Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
Complement Ther Med. 2018 Oct;40:29-36. doi: 10.1016/j.ctim.2018.07.003. Epub 2018 Jul 10.
The main objective of this study was to assess whether treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with Chinese herbal medicine (CHM), can improve the five-year survival rate in patients suffering from advanced non-small cell lung cancer (NSCLC), compared to patients treated by EGFR-TKIs alone.
The study is based on information in the sub-dataset of the National Health Insurance Research Database (NHIRD) from years 2000 to 2010, during which time a total of 14,244 patients were diagnosed with NSCLC in Taiwan. After selection by exclusion criteria and matching process, 2,616 NSCLC patients were included in the study. Statistical analysis was utilized to evaluate the differences in characteristic distribution, and to compare the survival rates between the CHM cohort and non-CHM cohort.
Patients with advanced NSCLC using CHM as an adjunct therapy exhibited a significantly improved survival rate [hazard ration (HR) = 0.8; 95% confidence interval (CI): 0.73-0.87, p value<0.001], compared with non-CHM users. Based on a survival analysis by Kaplan-Meier method, the 5-year survival rate of CHM users was 4.9% higher, with the most notable difference being an elevated 2-year survival rate of up to 12.75%. In addition to the survival rate analysis, we provide the ten most used single herbs and herbal formulas prescribed for patients with advanced NSCLC.
This nationwide retrospective cohort study provides evidence supporting CHM as an effective adjunctive therapy to ameliorate the side effects of target therapy and prolong the five-year survival rate of patients with advanced NSCLC.
本研究的主要目的是评估表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）联合中药（CHM）治疗是否能提高晚期非小细胞肺癌（NSCLC）患者的五年生存率，与单独接受 EGFR-TKIs 治疗的患者相比。
本研究基于 2000 年至 2010 年国家健康保险研究数据库（NHIRD）的子数据集的信息，在此期间，台湾共有 14244 例患者被诊断为 NSCLC。经过排除标准和匹配过程的选择，共有 2616 例 NSCLC 患者纳入本研究。统计分析用于评估特征分布的差异，并比较 CHM 组和非-CHM 组的生存率。
使用 CHM 作为辅助治疗的晚期 NSCLC 患者的生存率显著提高[风险比（HR）=0.8；95%置信区间（CI）：0.73-0.87，p 值<0.001]，与非-CHM 使用者相比。基于 Kaplan-Meier 方法的生存分析，CHM 使用者的 5 年生存率提高了 4.9%，最显著的差异是 2 年生存率提高了 12.75%。除了生存率分析，我们还提供了用于治疗晚期 NSCLC 患者的十种最常用的单味草药和草药配方。
这项全国性回顾性队列研究提供了证据支持 CHM 作为一种有效的辅助治疗方法，可以改善靶向治疗的副作用，并延长晚期 NSCLC 患者的五年生存率。
