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Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: A Nationwide Population-Based Cohort Study.
Integr Cancer Ther. 2018 06; 17(2):411-422.IC

Abstract

BACKGROUND

Pancreatic cancer is a difficult-to-treat cancer with a late presentation and poor prognosis. Some patients seek traditional Chinese medicine (TCM) consultation. We aimed to investigate the benefits of complementary Chinese herbal medicine (CHM) among patients with pancreatic cancer in Taiwan.

METHODS

We included all patients with pancreatic cancer who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 1997 and 2010. We used 1:1 frequency matching by age, sex, the initial diagnostic year of pancreatic cancer, and index year to enroll 386 CHM users and 386 non-CHM users. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time.

RESULTS

According to the Cox hazard ratio model mutually adjusted for CHM use, age, sex, urbanization level, comorbidity, and treatments, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.67, 95% CI = 0.56-0.79). Those who received CHM therapy for more than 90 days had significantly lower hazard ratios of mortality risk than non-CHM users (90- to 180-day group: adjusted HR = 0.56, 95% CI = 0.42-0.75; >180-day group: HR = 0.33, 95% CI = 0.24-0.45). The survival probability was higher for patients in the CHM group. Bai-hua-she-she-cao (Herba Oldenlandiae; Hedyotis diffusa Spreng) and Xiang-sha-liu-jun-zi-tang (Costus and Chinese Amomum Combination) were the most commonly used single herb and Chinese herbal formula, respectively.

CONCLUSIONS

Complementary Chinese herbal therapy might be associated with reduced mortality among patients with pancreatic cancer. Further prospective clinical trial is warranted.

Authors+Show Affiliations

1 Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 2 Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.1 Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 2 Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.3 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.4 Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan. 5 Research Center for Traditional Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.2 Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.6 Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.1 Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 2 Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan. 7 School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan.1 Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 8 School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan.1 Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 4 Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.2 Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan. 7 School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan.1 Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 4 Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan. 5 Research Center for Traditional Chinese Medicine, China Medical University Hospital, Taichung, Taiwan. 9 Research Center for Chinese Herbal Medicine, China Medical University, Taichung, Taiwan. 10 Department of Biotechnology, Asia University, Taichung, Taiwan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28774207

Citation

Kuo, Yi-Ting, et al. "Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: a Nationwide Population-Based Cohort Study." Integrative Cancer Therapies, vol. 17, no. 2, 2018, pp. 411-422.
Kuo YT, Liao HH, Chiang JH, et al. Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: A Nationwide Population-Based Cohort Study. Integr Cancer Ther. 2018;17(2):411-422.
Kuo, Y. T., Liao, H. H., Chiang, J. H., Wu, M. Y., Chen, B. C., Chang, C. M., Yeh, M. H., Chang, T. T., Sun, M. F., Yeh, C. C., & Yen, H. R. (2018). Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: A Nationwide Population-Based Cohort Study. Integrative Cancer Therapies, 17(2), 411-422. https://doi.org/10.1177/1534735417722224
Kuo YT, et al. Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: a Nationwide Population-Based Cohort Study. Integr Cancer Ther. 2018;17(2):411-422. PubMed PMID: 28774207.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: A Nationwide Population-Based Cohort Study. AU - Kuo,Yi-Ting, AU - Liao,Hou-Hsun, AU - Chiang,Jen-Huai, AU - Wu,Mei-Yao, AU - Chen,Bor-Chyuan, AU - Chang,Ching-Mao, AU - Yeh,Ming-Hsien, AU - Chang,Tung-Ti, AU - Sun,Mao-Feng, AU - Yeh,Chia-Chou, AU - Yen,Hung-Rong, Y1 - 2017/08/03/ PY - 2017/8/5/pubmed PY - 2019/2/7/medline PY - 2017/8/5/entrez KW - Chinese herbal medicine KW - National Health Insurance Research Database KW - complementary and alternative medicine KW - pancreatic cancer KW - traditional Chinese medicine SP - 411 EP - 422 JF - Integrative cancer therapies JO - Integr Cancer Ther VL - 17 IS - 2 N2 - BACKGROUND: Pancreatic cancer is a difficult-to-treat cancer with a late presentation and poor prognosis. Some patients seek traditional Chinese medicine (TCM) consultation. We aimed to investigate the benefits of complementary Chinese herbal medicine (CHM) among patients with pancreatic cancer in Taiwan. METHODS: We included all patients with pancreatic cancer who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 1997 and 2010. We used 1:1 frequency matching by age, sex, the initial diagnostic year of pancreatic cancer, and index year to enroll 386 CHM users and 386 non-CHM users. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time. RESULTS: According to the Cox hazard ratio model mutually adjusted for CHM use, age, sex, urbanization level, comorbidity, and treatments, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.67, 95% CI = 0.56-0.79). Those who received CHM therapy for more than 90 days had significantly lower hazard ratios of mortality risk than non-CHM users (90- to 180-day group: adjusted HR = 0.56, 95% CI = 0.42-0.75; >180-day group: HR = 0.33, 95% CI = 0.24-0.45). The survival probability was higher for patients in the CHM group. Bai-hua-she-she-cao (Herba Oldenlandiae; Hedyotis diffusa Spreng) and Xiang-sha-liu-jun-zi-tang (Costus and Chinese Amomum Combination) were the most commonly used single herb and Chinese herbal formula, respectively. CONCLUSIONS: Complementary Chinese herbal therapy might be associated with reduced mortality among patients with pancreatic cancer. Further prospective clinical trial is warranted. SN - 1552-695X UR - https://www.unboundmedicine.com/medline/citation/28774207/Complementary_Chinese_Herbal_Medicine_Therapy_Improves_Survival_of_Patients_With_Pancreatic_Cancer_in_Taiwan:_A_Nationwide_Population_Based_Cohort_Study_ L2 - https://journals.sagepub.com/doi/10.1177/1534735417722224?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -