Stomach neoplasms,Drug therapy,Combination,Medicine, Chinese traditional,Integrative medicine,Plants, medicinal ," /> Stomach neoplasms,Drug therapy,Combination,Medicine, Chinese traditional,Integrative medicine,Plants, medicinal ,"/> Traditional Chinese medicine integrated with chemotherapy for stage IV non-surgical gastric cancer: A retrospective clinical analysis
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Journal of Integrative Medicine ›› 2017, Vol. 15 ›› Issue (6): 469-475.doi: 10.1016/S2095-4964(17)60377-7

Special Issue: Traditional Chinese Medicine

• Research Article • Previous Articles     Next Articles

Traditional Chinese medicine integrated with chemotherapy for stage IV non-surgical gastric cancer: A retrospective clinical analysis

Xuan Liu, Li-juan Xiu, Jian-peng Jiao, Jing Zhao, Ying Zhao, Ye Lu, Jun Shi, Yong-jin Li, Min Ye, Yu-fang Gu, Xiao-wei Wang, Jing-yu Xu, Ci-an Zhang, Yong-ying Liu, Yun Luo, Xiao-qiang Yue   

  1. Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • Received:2017-03-20 Accepted:2017-08-14 Online:2017-11-15 Published:2017-11-07
  • Contact: Xiao-qiang Yue, PhD, Associate Professor; E-mail: yuexiaoqiang@163.com
  • Supported by:
    This study was financially supported by the Natural Science Foundation of Shanghai Science and Technology Commission (No. 17ZR1438800, for Dr. Xuan Liu), Traditional Chinese Medicine Guiding Project of Shanghai Science and Technology Commission (No.13401907500, for Zhi-feng Qin), Shanghai Municipal Commission of Health and Family Planning Program (No. ZY3-CCCX-3-3056, for Dr. Li-juan Xiu) and National Natural Science Foundation Youth Program (No. 81603434, for Dr. Li-juan Xiu).

Objective

Traditional Chinese medicine (TCM) is regarded as an important treatment for gastric cancer patients, especially for those in advanced stage. To evaluate the effects of TCM treatment on gastric cancer patients, the authors performed a retrospective study to report the result of the integrated treatment of TCM with chemotherapy for stage IV non-surgical gastric cancer.

Methods

In this study, 182 patients with stage IV and non-surgical gastric cancer were retrospectively analyzed to evaluate the effects of TCM integrated with chemotherapy. Among the 182 cases, 88 cases received integrated therapy consisting of TCM and chemotherapy, while 94 cases received chemotherapy alone. The overall survival and Karnofsky performance status (KPS) score were measured as the main outcome.

Results

The median overall survival of the integrated therapy group and chemotherapy group were 16.9 and 10.5 months, respectively. The 1-, 3- and 5-year survival rates of integrated therapy group vs. chemotherapy group were 70% vs. 32%, 18% vs. 4%, and 11% vs. 0%, respectively. There was a significant difference between the two groups (χ2 = 42.244, P < 0.001). After six-month treatment, KPS scores of the integrated therapy group and the chemotherapy group were 75.00 ± 14.78 and 60.64 ± 21.39, respectively (P < 0.001). The Cox regression analysis showed that TCM treatment is a protective factor for patients' overall survival.

Conclusion

This study demonstrated that TCM integrated with chemotherapy may prolong overall survival and improve survival rate and life quality of patients with stage IV non-surgical gastric cancer.

Key words: Stomach neoplasms, Drug therapy, Combination, Medicine, Chinese traditional, Integrative medicine, Plants, medicinal

1 de Martel C, Forman D, Plummer M. Gastric cancer: epidemiology and risk factors.Gastroenterol Clin North Am. 2013; 42(2): 219-240.
2 Yang D, Hendifar A, Lenz C, Togawa K, Lenz F, Lurje G, Pohl A, Winder T, Ning Y, Groshen S, Lenz HJ.Survival of metastatic gastric cancer: significance of age, sex and race/ ethnicity.J Gastrointest Oncol. 2011; 2(2): 77-84.
3 Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015; 136(5): E359-E386.
4 Liu N, Wang X. Current status and research progress of perioperative chemotherapy in advanced gastric cancer. Zhonghua Wei Chang Wai Ke Za Zhi.2015; 18(10): 983- 985. Chinese with abstract in English.
5 Moehler M, Mueller A, Trarbach T, Lordick F, Seufferlein T, Kubicka S, Geissler M, Schwarz S, Galle PR, Kanzler S; German Arbeitsgemeinschaft Internistische Onkologie. Cetuximab with irinotecan, folinic acid and 5-fluorouracil as first-line treatment in advanced gastroesophageal cancer: a prospective multi-center biomarker-oriented phase II study.Ann Oncol. 2011; 22(6): 1358-1366.
6 Davies AR, Gossage JA, Zylstra J, Mattsson F, Lagergren J, Maisey N, Smyth EC, Cunningham D, Allum WH, Mason RC.Tumor stage after neoadjuvant chemotherapy determines survival after surgery for adenocarcinoma of the esophagus and esophagogastric junction. J Clin Oncol.2014; 32(27): 2983-2990.
7 Iveson T, Donehower RC, Davidenko I, Tjulandin S, Deptala A, Harrison M, Nirni S, Lakshmaiah K, Thomas A, Jiang Y, Zhu M, Tang R, Anderson A, Dubey S, Oliner KS, Loh E.Rilotumumab in combination with epirubidin, cisplatin, and capecitabine as first-line treatment for gastric or oesophagogastric junction adenocarcinoma: an openlabel, dose-de-escalation phase 1b study and a double-blind, randomised phase 2 study.Lancet Oncol. 2014; 15(9): 1007-1018.
8 Pinto C, Di Fabio F, Barone C, Siena S, Falcone A, Cascinu S, Rojas Llimpe FL, Stella G, Schinzari G, Artale S, Mutri V, Giaquinta S, Giannetta L, Bardelli A, Martoni AA.Phase II study of cetuximab in combination with cisplatin and docetaxel in patients with untreated advanced gastric or gastro-oesophageal junction adenocarcinoma (DOCETUX study). Br J Cancer.2009; 101(8): 1261-1268.
9 Sun DZ, Liu L, Jiao JP, Wei PK, Jiang LD, Xu L. Sydrome characteristics of traditional Chinese medicine: summary of a clinical survey in 767 patients with gastric cancer. Zhong Xi Yi Jie He Xue Bao.2010; 8(4): 321-330. Chinese with abstract in English.
10 Ji Q, Luo YQ, Wang WH, Liu X, Li Q, Su SB.Research advances in traditional Chinese medicine sydromes in cancer patients.J Integr Med. 2016; 14(1): 12-21.
11 Wu AW, Ji JF.Neoadjuvant chemotherapy for locally advanced gastric cancer: with or without radiation.World J Gastrointest Surg. 2012; 4(2): 27-31.
12 Zhang LP, Liao XY, Xu YM, Yan LJ, Yan GF, Wang XX, Duan YZ, Sun JG.Efficacy and safety of endostar® combined with chemotherapy in patients with advanced soft tissue sarcomas.Asian Pac J Cancer Prev. 2013; 14(7): 4255-4259.
13 Casaretto L, Sousa PL, Mari JJ.Chemotherapy versus support cancer treatment in advanced gastric cancer: a metaanalysis.Braz J Med Biol Res. 2006; 39(4): 431-440.
14 Yonemura Y, Elnemr A, Endou Y, Ishibashi H, Mizumoto A, Miura M, Li Y.Effects of neoadjuvant intraperitoneal/ systemic chemotherapy (bidirectional chemotherapy) for the treatment of patients with peritoneal metastasis from gastric cancer.Int J Surg Oncol. 2012; 2012: 148420.
15 Kitayama J, Ishigami H, Yamaguchi H, Yamashita H, Emoto S, Kaisaki S, Watanabe T.Salvage gastrectomy after intravenous and intraperitoneal paclitaxel (PTX) administration with oral S-1 for peritoneal dissemination of advanced gastric cancer with malignant ascites.Ann Surg Oncol. 2014; 21(2): 539-546.
16 Rivera F, Vega-Vi l l e g a s ME, López-Brea MF. Chemotherapy of advanced gastric cancer.Cancer Treat Rev. 2007; 33(4): 315-324.
17 Ling CQ, Yue XQ, Ling C.Three advantages of using traditional Chinese medicine to prevent and treat tumor.J Integr Med. 2014; 12(4): 331-335.
18 Rosati G, Ferrara D, Manzione L.New perspectives in the treatment of advanced or metastatic gastric cancer.World J Gastroenterol. 2009; 15(22): 2689-2692.
19 Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, Lordick F, Ohtsu A, Omuro Y, Satoh T, Aprile G, Kulikov E, Hill J, Lehle M, Rüschoff J, Kang YK; ToGA Trial Investigators. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial.Lancet. 2010; 376(9742): 687-697.
20 Li J, Qin S, Xu J, Guo W, Xiong J, Bai Y, Sun G, Yang Y, Wang L, Xu N, Cheng Y, Wang Z, Zheng L, Tao M, Zhu X, Ji D, Liu X, Yu H.Apatinib for chemotherapyrefractory advanced metastatic gastric cancer: results from a randomized, placebo-controlled, parallel-arm, phase II trial.J Clin Oncol. 2013; 31(26): 3219-3225.
21 Sun W, Powell M, O’Dwyer PJ, Catalano P, Ansari RH, Benson AB 3rd. Phase II study of sorafenib in combination with docetaxel and cisplatin in the treatment of metastatic or advanced gastric and gastroesophageal junction adenocarcinoma: ECOG 5203.J Clin Oncol. 2010; 28(18): 2947-2951.
22 Zhao Y, Wang XW, Lu Y, Liu X, Xiu LJ, Yue XQ, Wei PK. Effect of Xiaotan Sanjie decoction treatment based on syndrome differentiation on quality of life of patients with intermediate and advanced gastric cancer. Di Er Jun Yi Da Xue Xue Bao.2016; 37(11): 1333-1337. Chinese with abstract in English.
23 Zhao AG, Cao W, Xu Y, Zhao G, Liu BY, Yang JZ, Gu Y, Yuan W, Zhu YJ, Han YY, Yang JK. Survival benefit of an herbal formula for invigorating spleen for elderly patients with gastric cancer. Zhong Xi Yi Jie He Xue Bao.2010; 8(3): 224-230. Chinese with abstract in English.
24 Sun DZ, Jiao JP, Ju DW, Ye M, Zhang X, Xu JY, Lu Y, He J, Wei PK, Yang MH.Tumor interstitial fluid and gastric cancer metastasis: an experimental study to verify the hypothesis of “tumor-phlegm microenvironment”.Chin J Integr Med. 2012; 18(5): 350-358.
25 Shi J, Wei PK.Xiaotan Sanjie decoction inhibits interleukin- 8-induced metastatic potency in gastric cancer. World J Gastroenterol.2015; 21(5): 1479-1487.
26 Yan B, Liu L, Zhao Y, Xiu LJ, Sun DZ, Liu X, Lu Y, Shi J, Zhang YC, Li YJ, Wang XW, Zhou YQ, Feng SH, Lv C, Wei PK, Qin ZF.Xiaotan Sanjie decoction attenuates tumor angiogenesis by manipulating Notch-1-regulated proliferation of gastric cancer stem-like cells.World J Gastroenterol. 2014; 20(36): 13105-13118.
27 Yan B, Zhou Y, Feng S, Lv C, Xiu L, Zhang Y, Shi J, Li Y, Wei P, Qin Z.β-Elemene-attenuated tumor angiogenesis by targeting Notch-1 in gastric cancer stem-like cells.Evid Based Complement Alternat Med. 2013; 2013: 268468.
28 Ju D, Sun D, Xiu L, Meng X, Zhang C, Wei P.Interleukin-8 is associated with adhesion, migration and invasion in human gastric cancer SCG-7901 cells.Med Oncol. 2012; 29(1): 91-99.
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