A Cohort Study to Examine the Use of Chinese Herbal Medicine in Combination with Conventional Therapies for Patients with Hepatocellular Carcinoma in China
作者单位：Integrative Cancer CentreGuangzhou University of Chinese Medicine First Affiliated Hospital School of Science and HealthWestern Sydney University National Institute of Complementary Medicine (NICM)Western Sydney University South West Sydney Local Health District
会议名称：《第十七届全国中西医结合肿瘤学术大会》
会议日期：2019年
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
关 键 词：Chinese herbal medicine hepatocellular carcinoma integrative therapy survival cohort study
摘 要：Background: Hepatocellular carcinoma(HCC) is one of the major malignancies associated with high mortality rates. Chinese herbal medicine(CHM) alone, or in combination with conventional therapies(CT) has been widely used for patients with HCC in China. This study was aimed to explore how integrative therapy(IT) with the combination of CHM and CT affects the survival of patients with intermediateadvanced HCC. Methods: A retrospective cohort study was performed at the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. Data of consecutive patients diagnosed with intermediate-advanced HCC and specific traditional Chinese medicine diagnostic pattern between January 2006 and December 2013 were retrieved from the electronic medical record system at the hospital. Patients were divided into three groups basedon the therapies used, i.e. IT, CHM alone and CT alone, and the survival times of these patients was compared. Results: A total of 328 patients were included in this study. Median follow up period was 26.4 months(95%CI: 22.7-38.9). Median overall survival was 11.0 months for IT, 8.6 months for CHM, and 9.4 months for CT groups(p0.001). The adjusted hazard ratio(HR) of death for the IT group was 0.55(95%CI: 0.38-0.79, p=0.001) relative to CT group and 0.68(95%CI: 0.52-0.90, p=0.007) relative to CHM group by adjusting the factors that impact the prognosis. Stratified analysis shows that IT can significantly lower the risk of death, especially for patients with good performance status(PS) and Child Pugh Class A. Conclusions: It was indicated that the integrative approach with combination of CHM and CT might improve survival for patients with intermediate-advanced HCC, especially for patients with good PS and Child-Pugh class A. However, a randomized control trial is warranted for a conclusive statement.