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 [HR], 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.

Original languageEnglish
Pages (from-to)1338-1344
Number of pages7
JournalCancer
Volume120
Issue number9
DOIs
Publication statusPublished - May 1 2014

Fingerprint

Chinese Traditional Medicine
Breast Neoplasms
Survival
Population
Therapeutics
Complementary Therapies
Confidence Intervals
Taxoids
Mortality
National Health Programs
Taiwan
Proportional Hazards Models
Observational Studies
Cohort Studies
Multivariate Analysis
Randomized Controlled Trials
Databases

Keywords

  • breast cancer
  • complementary and alternative medicine
  • National Health Insurance Research Database
  • taxane
  • traditional Chinese medicine

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{561adbd6548b48c9ade45f33388428d7,
title = "Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: A population-based study",
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 [HR], 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.",
keywords = "breast cancer, complementary and alternative medicine, National Health Insurance Research Database, taxane, traditional Chinese medicine",
author = "Yuan-Wen Lee and Ta-Liang Chen and Shih, {Yu Ru Vernon} and Tsai, {Chu Lin} and Chuen-Chau Chang and Hung-Hua Liang and Sung-Hui Tseng and Shu-Chen Chien and Ching-Chiung Wang",
year = "2014",
month = "5",
day = "1",
doi = "10.1002/cncr.28579",
language = "English",
volume = "120",
pages = "1338--1344",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "9",

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TY - JOUR

T1 - Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer

T2 - A population-based study

AU - Lee, Yuan-Wen

AU - Chen, Ta-Liang

AU - Shih, Yu Ru Vernon

AU - Tsai, Chu Lin

AU - Chang, Chuen-Chau

AU - Liang, Hung-Hua

AU - Tseng, Sung-Hui

AU - Chien, Shu-Chen

AU - Wang, Ching-Chiung

PY - 2014/5/1

Y1 - 2014/5/1

N2 - 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 [HR], 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.

AB - 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 [HR], 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.

KW - breast cancer

KW - complementary and alternative medicine

KW - National Health Insurance Research Database

KW - taxane

KW - traditional Chinese medicine

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