Department of Medical Oncology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No. 725 South Wanping Road, Shanghai 200032, China.
Department of Medical Oncology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, No. 725 South Wanping Road, Shanghai 200032, China.
Phytomedicine. 2023 Dec;121:155087. doi: 10.1016/j.phymed.2023.155087. Epub 2023 Sep 13.
BACKGROUND: About 30% of pulmonary stage IV adenocarcinomas die within 3 months of diagnosis. Western medical treatments with Platinum-Based Chemotherapy=PBC and tyrosine-kinase inhibitors Targeted Therapy=TT can improve prognosis. In China, Traditional Chinese Medicine herbal treatments (TCM) are often used in addition to PBC and TT. A considerable number of patients refuse Western medical treatments and use TCM alone. However, the survival impact of the latter is unknown. HYPOTHESES TESTED: Treatment with TCM alone is prognostically superior to PBC alone. Addition of PBC or TT or both TT to TCM improves survival. METHODS: In this prospective observational, non-interventional study of 1017 consecutive first-onset stage IV NSCLC patients with up to 10 years follow-up, 261 who Died of Disease (DOD) within 3 months were omitted, as they never got the optimal Western medical therapies. All 218 non-adenocarcinomas were also omitted, leaving 538 stage IV adenocarcinomas treated by TCM alone (n = 29), PBC alone (N = 19) and TCM and other Western medical combinations (299 TCM and PBC, 50 TCM and TT, 141 TCM and PBC and TT) with 3 - 120 months follow-up. Survivals were compared using Alive with Disease (AWD) and DOD as endpoints. RESULTS: The patients treated only with TCM had 7 months better median survival than those that received PBC alone (17 and 10 months). The patients that received TCM and PBC had a better median survival (24 months) than TCM alone and much better than PBC alone. None of the patients that received TCM alone survived > 54 months, whereas 18% of TCM and PBC patients survived much longer. Over the observation period of 3 - 120 months, survivals of TCM and TT, TCM and PBC and TT, and TCM and PBC were not different and therefore grouped as TCM and Western medicines. Median survival times of PBC alone and TCM alone were lower than that of TCM and Western medical treatments (p < 0.0001, 10, 17 and 27 months). CONCLUSIONS: Pulmonary stage IV adenocarcinoma patients with at least 3 months survival, treated with TCM alone have a significantly better survival than those treated with PBC alone. Adding Western PBC, TT or both to TCM further improves prognosis.
背景：约 30%的 IV 期肺腺癌患者在诊断后 3 个月内死亡。含铂化疗（PBC）和酪氨酸激酶抑制剂靶向治疗（TT）的西医治疗可以改善预后。在中国，除了 PBC 和 TT 外，还经常使用中药治疗。相当多的患者拒绝西医治疗，仅使用中药治疗。然而，后者对生存的影响尚不清楚。
假设检验：单独使用中药治疗的预后优于单独使用 PBC。PBC 或 TT 或两者 TT 联合 TCM 可改善生存。
方法：在这项对 1017 例连续首发 IV 期 NSCLC 患者进行的前瞻性观察性、非干预性研究中，排除了 261 例在 3 个月内死于疾病（DOD）的患者，因为他们从未接受过最佳的西医治疗。所有 218 例非腺癌也被排除在外，留下 538 例单独使用中药（n=29）、单独使用 PBC（N=19）和中药与其他西医联合治疗的 IV 期腺癌患者（299 例中药与 PBC，50 例中药与 TT，141 例中药与 PBC 和 TT），随访 3-120 个月。使用有疾病存活（AWD）和 DOD 作为终点比较生存率。
结果：仅接受中药治疗的患者中位生存期比单独接受 PBC 治疗的患者长 7 个月（17 个月和 10 个月）。接受 TCM 和 PBC 治疗的患者中位生存期（24 个月）优于单独接受 TCM 治疗，明显优于单独接受 PBC 治疗。单独接受 TCM 治疗的患者中没有存活超过 54 个月的患者，而 18%的 TCM 和 PBC 患者存活时间更长。在 3-120 个月的观察期内，TCM 和 TT、TCM 和 PBC 和 TT、TCM 和 PBC 的生存率没有差异，因此被归类为 TCM 和西药治疗。单独使用 PBC 和 TCM 的中位生存时间低于 TCM 和西药治疗（p<0.0001，10、17 和 27 个月）。
结论：至少存活 3 个月的 IV 期肺腺癌患者，单独使用中药治疗的生存显著优于单独使用 PBC 治疗。将西医 PBC、TT 或两者联合应用于 TCM 可进一步改善预后。
Zhong Xi Yi Jie He Xue Bao. 2010-3
Medicine (Baltimore). 2015-7
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