Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420983457. doi: 10.1177/1534735420983457.
This retrospective study investigated the efficacy and safety of chemotherapy (CTX) integrated with Traditional Korean Medicine (TKM) in patients with metastatic pancreatic cancer, in a single Korean center.
From January, 2014 to February, 2019, patients with metastatic pancreatic cancer who had received CTX were enrolled. Overall survival (OS), demographic characteristics, and adverse events were examined. Statistical analysis was utilized to evaluate the differences in characteristics and to compare the survival rates between the CTX group and CTX+TKM group. Kaplan-Meier curves were used to compare the differences in survival time. A Cox regression analysis was performed to determine the hazard ratio of the risk of mortality.
A total 37 participants were included and visited a TKM hospital 7.4 ± 8.3 months after being diagnosed with metastatic pancreatic cancer. The median age of the participants was 62 years; 26 patients (70.3%) had an Eastern Cooperative Oncology Group (ECOG) performance status between 0 and 2, and 23 patients (62.2 %) had first-line CTX failure. The median OS of all patients was 3.8 months (95% CI, 3.1-4.6). The CTX + TKM group showed longer survival (4.1 months; 95% CI, 2.4- .8) than the CTX group (2.4 months, 95% CI 0.2-4.6) but this was not statistically significant ( = .217). Chemotherapy with TKM treatment for more than 30 days (CTX + TKM ≥ 30) significantly prolonged median OS (9.1 months; 95% CI, 3.6-14.5; = .025) compared to chemotherapy alone. Cox hazard ratio analysis revealed that CTX + TKM ≥ 30 and prior chemotherapy were significantly independent prognostic factors for OS. The main herbs in the TKM treatment were Stokes and . Severe adverse events with respect to TKM treatment were not reported.
TKM treatment integrated with chemotherapy may prolong OS in patients with metastatic pancreatic cancer compared to chemotherapy treatment alone. More rigorous prospective clinical trials are needed to confirm this result.
本回顾性研究调查了在一家韩国单一中心，化疗（CTX）联合传统韩国医学（TKM）治疗转移性胰腺癌患者的疗效和安全性。
从 2014 年 1 月至 2019 年 2 月，纳入接受 CTX 治疗的转移性胰腺癌患者。检查总生存期（OS）、人口统计学特征和不良事件。采用统计学分析评估特征差异，并比较 CTX 组和 CTX+TKM 组的生存率。采用 Kaplan-Meier 曲线比较生存时间差异。采用 Cox 回归分析确定死亡率风险的危险比。
共纳入 37 名参与者，在被诊断为转移性胰腺癌后 7.4±8.3 个月就诊于 TKM 医院。参与者的中位年龄为 62 岁；26 名患者（70.3%）ECOG 表现状态为 0-2，23 名患者（62.2%）一线 CTX 治疗失败。所有患者的中位 OS 为 3.8 个月（95%CI，3.1-4.6）。CTX+TKM 组的生存时间（4.1 个月；95%CI，2.4-8）长于 CTX 组（2.4 个月，95%CI 0.2-4.6），但差异无统计学意义（=0.217）。CTX 联合 TKM 治疗超过 30 天（CTX+TKM≥30）与单纯化疗相比，中位 OS 显著延长（9.1 个月；95%CI，3.6-14.5；=0.025）。Cox 风险比分析显示，CTX+TKM≥30 和既往化疗是 OS 的独立显著预后因素。TKM 治疗中的主要草药为石见穿和白花蛇舌草。未报告 TKM 治疗的严重不良事件。
与单纯化疗相比，化疗联合 TKM 治疗可能延长转移性胰腺癌患者的 OS。需要更严格的前瞻性临床试验来证实这一结果。
