Association between Chinese Medicine Therapy and Survival Outcomes in Postoperative Patients with NSCLC: A Multicenter, Prospective, Cohort Study

• DOI: 10.1007/s11655-019-3168-6
• Publication Date: 2019-08-31T09:59:11Z
• Authors: Xue-qian Wang; Ying Zhang; Wei Hou; Ying-tian Wang; Jia-bin Zheng; Jie Li; Li-zhu Lin; Yi-lan Jiang; Shen-yu Wang; Ying Xie; Hong-liang Zhang; Qi-jin Shu; Ping Li; Wei Wang; Jian-liang You; Ge Li; Jie Liu; Hui-ting Fan; Mei-ying Zhang; Hong-sheng Lin
• Keywords: Adult; Male; Postoperative Care; China; Lung Neoplasms; Middle Aged; Combined Modality Therapy; Disease-Free Survival; 3. Good health; Cohort Studies; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Carcinoma, Non-Small-Cell Lung; Humans; Female; Postoperative Period; Medicine, Chinese Traditional; Aged; Follow-Up Studies

To evaluate the association between Chinese medicine (CM) therapy and disease-free survival (DFS) outcomes in postoperative patients with non-small cell lung cancer (NSCLC).This multiple-center prospective cohort study was conducted in 13 medical centers in China. Patients with stage I, II, or IIIA NSCLC who had undergone radical resection and received conventional postoperative treatment according to the National Comprehensive Cancer Network (NCCN) guidelines were recruited. The recruited patients were divided into a CM treatment group and a control group according to their wishes. Patients in the CM treatment group received continuous CM therapy for more than 6 months or until disease progression. Patients in the control group received CM therapy for less than 1 month. Follow-up was conducted over 3 years. The primary outcome was DFS, with recurrence/metastasis rates as a secondary outcome.Between May 2013 and August 2016, 503 patients were enrolled into the cohort; 266 were classified in the CM treatment group and 237 in the control group. Adjusting for covariates, high exposure to CM was associated with better DFS [hazard ratio (HR) = 0.417, 95% confidential interval (CI): 0.307-0.567)]. A longer duration of CM therapy (6-12 months, 12-18 months, >24 months) was associated with lower recurrence and metastasis rates (HR = 0.225, 0.119 and 0.083, respectively). In a subgroup exploratory analysis, CM therapy was also a protective factor of cancer recurrence and metastasis in both stage I-IIIA (HR=0.50, 95% CI: 0.37-0.67) and stage IIIA NSCLC postoperative patients (HR = 0.48, 95% CI: 0.33-0.71), DFS was even longer among CM treatment group patients.Longer duration of CM therapy could be considered a protective factor of cancer recurrence and metastasis. CM treatment is associated with improving survival outcomes of postoperative NSCLC patients in China. (Registration No. ChiCTR-OOC-14005398).