Xu Li-Li, Zhang Su-Fang, Wang Yu-Li, Luo Ying-Bin, Fang Zhi-Hong, Fang Yuan, Xu Rong-Zhong, Guo Peng, Wu Jian-Chun, Li Yan
Department of Oncology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Traditional Chinese and Western Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Evid Based Complement Alternat Med. 2021 Aug 23;2021:5522934. doi: 10.1155/2021/5522934. eCollection 2021.
To explore the efficacy of long-term use of Chinese herbal medicine (CHM) on survival time of lung cancer.
We conducted a retrospective cohort study on lung cancer patients. A propensity score matching (PSM) was performed to balance the covariates. Progression-free survival (PFS) was the primary endpoint and overall survival (OS) was the secondary endpoint. Patients who received CHM therapy from the initial date of diagnosis of lung cancer were included in the CHM group. Patients who were not treated with CHM during the same interval were categorized in the control group. A Cox regression model was used to explore the prognostic factors related to lung cancer. Hazard ratios of different subgroups were also analyzed.
A total of 1134 patients were included in our study: 761 patients were in the CHM group and 373 patients were in the control group. After PSM, the mPFS and mOS in the CHM group were 70.4 months and 129.1 months, respectively, while the mPFS and mOS in the control group were 23.8 months and 99.7 months, respectively. The results of survival analysis on each stage demonstrated that patients may benefit from the long-term CHM treatment especially for patients with early stage. One-year to ten-year progression-free survival rates in the CHM group were higher than those in the control group ( < 0.001). COX multivariate regression analysis indicated that CHM treatment, female, low age at diagnosis, early tumor stage, and surgery were independent protective factors against recurrence and metastasis of lung cancer. Subgroup analysis showed that CHM treatment could reduce the risk of recurrence and metastasis in each subgroup ( < 0.01).
Long-term CHM treatment with the which can be flexibly applied in the course of lung cancer treatment, not only has a positive influence on the progression-free survival time of lung cancer patients, but also reduces the risk of recurrence and metastasis of lung cancer.
探讨长期使用中药对肺癌患者生存时间的疗效。
我们对肺癌患者进行了一项回顾性队列研究。采用倾向评分匹配(PSM)来平衡协变量。无进展生存期(PFS)为主要终点,总生存期(OS)为次要终点。从肺癌诊断初始日期开始接受中药治疗的患者纳入中药组。在同一时间段内未接受中药治疗的患者归入对照组。采用Cox回归模型探讨与肺癌相关的预后因素。还分析了不同亚组的风险比。
我们的研究共纳入1134例患者:中药组761例,对照组373例。PSM后,中药组的中位PFS和中位OS分别为70.4个月和129.1个月,而对照组的中位PFS和中位OS分别为23.8个月和99.7个月。各阶段生存分析结果表明,患者可能从长期中药治疗中获益,尤其是早期患者。中药组1年至10年的无进展生存率高于对照组(<0.001)。COX多因素回归分析表明,中药治疗、女性、诊断时年龄较小、肿瘤早期阶段和手术是预防肺癌复发和转移的独立保护因素。亚组分析表明,中药治疗可降低各亚组的复发和转移风险(<0.01)。
长期中药治疗可灵活应用于肺癌治疗过程中,不仅对肺癌患者的无进展生存时间有积极影响,还可降低肺癌复发和转移的风险。