Urushiyama Hirokazu, Jo Taisuke, Yasunaga Hideo, Michihata Nobuaki, Yamana Hayato, Matsui Hiroki, Hasegawa Wakae, Hiraishi Yoshihisa, Mitani Akihisa, Fushimi Kiyohide, Nagase Takahide, Yamauchi Yasuhiro
Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
J Clin Med. 2018 Aug 28;7(9):246. doi: 10.3390/jcm7090246.
Irinotecan hydrochloride (CPT-11) is used to treat a wide spectrum of malignant tumors. Hangeshashin-to (Japanese herbal medicine TJ-14) is reportedly effective in preventing and controlling diarrhea associated with CPT-11. However, the effect of TJ-14 on tolerability of chemotherapy with CPT-11 has not been fully investigated. We used the Japanese Diagnosis Procedure Combination inpatient database to retrospectively identify patients who had received CPT-11 on their first admission with and without TJ-14. Patients who did receive TJ-14 ( = 7092) received CPT-11 more often and in larger doses than those who did not receive TJ-14 ( = 82,019). The incidence rate ratio of CPT-11 administration was 1.34 for frequency (95% confidence interval [CI], 1.31⁻1.38; < 0.001), and 1.16 for total dose (95% CI, 1.14⁻1.19; < 0.001) according to stabilized inverse probability treatment weighting using propensity scores. Instrumental variable analysis showed similar trends. In-hospital mortality was significantly lower in patients who received TJ-14 than in those who did not. Odds ratios of in-hospital death in patients receiving TJ-14 was 0.81 (95% CI, 0.71⁻0.93; = 0.002) according to stabilized inverse probability treatment weighting using propensity scores and 0.42 (95% CI, 0.22⁻0.81; = 0.009) according to instrumental variable analysis. Our findings indicate that TJ-14 improve the tolerability of CPT-11.
盐酸伊立替康（CPT - 11）用于治疗多种恶性肿瘤。据报道，汉方柴胡汤（日本草药TJ - 14）在预防和控制与CPT - 11相关的腹泻方面有效。然而，TJ - 14对CPT - 11化疗耐受性的影响尚未得到充分研究。我们使用日本诊断程序组合住院患者数据库，回顾性识别首次入院时接受CPT - 11治疗且使用或未使用TJ - 14的患者。接受TJ - 14的患者（n = 7092）比未接受TJ - 14的患者（n = 82,019）更频繁、更大剂量地接受CPT - 11治疗。根据使用倾向评分的稳定逆概率治疗加权法，CPT - 11给药的发生率比为频率1.34（95%置信区间[CI]，1.31⁻1.38；P < 0.001），总剂量为1.16（95% CI，1.14⁻1.19；P < 0.001）。工具变量分析显示了类似趋势。接受TJ - 14的患者院内死亡率显著低于未接受TJ - 14的患者。根据使用倾向评分的稳定逆概率治疗加权法，接受TJ - 14的患者院内死亡的优势比为0.81（95% CI，0.71⁻0.93；P = 0.002），根据工具变量分析为0.42（95% CI，0.22⁻0.81；P = 0.009）。我们的研究结果表明，TJ - 14可提高CPT - 11的耐受性。
