopathological tumor regression, the most effective tumors of chemotherapy showed the lowest H-score in resected colorectal carcinomas among the three groups (p < 0.01). SATB2 is a useful marker for both primary colorectal carcinoma and corresponding liver metastases, even with neoadjuvant chemotherapy. However, caution should be exercised when performing needle biopsy for metastatic foci with neoadjuvant therapy because expressions could be decreased, especially in chemotherapy-effective cases, and show immunohistochemically negative results.

Objective To investigate the effect of cancer drug sensitivity on the selection of chemotherapy for pancreatic cancer. Methods The cells from the cancer tissues of 156 pancreatic cancer patients were cultured with 6 kinds of chemotherapy drugs in vitro including gemcitabine (GEM), 5 fluorouracil (5-FU), Mitomycin C (MMC), Oxaliplatin (L-OHP) and irrinotecan (CPT-11), according to the in vitro standard of solitary tumor. More than 70% of inhibitory rate was highly sensitive, 50% ～ 70% was moderately sensitive, ＜ 50% was insensitive. The inhibitory rate of chemotherapy drugs were determined by MTT colorimetric assay. Results The pathological findings of the 156 cases of pancreatic cancer were pancreatic duct cancer in 135 cases, adenosquamous carcinoma in 13 cases, mucinous carcinoma in 8 cases.Pancreatic duct cancer was sensitive to all the 6 drugs; adenosquamous carcinoma and mucinous carcinoma was sensitive to all the drugs except for L-OHP and CPT-11, respectively. The inhibitory rate of GEM was higher than that of MMC, L-OHP and CPT-11 (P ＜ 0.05 ) , but there was no difference with 5-FU and DDP ( P ＞0.05 ). There was no difference among the other 5 drugs (P ＞ 0.05 ). However, the cells from different types of pancreatic cancers and the cells from different patients of the same type of pancreatic cancer have different sequence of sensitivity to the 6 kinds of chemotherapy drugs. For pancreatic duct cancer, the sequence of sensitivity was GEM ＞ DDP ＞ 5-FU ＞ CPT-11 ＞ MMC ＞ L-OHP; adenosquamous carcinoma was GEM, CPT-11 ＞ DDP, 5-FU, MMC ＞ L-OHP; mucinous carcinoma was L-OHP ＞ GEM ＞5-FU, MMC ＞ DDP ＞ CPT-11.Conclusions Cancer drug sensitivity test may help to select the fight chemotherapy and be of clinical value. Key words: Pancreatic neoplasms; Colorimetry; Drug monitoring; Chemotherapy

Background. Adjuvant chemotherapy is a standard treatment for stage III colorectal cancer patient under curative surgery. Since the toxicity of chemotherapy, the benefit of chemotherapy has been doubtful for elderly patients. This study evaluates the survival benefit of adjuvant chemotherapy in elderly patients. Methods. Atotal of 448 stage III colorectal cancer patients receiving curative surgery from April 2004 to December 2007 were enrolled. The primary outcome was post-operative disease-free survival (DFS) and overall survival (OS). The toxic effects measured during adjuvant chemotherapy include neutropenia, thrombocytopenia, anemia and infection event. Results. There were 241 patients younger than 70 and 207 patients older than 70. In the younger group, the 5-year disease-free survival (DFS) was slightly higher in the patients with adjuvant chemotherapy (5-year DFS: 62.1% vs. 33.3%, p=0.095), and the 5-year overall survival (OS) was significantly higher (5-year OS: 77.9% vs. 50.0%, p=0.026). However, in the older group, the 5-year OS was significantly higher in the adjuvant chemotherapy group (64.6% vs. 40.9%, p=0.013), but the 5-year DFS showed no difference (55.6% vs. 49.8%, p=0.668). The frequency of hematologic toxicity, such as anemia and neutropenia, was significantly higher in the older patients with intravenous chemotherapy. Conclusion. The effect of adjuvant chemotherapy in elderly patients with colorectal cancer was equivocal. Careful patient selection is necessary. Increased hematologic adverse events were observed in elderly patients with intravenous chemotherapy; close monitoring is necessary to avoid severe adverse events.

Serum carcinoembryonic antigen (CEA) and computed tomographic (CT) scans of the abdomen and pelvis have limited value in the follow-up of patients after surgical resection of a colorectal carcinoma. The CEA scan is a Tc-99m-labeled anti-CEA antibody for gamma camera imaging in the assessment of recurrent colorectal carcinoma. The authors describe a patient with a history of sigmoid resection for carcinoma who was examined for hematuria. A CT scan showed a mass in the pelvis resulting from either scarring or recurrent tumor. The CEA scan showed a focus of increased uptake in the pelvis. Surgery confirmed the mass, an invasive, moderately differentiated adenocarcinoma at the anastomotic site.

To investigate the prognostic factors of colorectal cancer patients with liver metastasis in order to provide reference for clinical practice. Clinicopathological and follow-up data of 264 cases of colorectal liver metastasis in our department from January 1997 to January 2012 were analyzed retrospectively. Among these 264 patients, 217 underwent primary colorectal cancer resection, 33 underwent combined resection of primary colorectal lesion plus liver metastasis, and 14 received stoma creation alone. Besides, 197 patients received adjuvant chemotherapy, 14 received adjuvant radiotherapy, and 42 underwent interventional treatment. Clinicopathological features and treatment scheme affecting prognosis were analyzed and prognostic stratification analysis was performed according to emergence time of liver metastasis (synchronous or metachronous). Of 264 patients, 1-, 3-, and 5-year overall survival rates were 77.0%, 31.7%, and 14.0%; median survival time was 25 months; 1-, 3-, and 5-year survival rates of synchronous colorectal liver metastasis were 68.8%, 22.3%, and 7.7%; 1-, 3-, and 5-year survival rates of metochronous colorectal liver metastasis were 95.8%, 49.0%, and 21.3%, whose difference was statistically significant (P<0.05). Multivariate analysis showed that primary tumor differentiation, CEA level, adjuvant chemotherapy, and radical resection were independent prognostic factors of colorectal cancer patients with liver metastasis (all P<0.05), while primary tumor differentiation, CEA level, and radical resection were independent prognostic factors of synchronous liver metastasis (all P<0.05), and primary tumor location and CEA level were independent prognostic factors of metachronous liver metastasis (all P<0.05). Radical operation and adjuvant chemotherapy should be emphasized for colorectal liver metastasis, especially for synchronous colorectal liver metastasis. Simple resection of primary tumor can not improve the overall survival of patients with colorectal liver metastasis.

To evaluate the clinical application of carbon nanoparticles labeled lymph node staining in curative laparoscopic resection for colorectal carcinoma. Sixty-five patients undergoing curative laparoscopic resection for colorectal carcinoma in the Sun Yat-sen Memorial Hospital between September 2011 and June 2013 were prospectively enrolled and randomly divided into label group (with carbon nanoparticles, n=34) and control group (without carbon nanoparticles, n=31). Association between labeled lymph nodes and metastasis was analyzed. The total number of retrieved lymph nodes and lymph nodes metastatic ratio were compared between the two groups. Mean number of retrieved lymph node of the label group was higher as compared to the control group (22.3±4.2 vs. 15.4±3.5, P<0.05). The total number of retrieved lymph node was 725 in the label group and 478 in the control group. Among them, lymph node < 5 mm accounted for 4.6% (33/725) in the label group, which was higher than 2.0% (10/478) (P=0.025) in the control group. The number of black stain label lymph node was 412, with black stain ratio 56.8% (412/725) in the label group. Metastatic ratio of black stain nodes was significantly higher than that of non-stain nodes [28.6% (118/412) vs. 19.5% (61/313), P=0.005]. The technique of carbon nanoparticles labeled lymph node staining in curative laparoscopic resection for colorectal carcinoma is easy and effective, which can increase the retrieved number of lymph nodes, especially for nodes < 5 mm. The black stain lymph nodes indicate higher risk of metastasis.

Objective To investigate the clinical value of Fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT examination to predict the prognosis of patients after colorectal cancer operation. Methods The retrospective cross-sectional study was adopted. The clinicopathological data of 80 patients with colorectal cancer who were admitted to the First Hospital of Nanjing Medical University from March 2007 to October 2015 were collected. Eighty patients received first preoperative 18F-FDG PET/CT examination and underwent operations under decisions of patients and their families, and then adjuvant chemotherapy were performed according to the patients′ condition. Observation indicators included: (1) preoperative imaging examination, (2) situations of treatment and follow-up, (3) analysis of prognostic factors. The patients were followed up by outpatient examination and telephone interview once every 3 months within postoperative 1 year, once every half a year within postoperative 2 years and then once a year up to May 2016. The follow-up included tumor recurrence or progression and survival of patients. Tumor-free survival time was from postoperative day 1 to tumor recurrence or progression and death or end of follow-up. Overall survival time was from postoperative day 1 to death or end of follow-up. Measurement data with skewed distribution were represented as M (Qn) and M (range). The optimal cutoff point of tumor-free survival of maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolism of volume (MTV) and total lesion of glycolysis (TLG) were investigated using the ROC curve analysis, and calculating area under the curve (AUC). The median was used as a cutoff point if there was smaller AUC. The Kaplan-Meier method and Log-rank test were respectively used for survival analysis and univariate analysis, and COX proportional hazards model for multivariate analysis. Results (1) Results of preoperative imaging examination: results of PET/CT in patients with colorectal cancer showed there were circumscribed thickening of bowel wall, intestinal cavity strictures, fuzzy fat space around the some lesions, enlarged lymph node and 18F-FDG uptake increased abnormally. The SUVmax, SUVmean, MTV and TLG of 80 patients were 11.83(4.26, 35.42), 7.06(2.38, 20.92), 20.47 cm3(1.29 cm3, 161.50 cm3) and 138.58(14.17, 857.89), respectively. ROC curve showed that the AUC of SUVmax , SUVmean, MTV and TLG were 0.453, 0.448, 0.815 and 0.749 [95% confidence interval (CI): 0.307-0.600, P>0.05; 0.303-0.594, P>0.05; 0.717- 0.913, P<0.05; 0.635- 0.863, P<0.05], respectively. The median SUVmax (11.83) and SUVmean(7.06) were used as the cutoff points due to smaller AUC of SUVmax and SUVmean. The cutoff point of MTV was 18.79 cm3 (sensitivity=86.2% and specificity=68.3%), and the cutoff point of TLG was 142.05 (sensitivity=75.9% and specificity=70.7%). (2) Situations of treatment and follow-up: among 80 patients, 13 underwent the radical resection of colorectal cancer and resection of liver metastasis and 67 underwent radical resection of colorectal cancer. Sixty-two patients received postoperative chemotherapy, including 45 with chemotherapy regimens of capecitabine and 17 with fluorouracil. Eighty patients were followed up for 41.8 months (range, 6.5-109.1 months ). During the follow-up, 29 patients had tumor recurrence or progression, and 19 patients were dead. The median tumor-free survival time, 1-, 3- and 5-year tumor-free survival rates in 80 patients were 19.5 months (range, 2.0-109.1 months), 73.7%, 36.3% and 18.8%, respectively. The median overall survival time, 1-, 3- and 5-year overall survival rates were 31.8 months (range, 3.3-109.1 months), 76.3%, 37.5% and 20.0%, respectively. (3) Analysis of prognostic factors: results of univariate analysis showed that tumor location, N staging, M staging, clinical staging, postoperative chemotherapy, MTV and TLG were relative factors affecting postoperative tumor-free survival rate (HR=3.469, 5.325, 5.295, 8.605, 2.630, 7.388, 5.155, 95% CI: 1.522-7.906, 2.256-12.568, 2.405-11.657, 2.969-24.937, 1.063-6.504, 2.550-21.403, 2.178-12.204, P<0.05). The tumor location, tumor differentiation, N staging, M staging, clinical staging, MTV and TLG were relative factors affecting postoperative overall survival rate (HR=2.697, 2.814, 3.083, 2.916, 4.193, 5.450, 4.876, 95% CI: 1.011-7.197, 1.121-7.062, 1.166-8.149, 1.140-7.454, 1.386-12.678, 1.581-18.786, 1.727-13.766, P<0.05). In multivariate analysis, stage Ⅲ-Ⅳ of clinical staging and TLG≥142.05 were independent risk factors affecting postoperative tumor-free survival rate (HR=9.879, 3.569, 95% CI: 1.854-22.836, 1.127-11.306, P<0.05). The stage M1, stage Ⅲ-Ⅳ of clinical staging and TLG≥142.05 were independent risk factors affecting postoperative overall survival rate (HR=4.522, 9.315, 10.120, 95% CI: 1.223-16.717, 1.338-24.864, 2.385-12.947, P<0.05). Conclusion TLG through 18F-FDG PET/CT examination is an independent prognostic factor affecting postoperative tumor-free survival rate and overall survival rate in patients with colorectal cancer after curative resection, and it has certainly reference value for prognosis. Key words: Colorectal neoplasms; Prognosis; Tomography, emission-computed; Tomography, X-ray computed; Deoxyglucose

The chemotherapy regimen is particularly important for colorectal carcinoma patients with postoperative basic diseases, especially myocardial infarction. The patient in this case, diagnosed as postoperative stage IIIC rectal carcinoma with myocardial infarction, was treated with raltitrexed-based chemotherapy regimen. The treatment was successfully and the heart function remained stable. In this case report, we share the treatment process as follows. Key words: Rectal neoplasms; Fluoropyrimidines; Myocardial infarction; Raltitrexed

Objective To investigate the influence of time of initiating adjuvant chemotherapy (AC) on intrahepatic recurrence-free survival (RFS) and liver injury in patients with synchronous colorectal liver metastasis (CRLM) after receiving microwave ablation (MWA). Methods Data were retrospectively collected from patients with synchronous CRLM undergoing ultrasound-guided percutaneous MWA combined with AC at our center from October 2013 to January 2019. According to the time of initiating AC relative to the date of MWA, the patients were categorized into two groups:≤4 weeks (G1) and 4~8 weeks (G2). Kaplan-Meier method and log-rank test were used to compare the RFS between the two groups. Cox regression models were used for univariate and multivariate analyses to identify predictors of RFS. Besides, the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) before and after the first AC were also compared between the G1 and G2 groups. Results A total of 144 patients were included in this study (G1, n=98; G2, n=46). Median RFS was 22.2 months. The RFS was significantly longer in the G1 group than in the G2 group (median RFS, 40.6 months vs 12.6 months, log-rank P=0.007). In Cox regression analysis, G2 (hazard ratio [HR]=1.917, 95% confidence interval CI: 1.104-3.327, P=0.021) and the number of tumors (HR=1.292, 95%CI: 1.096-1.524, P=0.002) were independent predictors of shorter RFS. There was no difference in ALT or AST level between the G1 and G2 groups before and after the first AC (P>0.05). Conclusion For synchronous CRLM patients, receiving AC within 4 weeks after MWA may be beneficial to longer RFS. Key words: Colorectal neoplasm; Liver metastasis; Microwave ablation; Recurrence; Adjuvant chemotherapy

The first step of colorectal carcinoma spread depends on the ability of the tumor cells to degrade and invade the extracellular matrix (ECM). The objectives of the current study were to evaluate the serum pattern of laminin, C-terminal peptide of Type I (PIP), and N-terminal peptide of Type III (PIIIP) procollagens, markers of ECM synthesis, in the follow-up of patients after resection for colorectal carcinoma and to evaluate their role in predicting local recurrence or metastases. A total of 32 patients who had undergone resection for colorectal carcinoma were followed for a median period of 24 months (range, 6-36 months). Every 3 months, laminin, PIP, and PIIIP were measured in the sera together with the tumor markers carcinoembryonic antigen (CEA), CA 19-9, and tissue plasminogen activator (TPA). Twenty-one patients (Group 1) had no signs of recurrence, whereas the remaining 11 (Group 2) developed hepatic (n = 7) or pulmonary (n = 4) metastases. No variations were observed in either group for laminin, CEA, CA 19-9, or TPA, whereas significant increases in PIP and PIIIP were observed in both groups 3 months after surgery. The increase in PIP and PIIIP at the 3-month follow-up was significantly greater in Group 1 than in Group 2. The difference between values at 3 months and basal values enabled a discrimination between Group 1 and Group 2, with a sensitivity of 36% and 91% and a specificity of 71% and 71% for PIP and PIIIP, respectively. The authors believe PIIIP is useful as an early prognostic indicator of recurrence in the follow-up of patients who have undergone radical resection for colorectal carcinoma.

Background and Purpose. 5-fluorouracil (5-FU)-based chemotherapy for colorectal cancer has been used for many years. Complications associated with 5-FU based chemotherapy are not rare, but central neurological effects, including encephalopathy, are unusual. Here, we analyzed our experience with complications associated with chemotherapy of colorectal cancer with the intent of learning how we might decrease the risk of complications. Methods. We retrospectively reviewed the medical records of patients in our section of Taipei Tzu Chi hospital who had received adjuvant or neoadjuvant chemotherapy from 2010 to 2014 for the treatment of colorectal cancer. We compared and analyzed the patients’ clinical characteristics, pre-chemotherapy laboratory data, chemotherapy regimens, and complications. Results. Eighty patients received the FOLFOX6 regimen; 13 patients received the FOLFIRI regimen together with bevacizumab. Four cases of hyperammonemic encephalopathy occurred. All cases were in patients who had received 5-FU dissolved in a modest volume (500 ml) saline, whereas no cases occurred in patients who received 5-FU in 2000 ml saline. No statically significant differences in pre-chemotherapy laboratory data, body surface area, or chemotherapy dose between patients with encephalopathy and those without encephalopathy were identified. We also analyzed all cases in which the dose of chemotherapy was reduced for any reason.We found a trend towards dose reduction associated with the administration of the chemotherapeutic agents in limited amounts of saline and a BUN/ creatinine ratio ＞ 20. Conclusions.We conclude that the administration of 5-FU in a low volume of fluid increases the risk of hyperammonemic encephalopathy and probably the need to reduce the doses of chemotherapeutic agents. Chemotherapeutic regimens with 5-FU in 500 ml saline should be avoided, especially if the pre-chemotherapy BUN/creatinine ratio is greater than 20.

Liver metastasis is the most common metastasis pattern of colorectal cancer. In recent years, with the renewal of the concept of diagnosis and treatment, the progress of surgical technology and the diversification of treatment options, the prognosis (overall survival, OS) of patients with colorectal cancer liver metastasis (CRCLM) has also been significantly improved. In this review, we introduced the recent updates of concepts including oligometastases, no evidence of disease (NED), criteria of resectable disease, parenchymal sparing surgery, different types of R1 resection margin, liver first approach, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), hepatic arterial infusion (HAI), and other novel local treatments, in the care of patients with CRCLM. At the same time, the overall treatment modalities of patients with initial resectable and initial unresectable liver metastases are introduced, including some new advances in neoadjuvant chemotherapy, adjuvant chemotherapy, palliative chemotherapy and targeted drug use strategies. Key words: Colorectal cancer; Liver metastasis; Treatment strategies

Sixty-six chemotherapy-naive patients with non-small-cell carcinoma of the lung were given two courses of systemic chemotherapy consisting of mitomycin C, vindesine, and cisplatin. The effect of the timing of administration of grannulocyte colony-stimulating factor (G-CSF) on the incidence of neutropenic fever, the nadir leukocyte count, the duration of neutropenia ( < or = 1000/mm3), and the time needed for recovery from neutropenia was studied. Patients were assigned at random to begin receiving G-CSF (50 microns/m2, subcutaneously) either when the leukocyte count was less than or equal to 1000/mm3 (group I) or when it was between 1000/mm3 and 2000/mm3 (group II), in a crossover fashion. The nadir leukocyte count was lower in group I than in group II (859/mm3 and 1215/mm3, respectively). The duration of leukopenia (defined as a leukocyte count less than or equal to 1000/mm3) was greater in group I than in group II (1.5 days and 0.8 day, respectively), as was the time needed for recovery to a leukocyte count of 2000/mm3 (1.9 days and 1.6 days, respectively) (p < 0.05). No differences were found in the incidence of neutropenic fever (group I: 44%, group Ii: 45%), in the duration of fever (group I: 2.3 days, group II: 2.8 days), or in the duration of G-CSF use (group I: 6.3 days, group II: 6.8 days). There were no treatment-related deaths in either group. We conclude that when this type of combination chemotherapy is given for non-small-cell carcinoma of the lung, administration of G-CSF can be postponed without clinical problems until the leukocyte count is less than of equal to 1000/mm3.

Objective To evaluate the efficacy of adjuvant chemotherapy combined with traditional Chinese medicine (TCM) on the prevention of the radical resected non-small cell lung cancer (NSCLC) relapse and metastasis. Methods A double-blind and randomized controlled clinical trial including 100 patients with radical resected NSCLC enrolled was designed. The subjects were randomly divided into two groups, adjuvant chemotherapy group combine with placebo (control group) and adjuvant chemotherapy combined with TCM group (trial group). 4 cycles of adjuvant chemotherapy [NC regimen: vinorelbine 25 mg/m2, d1 and d8 combined with carboplatin AUC = 5 mg/(ml·min), d1] were used after surgery. The curve of disease free survival (DFS) was drew by Kaplan-Meier test. Two groups' curative effects were compared by repeated measurement of quality of life (QOL) score and TCM symptom score before, during and after treatment. Results The median DFS of trail group was longer than that of control group (36.00 months vs 23.98 months, P = 0.047). Stratification analysis showed that DFS of trial group was longer than that of control group for the Ⅰ-Ⅱ stage patients (35.32 months vs 28.82 months, P = 0.037), and DFSs of both groups for patients in ⅢA stage were no difference (P = 0.555). TCM symptom complex score of the trail group was decreased after treatment and had a significantly statistical difference (P = 0.022). Cox multivariate analysis showed that the tumor stage was the main influence factor of DFS (P = 0.000). Physical function, role function, emotional function, and overall health status were significantly improved after treatment (P < 0.05). In the related symptoms, fatigue, pain, insomnia were gradually improved with the extension of treatment time and the implementation of the supplementary treatment, but there was no significant difference in the QOL between the two groups. In the trail group, there were 8 cases of adverse events, which was less than that in the control group (14 cases) (P = 0.045). Conclusion Adjuvant chemotherapy combined with TCM can prolong the DFS of patients with radical resected NSCLC, reduce recurrence rate, relieve the adverse effects of chemotherapy, and improve the clinical and Chinese medical symptoms. Key words: Carcinoma, non-small-cell lung; Postoperative adjuvant chemotherapy; Adjuvant chemotherapy combined with traditional Chinese medicine; Disease-free survival; Quality of life; Chinese medicine symptom