TCM - Traditionele Chinese Medicijnen voorkomen significant veel beter een recidief na operatie van levertumoren vanuit primaire leverkanker (HCC) in vergelijking met TACE

15 maart 2018: Lees ook dit artikel:

https://kanker-actueel.nl/traditionele-chinese-kruiden-tcm-voorkomen-veel-beter-een-recidief-van-levertumoren-en-geeft-45-procent-betere-overall-overleving-dan-trans-arteriele-chemo-embolisatie-tace-copy-1.html

27 augustus 2013: Bron: J Integr Med. 2013 Mar;11(2):90-100. doi: 10.3736/jintegrmed. 2013021

TCM - Traditionele Chinese Medicijnen voorkomen significant veel beter een recidief na operatie van levertumoren vanuit primaire leverkanker (HCC - hepatocellular carcinoma) in vergelijking met TACE - Trans Arteriële Chemo Embolisatie. Dit blijkt uit een gerandomiseerde open label studie, die werd uitgevoerd bij totaal 379 patiënten verdeeld over vijf ziekenhuizen in China.

Hoewel deze studie is uitgevoerd bij primaire leverkanker kun je naar mijn mening ook dit zien als een bewijs voor TCM bij alle levertumoren vanuit welke primaire tumor dan ook. Zie ook andere studiepublicaties over TCM - Traditionele Chinese Medicijnen in gerelateerde artikelen, wat in feite allemaal kruiden en extracten daarvan zijn. Bij de natuurapotheek in Pijnacker zijn ze gespecialiseerd in TCM - Traditionele Chinese Medicijnen - Chinese kruiden en kunt u bv. een voedingsupplement krijgen onder de naam chemosupport wat een mix is van o.a. Chinese kruiden, te gebruiken naast chemo. In deze studie blijken bepaalde Chinese kruiden: een Cinobufacini injectie en Jiedu granule alleen voor een significant betere recidiefvrije tijd en overleving te zorgen. Met alleszins acceptabele bijwerkingen en dus kwaliteit van leven

Studieresultaten:

Opzet van de studie:

Dit is een multicenter, open-label, gerandomiseerde, gecontroleerde studie, die werd uitgevoerd in vijf centra van China. Een totaal van 379 patiënten die aan de toelatingscriteria voldeden werden gerandomiseerd ingedeeld in deze studie. 188 patiënten werden toegewezen aan de THM groep (TCM behandeling) en kregen een
Cinobufacini injectie en oraal Jiedu granule en de andere 191 patiënten werden toegewezen aan de TACE groep en kregen na de operatie 1 behandeling met TACE - Trans Arteriële Chemo Embolisatie.

Doel van de studie:

Primaire doelen waren hoeveel recidieven zich jaarlijks zouden voordoen en de tijd tot een recidief. Incidentie van bijwerkingen werden beschouwd als een secundair doel.

Resultaten:

Van de 364 patiënten die werden opgenomen in de intention-to-treat analyse, kregen 67 patiënten van de THM-groep en 87 van de TACE groep een recidief, met een hazard ratio van 0,695 (P = 0.048).
Mediane ziektevrije overleving van patiënten uit de THM groep en TACE groep was respectievelijk 46.89 maanden en 34.49 maanden. Recidief cijfers op 1, 2 en 3 jaar waren respectievelijk 17,7%, 33,0% en 43,5% voor de THM-groep en 28,8%, 42,5% en 54,0% voor de TACE groep, respectievelijk (p = 0.026).
Multivariate analyse gaf aan dat een THM behandeling een groot voordeel liet zien voor het verlengen van de recidiefvrije overleving. Bijwerkingen waren mild en de abnormaliteit van laboratoriumuitslagen van de twee groepen waren vergelijkbaar.

Conclusie:

In vergelijking met een TACE behandeling, werd een THM behandeling (TCM met Cinobufacini injectie en oraal Jiedu granule) geassocieerd met significant verminderd risico van een optredend recidief van kleine levertumoren vanuit primaire leverkanker - HCC na operatie, met vergelijkbare bijwerkingen.

)Het volledige studieverslag: Traditional herbal medicine in preventing recurrence after resection of small hepatocellular carcinoma: a multicenter randomized controlled trial is ook in het engels gratis in te zien.

Hier het abstract van de studie met referentielijst:

In comparison with TACE therapy, the THM regimen (TCM - Traditional Chinese Medicin - Cinobufacini injection and Jiedu granule) was associated with diminished risk of recurrence of small-sized HCC after resection, with comparable adverse events

Journal of Chinese Integrative Medicine: Volume 11 March, 2013 Number 2

DOI: 10.3736/jintegrmed2013021

Traditional herbal medicine in preventing recurrence after resection of small hepatocellular carcinoma: a multicenter randomized controlled trial

1.	Xiao-feng Zhai (Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai 200433, China )
2.	Zhe Chen (Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai 200433, China )
3.	Bai Li (Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai 200433, China )
4.	Feng Shen (Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China )
5.	Jia Fan (Liver Cancer Institute, Fudan University, Shanghai 200032, China )
6.	Wei-ping Zhou (Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China )
7.	Yun-ke Yang (Department of Traditional Chinese Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China )
8.	Jing Xu (Department of Hepatic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China )
9.	Xiao Qin (Department of Hepatic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China )
10.	Le-qun Li (Department of Hepatobiliary Surgery, Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China )
11.	Chang-quan Ling (Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai 200433, China )

BACKGROUND: Disease recurrence is a main challenge in treatment of hepatocellular carcinoma (HCC). There is no generally accepted method for preventing recurrence of HCC after resection.

OBJECTIVE: To compare the efficacy of a traditional herbal medicine (THM) regimen and transarterial chemoembolization (TACE) in preventing recurrence in post-resection patients with small HCC.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This is a multicenter, open-label, randomized, controlled study, which was undertaken in five centers of China. A total of 379 patients who met the eligibility criteria and underwent randomization were enrolled in this trial. One hundred and eighty-eight patients were assigned to the THM group and received Cinobufacini injection and Jiedu Granule, and the other 191 patients were assigned to the TACE group and received one single course of TACE.

MAIN OUTCOME MEASURES: Primary outcome measures were the annual recurrence rate and the time to recurrence. Incidence of adverse events was regarded as the secondary outcome measure.

RESULTS: Among the 364 patients who were included in the intention-to-treat analysis, 67 patients of the THM group and 87 of the TACE group had recurrence, with a hazard ratio of 0.695 (P = 0.048). Median recurrence-free survival of the patients in the THM and TACE groups was 46.89 and 34.49 months, respectively. Recurrence rates at 1, 2 and 3 years were 17.7%, 33.0% and 43.5% for the THM group, and 28.8%, 42.5% and 54.0% for the TACE group, respectively (P = 0.026). Multivariate analysis indicated that the THM regimen had a big advantage for prolonging the recurrence-free survival. Adverse events were mild and abnormality of laboratory indices of the two groups were similar.

CONCLUSION: In comparison with TACE therapy, the THM regimen was associated with diminished risk of recurrence of small-sized HCC after resection, with comparable adverse events.

TRIAL REGISTRTION IDENTIFIER: This trial was registered in the Chinese Clinical Trial Registry with the identifier ChiCTR–TRC-07000033.

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DOI: 10.3736/jintegrmed2013021

Zhai XF, Chen Z, Li B, Shen F, Fan J, Zhou WP, Yang YK, Xu J, Qin X, Li LQ, Ling CQ. Traditional herbal medicine in preventing recurrence after resection of small hepatocellular carcinoma: a multicenter randomized controlled trial. J Integr Med. 2013; 11(2): 90-100.

Received February 8, 2013; accepted February 27, 2013.

Correspondence: Chang-quan Ling, MD, Professor; Tel: +86-21-81871551; E-mail: lingchangquan@gmail.com

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