Beijing University of Chinese Medicine, Beijing, China.
China-Japan Friendship Hospital, Beijing, China.
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420958488. doi: 10.1177/1534735420958488.
Type 1 gastric neuroendocrine tumors (g-NETs) have a good prognosis but a high recurrence rate.
To observe the clinical efficacy of the treatment of type 1 g-NETs with the Chinese herbal decoction SMLJ01.
A prospective and retrospective, clinical, controlled observation was conducted in 4 Chinese centers from 2012 to 2019. Patients with type 1 g-NETs were nonrandomly divided into treatment and control groups after endoscopic treatment based on herbal treatment administered according to their wishes. The treatment group received oral SMLJ01, with follow-up every 6 to 12 months, while the control group received follow-up alone. Patient follow-up (via telephone) from 2012 to 2017 was mainly retrospective. All patients after 2017 were followed prospectively. The recurrence times and rates were compared after treatment for at least 6 months. Symptom improvements were evaluated in the treatment group. The follow-up ended on October 31, 2019.
During a median follow-up of 22 months (range: 2-86 months), the survival rate was 100%, and no metastases occurred. Twenty-one of the 82 treated patients (25.6%) had recurrence after a median of 22 months, and 22 of the 54 control patients (40.7%) had recurrence after a median of 8 months ( = .063). The Kaplan-Meier curve analysis showed that the patients in the treatment group had a significantly longer median recurrence-free survival (RFS) time than those in the control group ( = .001). The risk of recurrence in the treatment group was 0.38 relative to that in the control group (95% CI: 0.20-0.70). The symptom score of the patients after taking Chinese medicine was 19.5 (10.3, 28.0), which was significantly lower than before treatment (31.5 (19.3, 38.0)). The difference was statistically significant ( < .01).
SMLJ01, with the effects of soothing the liver, strengthening the spleen, increasing acid and harmonizing the stomach, may help reduce the recurrence rate, relieve symptoms and prolong the recurrence time in patients with type 1 g-NETs and is worthy of evaluation with further randomized research with large sample sizes and longer follow-up periods.
1 型胃神经内分泌肿瘤(g-NETs)具有良好的预后,但复发率较高。
观察中药复方 SMLJ01 治疗 1 型 g-NETs 的临床疗效。
2012 年至 2019 年,在中国 4 家中心进行了前瞻性和回顾性、临床、对照观察。根据患者的意愿进行草药治疗后,内镜治疗后的 1 型 g-NETs 患者被非随机分为治疗组和对照组。治疗组口服 SMLJ01,每 6-12 个月随访一次,对照组仅随访。2012 年至 2017 年的患者随访主要为回顾性,2017 年后所有患者均前瞻性随访。治疗至少 6 个月后比较复发次数和复发率。评估治疗组的症状改善情况。随访于 2019 年 10 月 31 日结束。
中位随访 22 个月(范围:2-86 个月)时,生存率为 100%,无转移发生。82 例治疗患者中有 21 例(25.6%)在中位 22 个月后复发,54 例对照患者中有 22 例(40.7%)在中位 8 个月后复发( = .063)。Kaplan-Meier 曲线分析显示,治疗组患者的中位无复发生存时间明显长于对照组( = .001)。治疗组的复发风险相对于对照组为 0.38(95%CI:0.20-0.70)。服用中药后患者的症状评分(19.5,10.3,28.0)明显低于治疗前(31.5,19.3,38.0)( < .01)。
SMLJ01 具有柔肝健脾、增酸和胃的作用,可能有助于降低 1 型 g-NETs 患者的复发率,缓解症状,延长复发时间,值得进一步进行大样本量、长期随访的随机研究评估。