Pine Street Foundation, San Anselmo, CA, USA.
Integr Cancer Ther. 2011 Sep;10(3):240-59. doi: 10.1177/1534735411406539. Epub 2011 Sep 30.
Although localized colon cancer is often successfully treated with surgery, advanced disease requires aggressive systemic therapy that has lower effectiveness. Approximately 30% to 75% of patients with colon cancer use complementary and alternative medicine (CAM), but there is limited formal evidence of survival efficacy. In a consecutive case series with 10-year follow-up of all colon cancer patients (n = 193) presenting at a San Francisco Bay-Area center for Chinese medicine (Pine Street Clinic, San Anselmo, CA), the authors compared survival in patients choosing short-term treatment lasting the duration of chemotherapy/radiotherapy with those continuing long-term. To put these data into the context of treatment responses seen in conventional medical practice, they also compared survival with Pan-Asian medicine + vitamins (PAM+V) with that of concurrent external controls from Kaiser Permanente Northern California and California Cancer Registries. Kaplan-Meier, traditional Cox regression, and more modern methods were used for causal inference-namely, propensity score and marginal structural models (MSMs), which have not been used before in studies of cancer survival and Chinese herbal medicine. PAM+V combined with conventional therapy, compared with conventional therapy alone, reduced the risk of death in stage I by 95%, stage II by 64%, stage III by 29%, and stage IV by 75%. There was no significant difference between short-term and long-term PAM+V. Combining PAM+V with conventional therapy improved survival, compared with conventional therapy alone, suggesting that prospective trials combining PAM+V with conventional therapy are justified.
虽然局部结肠癌通常可以通过手术成功治疗，但晚期疾病需要积极的系统治疗，但其效果较低。大约 30%至 75%的结肠癌患者使用补充和替代医学（CAM），但关于其生存效果的正式证据有限。在一项对旧金山湾区中医中心（加利福尼亚州圣安塞尔莫的松树街诊所）所有结肠癌患者（n=193）进行的 10 年随访的连续病例系列研究中，作者比较了选择短期治疗（持续化疗/放疗时间）的患者与长期治疗的患者的生存情况。为了将这些数据置于常规医学实践中观察到的治疗反应的背景下，他们还将泛亚医学+维生素（PAM+V）与 Kaiser Permanente 北加利福尼亚和加利福尼亚癌症登记处的同期外部对照的生存情况进行了比较。使用了 Kaplan-Meier、传统 Cox 回归和更现代的方法进行因果推断，即倾向评分和边缘结构模型（MSM），这些方法以前从未用于癌症生存和中药研究中。与单纯常规治疗相比，PAM+V 联合常规治疗可将 I 期、II 期、III 期和 IV 期的死亡风险分别降低 95%、64%、29%和 75%。短期和长期 PAM+V 之间没有显著差异。与单纯常规治疗相比，PAM+V 联合常规治疗可提高生存率，这表明有理由进行前瞻性试验，将 PAM+V 与常规疗法相结合。
