10 november 2022: zie ook dit artikel: https://kanker-actueel.nl/zhengyuan-capsule-gecombineerd-met-neoadjuvante-chemotherapie-voor-triple-negatieve-borstkanker-geeft-veel-meer-complete-remissies-en-de-helft-minder-bijwerkingen.html
14 april 2018: zie ook: https://kanker-actueel.nl/studiepublicaties-van-niet-toxische-middelen-en-behandelingen-uit-literatuurlijst-van-arts-bioloog-drs-engelbert-valstar-gerelateerd-aan-borstkanker.html
14 april 2018: Bron: CANCER: 3 February 2014
De niet-gecorrigeerde Cox-regressieanalyse toonde een sterke associatie aan tussen het gebruik van TCM en een afname van mortaliteit (Table 2). In vergelijking met TCM-niet-gebruikers hadden TCM-gebruikers een verlaagde kans op overlijden aan hun borstkanker van 47% (niet-gecorrigeerde HR, 0,53, 95% CI, 0,37-0,77 [P <0,001]).
| Univariate Analysis | Multivariate Analysis | |||||
|---|---|---|---|---|---|---|
| Variable | HR | 95% CI | P | aHRa | 95% CI | P |
| TCM use | ||||||
| Nonusers (<30 d) | 1 | 1 | ||||
| TCM users (≥30 d) | 0.53 | 0.37‐0.77 | <.001 | 0.50 | 0.35‐0.73 | <.001 |
| 30‐180 d | 0.58 | 0.36‐0.95 | .03 | 0.55 | 0.33‐0.90 | .02 |
| >180 d | 0.48 | 0.29‐0.81 | .006 | 0.46 | 0.27‐0.78 | .004 |
| Age (per 1 y) | 1.01 | 1.00‐1.02 | .12 | 1.00 | 0.99‐1.02 | .58 |
| Congestive heart failure | 1.91 | 0.98‐3.72 | .06 | 1.31 | 0.67‐2.56 | .44 |
| Distant metastases | 3.10 | 2.44‐3.94 | <.001 | 2.44 | 1.84‐3.24 | <.001 |
| Surgery | ||||||
| None | 1 | 1 | ||||
| Breast‐conserving surgery | 0.42 | 0.30‐0.61 | <.001 | 0.56 | 0.38‐0.81 | .002 |
| Mastectomy | 0.33 | 0.25‐0.43 | <.001 | 0.54 | 0.40‐0.73 | <.001 |
| Hormonal or targeted biologic therapy | 1.46 | 1.10‐1.92 | .01 | 1.06 | 0.80‐1.41 | .69 |
| Radiotherapy | 1.36 | 1.06‐1.75 | .02 | 1.56 | 1.21‐2.01 | <.001 |
- Abbreviations: 95% CI, 95% confidence interval; aHR, adjusted hazards ratio; HR, hazards ratio; TCM, traditional Chinese medicine.
- a Adjusting for all variables listed.
Verdere analyse toonde een dosis-responsrelatie aan tussen gebruik van TCM en mortaliteit. De aangepaste HR's waren 0,55 (95% CI, 0,33-0,90) en 0,46 (95% CI, 0,27-0,78) voor patiënten met TCM gebruik van respectievelijk 30 tot 180 dagen en meer dan 180 dagen. Hoe langer de duur van het TCM-gebruik, hoe lager het sterftecijfer (P voor trend <.001). De andere onafhankelijke voorspellers van verhoogde mortaliteit omvatten uitzaaiingen op afstand, inoperabele chirurgische status en radiotherapie.
Vergelijkbare resultaten werden verkregen wanneer de analyses werden beperkt tot patiënten met uitzaaiingen op afstand. Van de 269 patiënten met metastasen op afstand, na correctie voor leeftijd, voorgeschiedenis van congestief hartfalen, chirurgie, hormonale of gerichte biologische therapie en radiotherapie, werd TCM-gebruik nog steeds geassocieerd met verminderde mortaliteit (gecorrigeerde HR 0.39; 95% CI, 0.23-0.67 [P <.001]) in vergelijking met niet-gebruik van TCM.
De meest gebruikelijke vormen van TCM van de 115 TCM-gebruikers waren Jia Wei Xiao Yao San, Pu Gong Ying en Bai Hua She She Cao, die werden gebruikt door 57 TCM-gebruikers (49,6%), 51 TCM-gebruikers (44,3%) en 50 TCM gebruikers (43,5%), respectievelijk (Table 3).
Van de 10 meest voorkomende TCM's waren er 3 met kruidenformules en 7 met enkele kruiden. Cox-regressieanalyse met proportionele risico's toonde aan dat de 3 meest effectieve (laagste HRs) TCM-agentia bij het verminderen van mortaliteit waren Bai Hua She She Cao, Ban Zhi Lian en Huang Qi (Table 4).
Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: A population‐based study
| TCM Users
(N = 115) | TCM Nonusers
(N = 614) | ||||
|---|---|---|---|---|---|
| Characteristics | Mean (SD) or No. (%) | Mean (SD) or No. (%) | P | ||
| Age, y | 50.5 | (8.9) | 52.3 | (10.0) | .08 |
| Urbanization | |||||
| Low | 8 | (7.0) | 37 | (6.0) | .63 |
| Moderate | 24 | (20.9) | 153 | (24.9) | |
| High | 83 | (72.2) | 424 | (69.1) | |
| Comorbidity | |||||
| Hypertension | 10 | (8.7) | 83 | (13.5) | .16 |
| Diabetes mellitus | 1 | (0.9) | 25 | (4.1) | .10 |
| Congestive heart failure | 3 | (2.6) | 15 | (2.4) | >.99 |
| Stroke | 1 | (0.9) | 24 | (3.9) | .16 |
| Chronic pulmonary disease | 15 | (13.0) | 92 | (15.0) | .59 |
| Liver disease | 16 | (13.9) | 100 | (16.3) | .52 |
| Distant metastases | 41 | (35.7) | 228 | (37.1) | .76 |
| Type of treatment | |||||
| Surgery | |||||
| None | 28 | (24.4) | 191 | (31.1) | .29 |
| Breast‐conserving surgery | 19 | (16.5) | 105 | (17.1) | |
| Mastectomy | 68 | (59.1) | 318 | (51.8) | |
| Combination of chemotherapy | 110 | (95.7) | 586 | (95.4) | .92 |
| Hormonal or targeted biologic therapy | 81 | (70.4) | 409 | (66.6) | .42 |
| Radiotherapy | 66 | (57.4) | 367 | (59.8) | .63 |
- Abbreviations: SD, standard deviation;TCM, traditional Chinese medicine.
The mean follow‐up period for the patients was 2.8 years ± 1.9 years; 277 deaths occurred and the overall mortality rate was 38.0% during the analysis period. TCM users had 32 deaths (27.8%) and TCM nonusers had 245 deaths (39.9%). The Kaplan‐Meier survival curve and log‐rank test revealed a statistically significant difference between the survival curves of the groups (P < .001) (Fig. 1).
De resultaten van deze observationele studie suggereren dat aanvullende therapie met TCM de overleving van patiënten met gevorderde borstkanker die taxanen krijgen, kan verbeteren. De huidige studie suggereert dat TCM kan worden gebruikt als een integraal onderdeel van een effectieve behandeling voor kanker. Toekomstige gerandomiseerde gecontroleerde studies zijn nodig om deze observationele bevindingen te bevestigen.
het volledige studierapport is gratis ijn te zien:
Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: A population‐based study
Abstract met referentielijst:
Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer
Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: A population‐based study
This study was based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by National Health Research Institutes. The interpretations and conclusions contained herein do not represent the opinions of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institutes
Abstract
BACKGROUND
Traditional Chinese medicine (TCM) is one of the most common complementary and alternative medicines used in the treatment of patients with breast cancer. However, the clinical effect of TCM on survival, which is a major concern in these individuals, lacks evidence from large‐scale clinical studies.
METHODS
The authors used the Taiwan National Health Insurance Research Database to conduct a retrospective population‐based cohort study of patients with advanced breast cancer between 2001 and 2010. The patients were separated into TCM users and nonusers, and Cox regression models were applied to determine the association between the use of TCM and patient survival.
RESULTS
A total of 729 patients with advanced breast cancer receiving taxanes were included in the current study. Of this cohort, the mean age was 52.0 years; 115 patients were TCM users (15.8%) and 614 patients were TCM nonusers. The mean follow‐up was 2.8 years, with 277 deaths reported to occur during the 10‐year period. Multivariate analysis demonstrated that, compared with nonusers, the use of TCM was associated with a significantly decreased risk of all‐cause mortality (adjusted hazards ratio , 0.55 [95% confidence interval, 0.33‐0.90] for TCM use of 30‐180 days; adjusted HR, 0.46 [95% confidence interval, 0.27‐0.78] for TCM use of > 180 days). Among the frequently used TCMs, those found to be most effective (lowest HRs) in reducing mortality were Bai Hua She She Cao, Ban Zhi Lian, and Huang Qi.
CONCLUSIONS
The results of the current observational study suggest that adjunctive TCM therapy may lower the risk of death in patients with advanced breast cancer. Future randomized controlled trials are required to validate these findings. Cancer 2014;120:1338–1344. © 2014 American Cancer Society.
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