Xue-Qian Wang1, Ying Zhang1, Wei Hou1, Ying-Tian Wang1, Jia-Bin Zheng1, Jie Li1, Li-Zhu Lin2, Yi-Lan Jiang3, Shen-Yu Wang4, Ying Xie5, Hong-Liang Zhang6, Qi-Jin Shu7, Ping Li8, Wei Wang9, Jian-Liang You10, Ge Li11, Jie Liu1, Hui-Ting Fan1, Mei-Ying Zhang1, Hong-Sheng Lin12. 1. Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. 2. Department of Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China. 3. Department of Oncology, Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, Changsha, 410000, China. 4. Department of Integrated TCM & Western Medicine, Cancer Hospital of Liaoning Province, Shenyang, 110000, China. 5. Department of Traditional Chinese Medicine, Cancer Hospital of Shanxi Province, Taiyuan, 030000, China. 6. Department of Oncology, The Xinjiang Uygur Autonomous Region Traditional Chinese Medicine Hospital, Urumqi, 830000, China. 7. Department of Oncology, Zhejiang Province Traditional Chinese Medicine Hospital, Hangzhou, 310000, China. 8. Oncology Department of Traditional Chinese Medicine, Anhui Provincial Hospital, Hefei, 230000, China. 9. Oncology Department of Traditional Chinese Medicine, Chongqing Cancer Hospital, Chongqing, 400000, China. 10. Department of Oncology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi, Jiangsu Province, 214000, China. 11. Department of Oncology, Dalian Hospital of Traditional Chinese Medicine, Dalian, Liaoning Province, 116000, China. 12. Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. drlinhongsheng@163.com.
Abstract
OBJECTIVE: To evaluate the association between Chinese medicine (CM) therapy and disease-free survival (DFS) outcomes in postoperative patients with non-small cell lung cancer (NSCLC). METHODS: This multiple-center prospective cohort study was conducted in 13 medical centers in China. Patients with stage I, II, or IIIA NSCLC who had undergone radical resection and received conventional postoperative treatment according to the National Comprehensive Cancer Network (NCCN) guidelines were recruited. The recruited patients were divided into a CM treatment group and a control group according to their wishes. Patients in the CM treatment group received continuous CM therapy for more than 6 months or until disease progression. Patients in the control group received CM therapy for less than 1 month. Follow-up was conducted over 3 years. The primary outcome was DFS, with recurrence/metastasis rates as a secondary outcome. RESULTS: Between May 2013 and August 2016, 503 patients were enrolled into the cohort; 266 were classified in the CM treatment group and 237 in the control group. Adjusting for covariates, high exposure to CM was associated with better DFS [hazard ratio (HR) = 0.417, 95% confidential interval (CI): 0.307-0.567)]. A longer duration of CM therapy (6-12 months, 12-18 months, >24 months) was associated with lower recurrence and metastasis rates (HR = 0.225, 0.119 and 0.083, respectively). In a subgroup exploratory analysis, CM therapy was also a protective factor of cancer recurrence and metastasis in both stage I-IIIA (HR=0.50, 95% CI: 0.37-0.67) and stage IIIA NSCLC postoperative patients (HR = 0.48, 95% CI: 0.33-0.71), DFS was even longer among CM treatment group patients. CONCLUSIONS: Longer duration of CM therapy could be considered a protective factor of cancer recurrence and metastasis. CM treatment is associated with improving survival outcomes of postoperative NSCLC patients in China. (Registration No. ChiCTR-OOC-14005398).
OBJECTIVE: To evaluate the association between Chinese medicine (CM) therapy and disease-free survival (DFS) outcomes in postoperative patients with non-small cell lung cancer (NSCLC). METHODS: This multiple-center prospective cohort study was conducted in 13 medical centers in China. Patients with stage I, II, or IIIA NSCLC who had undergone radical resection and received conventional postoperative treatment according to the National Comprehensive Cancer Network (NCCN) guidelines were recruited. The recruited patients were divided into a CM treatment group and a control group according to their wishes. Patients in the CM treatment group received continuous CM therapy for more than 6 months or until disease progression. Patients in the control group received CM therapy for less than 1 month. Follow-up was conducted over 3 years. The primary outcome was DFS, with recurrence/metastasis rates as a secondary outcome. RESULTS: Between May 2013 and August 2016, 503 patients were enrolled into the cohort; 266 were classified in the CM treatment group and 237 in the control group. Adjusting for covariates, high exposure to CM was associated with better DFS [hazard ratio (HR) = 0.417, 95% confidential interval (CI): 0.307-0.567)]. A longer duration of CM therapy (6-12 months, 12-18 months, >24 months) was associated with lower recurrence and metastasis rates (HR = 0.225, 0.119 and 0.083, respectively). In a subgroup exploratory analysis, CM therapy was also a protective factor of cancer recurrence and metastasis in both stage I-IIIA (HR=0.50, 95% CI: 0.37-0.67) and stage IIIA NSCLC postoperativepatients (HR = 0.48, 95% CI: 0.33-0.71), DFS was even longer among CM treatment group patients. CONCLUSIONS: Longer duration of CM therapy could be considered a protective factor of cancer recurrence and metastasis. CM treatment is associated with improving survival outcomes of postoperative NSCLCpatients in China. (Registration No. ChiCTR-OOC-14005398).
Entities:
Keywords:
Chinese medicine; cohort study; disease-free survival; non-small cell lung cancer; postoperative care