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

Table 1 Timeline

Relevant past medical history and interventions
No relevant past medical history
Date	Summaries from Initial and follow-up visits	Diagnostic testing	Interventions
June 2015	Left upper limb convulsions, urinary incontinence, nausea, vomiting, and loss of consciousness with no apparent cause	CT examination in a local hospital showed no obvious abnormality, but MRI indicated a space-occupying lesion in the right frontal lobe	Without any treatment
October 2015	Headache, limb weakness, and left hemiplegia	Repeat CT suggested a right frontal parietal lobe cerebral hemorrhage	Symptomatic supportive treatment, including carbamazepine 400 mg twice/d orally. However, the patient stopped carbamazepine of his own accord due to aggravated limb weakness
February 2016	Final diagnosis: glioblastoma, maximum diameter about 5 cm	Cranial MRI showed that the right frontal parietal lobe was occupied by a mass, identified as a possible high-grade glioma. Hematoxylin-eosin staining showed that the tumor cells diffused and infiltrated. Cells were heteromorphic with mitotic figures, microvessel hyperplasia and palisade necrosis. Tumor cells were immunopositive for glial fibrillary acidic protein immunostaining, and about 70% of tumor cells were positive for Ki-67	Partial resection and concurrent chemoradiation therapy until April 2016, with 75 mg/m2 TMZ once daily for 45 d combined with focal radiotherapy of 60 Gy administered in 30 fractions
April 2016	Intolerable ADRs, including nausea, vomiting, and loss of appetite	None	Discontinued the chemoradiotherapy
June 2016	Postoperative review: maximum diameter about 3.5 cm	Enhanced right frontal parietal lobe space-occupying lesion, maximum diameter about 3.5 cm	Kangliu Pill 7.5 g three times/d
October 2016	Maximum diameter from about 3.5 to about 2 cm	Enhanced lesion at the junction of the right frontal and parietal lobes, maximum diameter about 2 cm	Continue Kangliu pill 7.5 g three times/d
April 2019	Maximum diameter about 1 cm	Enhanced lesion at the junction of the right frontal and parietal lobes, maximum diameter about 1 cm	Continue Kangliu pill 7.5 g three times/d
Final outcome
The patient’s symptoms of headache, limb weakness, and left hemiplegia were relieved, with no side effects

CT: Computed tomography; MRI: Magnetic resonance imaging; ADRs: Adverse reactions.