Abstract
Objective
To evaluate the effectiveness of a comprehensive therapy of traditional Chinese medicine (TCM) in reducing the relapse and metastasis of stage II and III colorectal cancer based on conventional Western medicine (WM) therapy.
Methods
Two hundred and twenty-two patients in total, diagnosed as stage II and III colorectal cancer from February 2000 to March 2006, were recruited from Xiyuan Hospital, China Academy of Chinese Medical Sciences and the General Hospital of Beijing Military Area. They were followed-up once every 3–6 months. Twenty cases dropped out from the cohort. The remaining 202 patients were all treated with routine WM treatment [including R0 radical operation, or chemotherapy or/and radiotherapy according to national comprehensive cancer network (NCCN) clinical guidelines]. These patients were assigned to two groups based on whether or not they were additionally treated with TCM comprehensive therapy (orally administered with a decoction according to syndrome differentiation, combined with a traditional patent drug over one year). Ninety-eight patients from Xiyuan Hospital were treated with WM and TCM (combined group), and 104 patients from the General Hospital of Beijing Military Area were treated with WM alone (WM group). The demographic data at baseline were comparable, including the operation times, age, sex, TNM staging, and pathological types. The patients were followed-up for one to five years. Up to now, there are 98, 98, 77, 64, and 47 patients with 1, 2, 3, 4, and 5 years of follow-up in the combined group, respectively; and 104, 104, 97, 81, and 55 patients in the WM group, respectively. The results of the 5-year follow-up of all the patients will be available in 2011.
Results
The relapse/metastasis rate of 1-, 2-, 3-, 4-, and 5-year were 0 (0/98), 2.04% (2/98), 11.69% (9/77), 14.06% (9/64), and 21.28% (10/47) in the combined group, and were 4.80%(5/104), 16.35% (17/104), 21.65% (21/97), 25.93% (21/81), and 38.18%(21/55) in the WM group, respectively. A significant difference was found in the second year between the two groups (χ 2=12.117, P=0.000). Median relapse/metastasis time was 26.5 months in the combined group and 16.0 months in the WM group.
Conclusion
The combined therapy of TCM and WM may have great clinical value and a potential for decreasing the relapse or metastasis rate in stage II and III colorectal cancer after conventional WM therapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74–108.
National Cancer Prevention and Control Research Office, Information Statistics Center of Ministry of Health. Monitoring Chinese cities, counties cancer incidence and death. Beijing: China Medical Science and Technology Publishing House, 2002:24–34.
O’Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst 2004;96:1420–1425.
Rex DK, Kahi CJ, Levin B, et al. Guidelines for colonoscopy surveillance after cancer resection: a consensus update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer. CA Cancer J Clin 2006;56:160–167.
Liu J, Wang WP, Zhou PY, et al. Observation on therapeutic effect of Jianpi Huoxue herbs combined with chemotherapy in treating post-operational colonic cancer patients. Chin J Integr Tradit West Med (Chin) 2005;25(3):207–209.
National Cancer Prevention and Control Research Office, Chinese Anti-cancer Association. Diagnosis standard of common malignant tumor in China. Vol 3. Colorectal carcinoma. Beijing: Peking Medical University and Peking Union Medical College United Publishing House, 1990:2–23.
Sun Y, Zhou JC, ed. Manual of clinical oncology of internal medicine. 4th ed. Beijing: People’s Medical Publishing House, 2003:337–339.
Hua JD, ed. Cancer surgery. Beijing: People’s Military Medical Press,1995:463.
Dong ZW, Gu XZ, ed. Clinical oncology. Beijing: People’s Medical Publishing House, 2002:160.
de Gramont A, Tournigand C, André T, et al. Adjuvant therapy for stage II and III colorectal cancer. Semin Oncol 2007;34(2 Suppl 1):S37–40.
Wu Y, Luo L, Liu JP, et al. Herbal medicine for relapse and metastasis in patients operated for colorectal cancer. Cochrane Database of Systematic Reviews 2006; Issue 4. Art. No. CD006270.
Luo L, Yang YF, Li PH, et al. Cohort study on Fuzheng capsule and Quxie capsule in reducing relapse and metastasis of cancer in patients with stage II and III colorectal cancer after operation. Chin J Integr Tradit West Med (Chin) 2006; 26(8):677–680.
Ji JF. Molecular biology foundation of hepatic metastasis from colorectal cancer J Pract Oncol (Chin) 2003;18(2):84–87.
Boedefeld WM 2nd, Bland KI, Heslin MJ. Recent insights into angiogenesis, apoptosis, invasion, and metastasis in colorectal carcinoma. Ann Surg Oncol 2003;10:839–851.
Rudmik LR, Magliocco AM. Molecular mechanism of hepatic metastasis in colorectal cancer. J Surg Oncol 2005;92:347–359.
Author information
Authors and Affiliations
Corresponding author
Additional information
Supported by Norway National Evidence Based Medicine to Provide Financial Assistance Project (No. 0221)
Rights and permissions
About this article
Cite this article
Yang, Yf., Ge, Jz., Wu, Y. et al. Cohort study on the effect of a combined treatment of traditional Chinese medicine and Western medicine on the relapse and metastasis of 222 patients with stage II and III colorectal cancer after radical operation. Chin. J. Integr. Med. 14, 251–256 (2008). https://doi.org/10.1007/s11655-008-0251-9
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11655-008-0251-9