Niwa Institute for Immunology and Tosashimizu Hospital, Tosashimizu, Japan.
Integr Cancer Ther. 2013 Jan;12(1):50-68. doi: 10.1177/1534735412441704. Epub 2012 Apr 26.
Naturopathic treatment will benefit patients with hepatocellular carcinoma (HCC).
Retrospective analysis of case series of HCC patients treated with naturopathic agents.
HCC was diagnosed by dynamic computed tomography (CT) imaging and α-fetoprotein (AFP) or PIVKA II, or by histology. Tumor staging was determined by CT. A modified Childs-Pugh scoring was used to assess liver disease. Patients were treated with orally administered combinations of 12 naturopathic agents. Patients were monitored clinically and by CT tumor imaging, serial tumor markers, and liver function tests.
101 patients with HCC (67 men and 34 women, age 67.2 ± 8.8 years) were treated for a median of 13.4 months (range 0.8-100.8). Of these 84% had cirrhosis, 63% had hepatitis C virus, 18% had hepatitis B virus, 1% had both, and 9% had metastatic disease. Median modified Childs-Pugh score was 6 (range 3-13). Barcelona Clinic Liver Cancer tumor stages of 0, A, B, C, and D were found in 36%, 25%, 20%, 14%, and 6%, respectively. Median AFP was 40 (range 0-311,000). Median PIVKA II was 59 (0-378,000). Previous treatment was included none (27%), resection with relapse (20%), transarterial chemoembolization (50%), radiofrequency ablation (28%), percutaneous ethanol injection therapy (15%), chemotherapy (14%).
Initial treatment was with 2.6 ± 0.8 agents (range 2-4). Overall, patients were treated with 3.7 ± 1.2 agents (range 2-7). There was a significant correlation between number of agents administered and survival (P < .0001). Patients treated with ≥4 agents survived significantly longer than patients treated with ≤3 agents (40.2 vs 6.4 months, P < .0001). This difference could not be attributed to statistically significant differences in severity of liver disease or tumor stage, delay in treatment, previous treatment, concurrent nondrug treatment, or censoring effects. The greatest effect was seen in patients treated with at least 4 agents that included Cordyceps sinensis. This prolonged survival was without toxic side effects and appeared to potentiate the survival benefit of conventional therapy.
Treatment of HCC with a regimen of ≥4 agents prepared from natural products was associated with prolonged survival in a substantial portion of patients. The data provide level II evidence for the efficacy of naturopathic therapy in HCC.
顺势疗法治疗将有益于肝细胞癌（HCC）患者。
对接受顺势疗法药物治疗的 HCC 患者的病例系列进行回顾性分析。
通过动态计算机断层扫描（CT）成像和α-胎蛋白（AFP）或 PIVKA II 或组织学诊断 HCC。通过 CT 确定肿瘤分期。使用改良的 Childs-Pugh 评分来评估肝病。患者接受口服联合 12 种顺势疗法药物治疗。通过临床和 CT 肿瘤成像、连续肿瘤标志物和肝功能检查监测患者。
101 例 HCC 患者（67 名男性和 34 名女性，年龄 67.2 ± 8.8 岁）接受中位数为 13.4 个月（范围 0.8-100.8）的治疗。其中 84%有肝硬化，63%有丙型肝炎病毒，18%有乙型肝炎病毒，1%同时有两种，9%有转移性疾病。改良 Childs-Pugh 评分中位数为 6（范围 3-13）。巴塞罗那临床肝癌肿瘤分期 0、A、B、C 和 D 分别为 36%、25%、20%、14%和 6%。中位 AFP 为 40（范围 0-311000）。中位 PIVKA II 为 59（0-378000）。既往治疗包括无（27%）、复发切除（20%）、经动脉化疗栓塞（50%）、射频消融（28%）、经皮乙醇注射治疗（15%）、化疗（14%）。
初始治疗采用 2.6 ± 0.8 种药物（范围 2-4）。总体而言，患者接受 3.7 ± 1.2 种药物治疗（范围 2-7）。给予的药物数量与生存之间存在显著相关性（P<.0001）。接受≥4 种药物治疗的患者的生存期明显长于接受≤3 种药物治疗的患者（40.2 与 6.4 个月，P<.0001）。这种差异不能归因于肝病严重程度或肿瘤分期、治疗延迟、既往治疗、同时进行的非药物治疗或删失效应的统计学显著差异。在接受至少 4 种药物治疗的患者中观察到最大的效果，这些药物包括冬虫夏草。这种延长的生存期没有毒副作用，似乎增强了常规治疗的生存获益。
用天然产物组成的≥4 种药物方案治疗 HCC 与相当一部分患者的生存延长有关。该数据为顺势疗法治疗 HCC 的疗效提供了二级证据。
