Yueh-Ting Tsai1, Jung-Nien Lai2, Chien-Tung Wu3. 1. Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 112, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan. Electronic address: yuehting.tsai@gmail.com. 2. Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 112, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan; Taiwan Association for Traditional Chinese Medicine of Family, Taiwan. Electronic address: kareny@ms10.hinet.net. 3. Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 112, Taiwan; Taiwan Association for Traditional Chinese Medicine of Family, Taiwan. Electronic address: nealwu@gmail.com.
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE: The increased practice of traditional Chinese medicine (TCM) worldwide has raised concerns regarding herb-drug interactions. The purpose of our study was to analyze the use of Chinese herbal products (CHPs) and to estimate the influence of the use of CHP on tamoxifen induced endometrial cancer risk among female breast cancer patients in Taiwan. METHODS: All patients newly diagnosed with invasive breast cancer receiving tamoxifen treatment from January 1, 1998 to December 31, 2008 were selected from the National Health Insurance Research Database. The usage, frequency of service, and CHPs prescribed among the 20,466 tamoxifen-treated female breast cancer patients were analyzed. The logistic regression method was employed to estimate the odds ratios (ORs) for utilization of CHPs. Cox proportional hazard regression was performed to calculate the hazard ratios (HRs) for subsequent endometrial cancer for CHP non-users and CHP users among female breast cancer patients who had undergone tamoxifen treatment. RESULTS: More than half of the subjects had ever used a CHP. Jia-Wei-Xiao-Yao-San (Augmented Rambling Powder) and Shu-Jing-Huo-Xue-Tang (Channel-Coursing Blood-Quickening Decoction) were the two most commonly used CHPs. The HR for the development of endometrial cancer among CHP users was 0.50-fold (95% CI=0.38-0.64) compared to that of CHP non-users. CONCLUSION: More than half of the study subjects had ever used a CHP. Jia-Wei-Xiao-Yao-San was the most commonly used CHP. Among female breast cancer patients who had undergone tamoxifen therapy, CHP consumption decreased the risk of subsequent endometrial cancer. Exploring potential Chinese herb-tamoxifen interactions and integrating both healthcare approaches are beneficial to the overall health outcomes of tamoxifen-treated female breast cancer patients.
ETHNOPHARMACOLOGICAL RELEVANCE: The increased practice of traditional Chinese medicine (TCM) worldwide has raised concerns regarding herb-drug interactions. The purpose of our study was to analyze the use of Chinese herbal products (CHPs) and to estimate the influence of the use of CHP on tamoxifen induced endometrial cancer risk among female breast cancerpatients in Taiwan. METHODS: All patients newly diagnosed with invasive breast cancer receiving tamoxifen treatment from January 1, 1998 to December 31, 2008 were selected from the National Health Insurance Research Database. The usage, frequency of service, and CHPs prescribed among the 20,466 tamoxifen-treated female breast cancerpatients were analyzed. The logistic regression method was employed to estimate the odds ratios (ORs) for utilization of CHPs. Cox proportional hazard regression was performed to calculate the hazard ratios (HRs) for subsequent endometrial cancer for CHP non-users and CHP users among female breast cancerpatients who had undergone tamoxifen treatment. RESULTS: More than half of the subjects had ever used a CHP. Jia-Wei-Xiao-Yao-San (Augmented Rambling Powder) and Shu-Jing-Huo-Xue-Tang (Channel-Coursing Blood-Quickening Decoction) were the two most commonly used CHPs. The HR for the development of endometrial cancer among CHP users was 0.50-fold (95% CI=0.38-0.64) compared to that of CHP non-users. CONCLUSION: More than half of the study subjects had ever used a CHP. Jia-Wei-Xiao-Yao-San was the most commonly used CHP. Among female breast cancerpatients who had undergone tamoxifen therapy, CHP consumption decreased the risk of subsequent endometrial cancer. Exploring potential Chinese herb-tamoxifen interactions and integrating both healthcare approaches are beneficial to the overall health outcomes of tamoxifen-treated female breast cancerpatients.
Authors: Fabia De Oliveira Andrade; Wei Yu; Xiyuan Zhang; Elissa Carney; Rong Hu; Robert Clarke; Kevin FitzGerald; Leena Hilakivi-Clarke Journal: Endocr Relat Cancer Date: 2019-03-01 Impact factor: 5.678