Center of Integrative Medicine, Beijing Ditan Hospital, Affiliated to Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China.
Department of hepatobiliary spleen and stomach, Henan Province of TCM, No. 6 Dongfeng Road, Zhengzhou, 420002, Henan Province, China.
Phytomedicine. 2019 Sep;62:152930. doi: 10.1016/j.phymed.2019.152930. Epub 2019 May 11.
Many patients with hepatocellular carcinoma (HCC) in Asian countries seek adjuvant therapy with traditional Chinese medicine (TCM). This study aims to explore the benefits of TCM therapy in the long-term survival of patients with hepatocellular carcinoma in China.
In total, 3483 patients with HCC admitted to the Beijing Ditan Hospital of Capital Medical University were enrolled in this study. We used 1:1 frequency matching by sex, age, diagnosis time, Barcelona Clinic Liver Cancer staging, and type of treatments to compare the TCM users (n = 526) and non-TCM users (n = 526). A Cox multivariate regression model was employed to evaluate the effects of TCM therapy on the HR value and Kaplan-Meier survival curve for mortality risk in HCC patients. A log-rank test was performed to analyze the effect of TCM therapy on the survival time of HCC patients.
The Cox multivariate analysis indicated that TCM therapy was an independent protective factor for 5-year survival in patients with HCC (adjusted HR = 0.46, 95% CI 0.40-0.52, p < 0.0001). The Kaplan-Meier curve also showed that after PS matching, TCM users had a higher overall survival rate and a higher progression-free survival rate than non-TCM users. TCM users, regardless of the classification of etiology, tumor stage, liver function level, or type of treatment, all benefited significantly from TCM therapy. In addition, it was found that the most commonly used Chinese patent medications are Fufang Banmao Capsule, Huaier Granule, and Jinlong Capsule.
Using traditional Chinese medications as adjuvant therapy can probably prolong median survival time and improve the overall survival among patients with HCC. Further scientific studies and clinical trials are needed to examine the efficiency and safety.
许多亚洲国家的肝细胞癌 (HCC) 患者寻求中药 (TCM) 的辅助治疗。本研究旨在探讨 TCM 治疗在中国 HCC 患者长期生存中的获益。
共纳入 3483 例首都医科大学附属北京地坛医院 HCC 患者。采用 1:1 频数匹配法,按照性别、年龄、诊断时间、巴塞罗那临床肝癌分期和治疗方式对 TCM 使用者 (n = 526) 和非 TCM 使用者 (n = 526) 进行匹配。采用 Cox 多因素回归模型评估 TCM 治疗对 HCC 患者 HR 值和死亡率风险的 Kaplan-Meier 生存曲线的影响。采用对数秩检验分析 TCM 治疗对 HCC 患者生存时间的影响。
Cox 多因素分析表明,TCM 治疗是 HCC 患者 5 年生存的独立保护因素 (调整 HR = 0.46,95%CI 0.40-0.52,p < 0.0001)。Kaplan-Meier 曲线也显示,在 PS 匹配后,TCM 使用者的总生存率和无进展生存率均高于非 TCM 使用者。无论病因分类、肿瘤分期、肝功能水平或治疗方式如何,TCM 使用者均从 TCM 治疗中获益显著。此外,发现最常用的中药制剂有复方斑蝥胶囊、槐耳颗粒和金龙胶囊。
使用中药作为辅助治疗可能会延长 HCC 患者的中位生存时间并改善总体生存。需要进一步的科学研究和临床试验来检验其有效性和安全性。