A cohort study to examine the use of Chinese herbal medicine in combination with conventional therapies for patients with hepatocellular carcinoma in China

Lingling Sun; Paul Fahey; Xiaoshu Zhu; Weng Ng Weng; Zhuo Ping Chen; Yiwen Qiu; Hezheng Lai; Jietao Lin; Lizhu Lin

doi:10.1177/1534735418775819

A cohort study to examine the use of Chinese herbal medicine in combination with conventional therapies for patients with hepatocellular carcinoma in China

Lingling Sun, Paul Fahey, Xiaoshu Zhu, Weng Ng Weng, Zhuo Ping Chen, Yiwen Qiu, Hezheng Lai, Jietao Lin, Lizhu Lin

Western Sydney University

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

Abstract

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 aims to explore how integrative therapy (IT) through the combination of CHM and CT affects the survival of patients with intermediate-advanced 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 a 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 3 groups based on the therapies used, that is, 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% confidence interval [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 (P < .001). The adjusted hazard ratio (HR) of death for the IT group was 0.55 (95% CI = 0.38-0.79, P = .001) relative to the CT group and 0.68 (95% CI = 0.52-0.90, P = .007) relative to the CHM group, after adjusting for the factors that impact 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 controlled trial is warranted for a conclusive statement.

Original language	English
Pages (from-to)	902-911
Number of pages	10
Journal	Integrative Cancer Therapies
Volume	17
Issue number	3
DOIs	https://doi.org/10.1177/1534735418775819
Publication status	Published - 2018

Open Access - Access Right Statement

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Keywords

cancer
herbs
integrative medicine
liver
survival
therapeutic use

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/1534735418775819

Cite this

@article{ea63dde8913949439a17bbb942f65ea9,

title = "A cohort study to examine the use of Chinese herbal medicine in combination with conventional therapies for patients with hepatocellular carcinoma in China",

abstract = "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 aims to explore how integrative therapy (IT) through the combination of CHM and CT affects the survival of patients with intermediate-advanced 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 a 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 3 groups based on the therapies used, that is, 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% confidence interval [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 (P < .001). The adjusted hazard ratio (HR) of death for the IT group was 0.55 (95% CI = 0.38-0.79, P = .001) relative to the CT group and 0.68 (95% CI = 0.52-0.90, P = .007) relative to the CHM group, after adjusting for the factors that impact 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 controlled trial is warranted for a conclusive statement.",

keywords = "cancer, herbs, integrative medicine, liver, survival, therapeutic use",

author = "Lingling Sun and Paul Fahey and Xiaoshu Zhu and {Ng Weng}, Weng and Chen, {Zhuo Ping} and Yiwen Qiu and Hezheng Lai and Jietao Lin and Lizhu Lin",

year = "2018",

doi = "10.1177/1534735418775819",

language = "English",

volume = "17",

pages = "902--911",

journal = "Integrative Cancer Therapies",

issn = "1534-7354",

publisher = "SAGE Publications Inc.",

number = "3",

}

TY - JOUR

T1 - A cohort study to examine the use of Chinese herbal medicine in combination with conventional therapies for patients with hepatocellular carcinoma in China

AU - Sun, Lingling

AU - Fahey, Paul

AU - Zhu, Xiaoshu

AU - Ng Weng, Weng

AU - Chen, Zhuo Ping

AU - Qiu, Yiwen

AU - Lai, Hezheng

AU - Lin, Jietao

AU - Lin, Lizhu

PY - 2018

Y1 - 2018

N2 - 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 aims to explore how integrative therapy (IT) through the combination of CHM and CT affects the survival of patients with intermediate-advanced 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 a 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 3 groups based on the therapies used, that is, 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% confidence interval [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 (P < .001). The adjusted hazard ratio (HR) of death for the IT group was 0.55 (95% CI = 0.38-0.79, P = .001) relative to the CT group and 0.68 (95% CI = 0.52-0.90, P = .007) relative to the CHM group, after adjusting for the factors that impact 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 controlled trial is warranted for a conclusive statement.

AB - 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 aims to explore how integrative therapy (IT) through the combination of CHM and CT affects the survival of patients with intermediate-advanced 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 a 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 3 groups based on the therapies used, that is, 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% confidence interval [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 (P < .001). The adjusted hazard ratio (HR) of death for the IT group was 0.55 (95% CI = 0.38-0.79, P = .001) relative to the CT group and 0.68 (95% CI = 0.52-0.90, P = .007) relative to the CHM group, after adjusting for the factors that impact 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 controlled trial is warranted for a conclusive statement.

KW - cancer

KW - herbs

KW - integrative medicine

KW - liver

KW - survival

KW - therapeutic use

UR - http://handle.westernsydney.edu.au:8081/1959.7/uws:49935

U2 - 10.1177/1534735418775819

DO - 10.1177/1534735418775819

M3 - Article

SN - 1534-7354

VL - 17

SP - 902

EP - 911

JO - Integrative Cancer Therapies

JF - Integrative Cancer Therapies

IS - 3

ER -

A cohort study to examine the use of Chinese herbal medicine in combination with conventional therapies for patients with hepatocellular carcinoma in China

Abstract

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Keywords

UN SDGs

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