Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Department of Healthcare Administration, Asia University, Taichung, Taiwan.
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420915275. doi: 10.1177/1534735420915275.
Some patients with cancer use adjunctive Chinese medicine, which might improve the quality of life. This study aims to investigate the effects and relative factors of adjunctive Chinese medicine on survival of hepatocellular carcinoma patients at different stages. The study population was 23 581 newly diagnosed hepatocellular carcinoma patients and received surgery from 2004 to 2010 in Taiwan. After propensity score matching with a ratio of 1:10, this study included 1339 hepatocellular carcinoma patients who used adjunctive Chinese medicine and 13 390 hepatocellular carcinoma patients who used only Western medicine treatment. All patients were observed until the end of 2012. Kaplan-Meier method and Cox proportional hazards model was applied to find the relative risk of death between these 2 groups. The study results show that the relative risk of death was lower for patients with adjunctive Chinese medicine treatment than patients with only Western medicine treatment (hazard ratio = 0.68; 95% confidence interval = 0.62-0.74). The survival rates of patients with adjunctive Chinese medicine or Western medicine treatment were as follows: 1-year survival rate: 83% versus 72%; 3-year survival rate: 53% versus 44%; and 5-year survival rate: 40% versus 31%. The factors associated with survival of hepatocellular carcinoma patients included treatment, demographic characteristics, cancer stage, health status, physician characteristics, and characteristics of primary medical institution. Moreover, stage I and stage II hepatocellular carcinoma patients had better survival outcome than stage III patients by using adjunctive Chinese medicine therapy. The effect of adjunctive Chinese medicine was better on early-stage disease.
一些癌症患者会使用辅助性中药，这可能会提高生活质量。本研究旨在探讨辅助性中药对不同分期肝癌患者生存的影响及相关因素。研究人群为 2004 年至 2010 年在台湾接受手术治疗的 23581 例新诊断的肝癌患者。经过 1:10 的倾向评分匹配后，本研究纳入了 1339 例使用辅助性中药和 13390 例仅使用西药治疗的肝癌患者。所有患者均观察至 2012 年底。采用 Kaplan-Meier 法和 Cox 比例风险模型比较两组患者的死亡相对风险。研究结果显示，辅助性中药治疗患者的死亡相对风险低于仅接受西药治疗的患者（风险比=0.68；95%置信区间=0.62-0.74）。使用辅助性中药或西药治疗的患者的生存率如下：1 年生存率：83%比 72%；3 年生存率：53%比 44%；5 年生存率：40%比 31%。与肝癌患者生存相关的因素包括治疗、人口统计学特征、癌症分期、健康状况、医生特征和初级医疗机构的特征。此外，与仅接受西药治疗相比，采用辅助性中药治疗的 I 期和 II 期肝癌患者的生存结局更好。辅助性中药的效果在早期疾病中更好。
