Beijing YouAn Hospital, Capital Medical University, Beijing, China.
Chinese Academy of Agricultural Sciences, Gansu, China.
Integr Cancer Ther. 2023 Jan-Dec;22:15347354231170536. doi: 10.1177/15347354231170536.
In a previous study, we found that traditional Chinese medicine (TCM) alleviated the clinical symptoms and improved the quality of life (QoL) in patients with hepatocellular carcinoma (HCC).
A cohort was continuously followed up to determine the impact of the TCM adjuvant therapies on the prognosis of HCC after conventional treatments.
We did a retrospective monocentric cohort study including 175 eligible patients. The participants who received TCM adjuvant therapies were termed as TCM group. For the purpose of stratification analysis, the patients who received TCM adjuvant therapies over 3 months per year were further classified into the high frequency group, while the rest of the TCM users were classified into the low frequency group. Non-users were recorded as the control group. The primary outcome was overall survival (OS) and the secondary outcome was the mean progression-free survival (mPFS) primarily introduced in this study, referring to the time from initial diagnosis to the latest progression over the number of disease progressions. Analyses used Cox proportional hazards and Kaplan-Meier (K-M) methods, adjusted for stratification factors.
Until June 30, 2021, 56 patients survived, 21 patients were lost to follow-up, and 98 patients died from the disease. Each disease progression of every individual was recorded, and most of the PFS was within 1 year. The baseline data of the allocated groups were balanced, the result revealed that TCM adjuvant therapies might have little influence on OS ( = .129). However, the 1, 3, and 5-year progression-free survival rates of the patients in TCM and control group were 68.75%, 37.50%; 25.00%, 8.33% and 8.33%, 2.08%, respectively, indicating TCM use significantly extended the mPFS, and decreased the risk of disease progression by a factor of 0.676 ( = .006). In the patients with BCLC stage B HCC, compared with controls, a 37-month median OS advantage in the high frequency group was noted ( = .045); and the high frequency of TCM use significantly suppressed disease progression ( = .001).
The present study revealed that TCM adjuvant therapies could postpone disease progression in HCC. Furthermore, using TCM over 3 months per year might extend OS in patients with intermediate HCC.
在之前的研究中,我们发现中医(TCM)可缓解肝细胞癌(HCC)患者的临床症状并提高其生活质量(QoL)。
本研究连续随访队列以确定 TCM 辅助治疗对常规治疗后 HCC 预后的影响。
我们进行了一项回顾性单中心队列研究,纳入了 175 名符合条件的患者。接受 TCM 辅助治疗的患者被称为 TCM 组。为了进行分层分析,我们将每年接受 TCM 辅助治疗超过 3 个月的患者进一步分为高频组,其余 TCM 使用者分为低频组。未使用者被记录为对照组。主要结局为总生存期(OS),次要结局为本次研究首次引入的中位无进展生存期(mPFS),指从初始诊断到疾病进展数中最新进展的时间。分析采用 Cox 比例风险和 Kaplan-Meier(K-M)方法,根据分层因素进行调整。
截至 2021 年 6 月 30 日,56 名患者存活,21 名患者失访,98 名患者死于疾病。记录了每位患者的每个疾病进展情况,大多数 PFS 在 1 年内。分配组的基线数据平衡,结果表明 TCM 辅助治疗对 OS 的影响可能较小( = .129)。然而,TCM 组和对照组患者的 1、3 和 5 年无进展生存率分别为 68.75%、37.50%;25.00%、8.33%和 8.33%、2.08%,表明 TCM 使用显著延长了 mPFS,并将疾病进展的风险降低了 0.676 倍( = .006)。在 BCLC 分期为 B 的 HCC 患者中,与对照组相比,高频组的中位 OS 优势为 37 个月( = .045);TCM 使用的高频显著抑制了疾病进展( = .001)。
本研究表明,TCM 辅助治疗可延缓 HCC 疾病进展。此外,每年接受 TCM 治疗超过 3 个月可能会延长中期 HCC 患者的 OS。