YANG Yu-fei, GE Jian-zhong, WU Yu, XU Yun, LIANG Bi-yan, LUO Lin, WU Xian-wen, LIU Duan-qi, ZHANG Xia, SONG Fei-xiang, GENG Zhen-ying
Department of Oncology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing (100091), China.
Chin J Integr Med. 2008 Dec;14(4):251-6. doi: 10.1007/s11655-008-0251-9. Epub 2008 Dec 12.
To evaluate the effectiveness of a comprehensive therapy of traditional Chinese medicine (TCM) in reducing the relapse and metastasis of stage II and III colorectal cancer based on conventional Western medicine (WM) therapy.
Two hundred and twenty-two patients in total, diagnosed as stage II and III colorectal cancer from February 2000 to March 2006, were recruited from Xiyuan Hospital, China Academy of Chinese Medical Sciences and the General Hospital of Beijing Military Area. They were followed-up once every 3-6 months. Twenty cases dropped out from the cohort. The remaining 202 patients were all treated with routine WM treatment [including R0 radical operation, or chemotherapy or/and radiotherapy according to national comprehensive cancer network (NCCN) clinical guidelines]. These patients were assigned to two groups based on whether or not they were additionally treated with TCM comprehensive therapy (orally administered with a decoction according to syndrome differentiation, combined with a traditional patent drug over one year). Ninety-eight patients from Xiyuan Hospital were treated with WM and TCM (combined group), and 104 patients from the General Hospital of Beijing Military Area were treated with WM alone (WM group). The demographic data at baseline were comparable, including the operation times, age, sex, TNM staging, and pathological types. The patients were followed-up for one to five years. Up to now, there are 98, 98, 77, 64, and 47 patients with 1, 2, 3, 4, and 5 years of follow-up in the combined group, respectively; and 104, 104, 97, 81, and 55 patients in the WM group, respectively. The results of the 5-year follow-up of all the patients will be available in 2011.
The relapse/metastasis rate of 1-, 2-, 3-, 4-, and 5-year were 0 (0/98), 2.04% (2/98), 11.69% (9/77), 14.06% (9/64), and 21.28% (10/47) in the combined group, and were 4.80%(5/104), 16.35% (17/104), 21.65% (21/97), 25.93% (21/81), and 38.18%(21/55) in the WM group, respectively. A significant difference was found in the second year between the two groups (chi (2)=12.117, P=0.000). Median relapse/metastasis time was 26.5 months in the combined group and 16.0 months in the WM group.
The combined therapy of TCM and WM may have great clinical value and a potential for decreasing the relapse or metastasis rate in stage II and III colorectal cancer after conventional WM therapy.
基于西医常规治疗，评估中医综合疗法在降低Ⅱ、Ⅲ期结直肠癌复发和转移方面的有效性。
选取2000年2月至2006年3月在中国中医科学院西苑医院和北京军区总医院确诊为Ⅱ、Ⅲ期结直肠癌的患者共222例。每3 - 6个月进行一次随访。有20例患者退出该队列。其余202例患者均接受西医常规治疗[包括R0根治手术，或根据美国国立综合癌症网络（NCCN）临床指南进行化疗或/和放疗]。根据是否加用中医综合疗法（根据辨证口服汤剂，并联合一种中成药服用一年以上）将这些患者分为两组。西苑医院的98例患者接受西医和中医联合治疗（联合组），北京军区总医院的104例患者仅接受西医治疗（西医组）。两组患者的基线人口统计学数据具有可比性，包括手术时间、年龄、性别、TNM分期和病理类型。对患者进行1至5年的随访。截至目前，联合组分别有98例、98例、77例、64例和47例患者进行了1年、2年、3年、4年和5年的随访；西医组分别有104例、104例、97例、81例和55例患者进行了相应年限的随访。所有患者5年随访结果将于2011年得出。
联合组1年、2年、3年、4年和5年的复发/转移率分别为0（0/98）、2.04%（2/98）、11.69%（9/77）、14.06%（9/64）和21.28%（10/47），西医组分别为4.80%（5/104）、16.35%（17/104）、21.65%（21/97）、25.93%（21/81）和38.18%（21/55）。两组在第二年有显著差异（χ² = 12.117，P = 0.000）。联合组复发/转移的中位时间为26.5个月，西医组为16.0个月。
中西医结合疗法在西医常规治疗后，对于降低Ⅱ、Ⅲ期结直肠癌的复发或转移率可能具有重要的临床价值和潜力。
