Chinese Medicine Prolongs Overall Survival of Chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study

CAO Ni-da; ZHU Xiao-hong; MA Fang-qi; XU Yan; DONG Jia-huan; QIN Meng-meng; LIU Tian-shu; ZHU Chun-chao; GUO Wei-jian; DING Hong-hua; GUO Yuan-biao; LIU Li-kun; SONG Jin-jie; WU Ji-ping; CHENG Yue-lei; ZENG Lin; ZHAO Ai-guang

doi:10.1007/s11655-024-4107-8

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Chinese Medicine Prolongs Overall Survival of Chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study

Original Article | Updated：2024-07-03

- Chinese Medicine Prolongs Overall Survival of Chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study
- Chinese Journal of Integrative Medicine Vol. 30, Issue 6, Pages: 489-498(2024)
- Affiliations：
  
  1.Oncology Department Ⅰ, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai (200032), China
  2.Oncology Department, Zhongshan Hospital, Fudan University, Shanghai (200032), China
  3.Gastrointestinal Surgery Department, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai (200127), China
  4.Oncology Department,Fudan University Shanghai Cancer Center, Shanghai (200032), China
  5.Oncology Department, Shanghai General Hospital,Shanghai Jiaotong University School of Medicine, Shanghai(200080), China
  6.Traditional Chinese Medicine Department,Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai (200025), China
  7.Oncology Department, Shanxi Traditional Chinese Medicine Hospital, Taiyuan (030012), China
  8.Oncology Department, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing (102445), China
  9.Oncology Department, Yunnan Province Hospital of Traditional Chinese Medicine, Kunming (650021), China
  10.Oncology Department,Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai (201203), China
  11.Shanghai NewCore Biotechnology Co., Ltd., Shanghai (200240), China
- Author bio：
  
  Prof. ZHAO Ai-guang, E-mail: aiguang@hotmail.com
- Funds：
- DOI：10.1007/s11655-024-4107-8
  CLC：
- Published：2024-06，
  
  Accepted：25 December 2023
Scan for full text
CAO Ni-da, ZHU Xiao-hong, MA Fang-qi, et al. Chinese Medicine Prolongs Overall Survival of Chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study. [J]. Chinese Journal of Integrative Medicine 30(6):489-498(2024)
DOI：

CAO Ni-da, ZHU Xiao-hong, MA Fang-qi, et al. Chinese Medicine Prolongs Overall Survival of Chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study. [J]. Chinese Journal of Integrative Medicine 30(6):489-498(2024) DOI： 10.1007/s11655-024-4107-8.

摘要

目的:

描述近20年来我国晚期胃癌的治疗模式和生存状况

客观评价中医药规范化治疗对晚期胃癌生存的影响.

方法:

采用多中心注册登记和倾向性评分分析方法

描述2000—2021年我国晚期胃癌患者的诊断特征、治疗模式发展和生存状况. 评估非中医药队列 (标准药物治疗) 和中医药队列 (综合标准中医药治疗3个月以上) 的总生存时间 (OS) .

结果:

共纳入经组织学证实的局部进展期和 (或) 转移性胃癌和胃食管结合部腺癌患者2 001例. 其中1607例接受了全身化疗

215例 () 接受了分子靶向治疗

44例 () 接受了检查点抑制剂治疗

769例 () 接受了中医药治疗. 一线 (1L) 治疗方案以两药方案为主

其中氟嘧啶+铂类方案最常见 (60.09%) . 45.71%的HER2扩增患者一线治疗接受曲妥珠单抗治疗. 三线 (3L) 治疗中阿帕替尼应用增加 (33.33%) . 自2020年以来

检查点抑制剂的应用有所增加. COX分析显示Lauren分型混合型 (

=0.017) 、1L

6个周期 (

=0.000) 、中医药治疗 (

=0.000) 、姑息性胃切除术 (

=0.000) 、接受曲妥珠单抗 (

=0.011) 、接受阿帕替尼 (

=0.008) 是影响晚期胃癌患者OS的独立预后因素. 经倾向性评分匹配和逆概率加权匹配后

中药队列和非中药队列患者的中位OS分别为18.17个月和12.45个月 (

0.001) .

结论:

我国晚期胃癌真实世界诊疗实践中

治疗方案的选择与指南基本一致. 两药方案是一线治疗的主要方案. 规范化中医药治疗是晚期胃癌患者生存期的独立预后因素

可延长中国晚期胃癌患者的总生存期.

Abstract

Objective:

To describe the treatment patterns and survival status of advanced gastric cancer (AGC) in China in the past two decades

and objectively evaluate the impact of standardized Chinese medicine (CM) treatment on the survival of AGC patients.

Methods:

This multicenter registry designed and propensity score analysis study described the diagnosis characteristics

treatment-pattern development and survival status of AGC from 10 hospitals in China between January 1

2000 and July 31

2021. Overall survival (OS) was evaluated between non-CM cohort (standard medical treatment) and CM cohort (integrated standard CM treatment ≥3 months). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to adjust any difference in average outcomes for bias.

Results:

A total of 2

001 patients histologically confirmed locally advanced and/or metastasis stomach and gastroesophageal junction adenocarcinoma were enrolled. Among them

607 received systemic chemotherapy

215 (10.74%) accepted molecular targeted therapy

44 (2.2%) received checkpoint inhibitor therapy

and 769 (38.43%) received CM. Two-drug regimen was the main choice for first-line treatment

with fluoropyrimidine plus platinum as the most common regimen (530 cases

60.09%). While 45.71% (16 cases) of patients with HER2 amplification received trastuzumab in first-line. The application of apatinib increased (33.33%) in third-line. The application of checkpoint inhibitors has increased since 2020. COX analysis showed that Lauren mixed type (

=0.017)

cycles of first-line treatment

6 (

=0.000)

CM (

=0.000)

palliative gastrectomy (

=0.000)

trastuzumab (

=0.011)

and apatinib (

=0.008) were independent prognostic factors for the OS of AGC. After PSM and IPTW

the median OS of CM cohort and non-CM cohort was 18.17 and 12.45 months

respectively (

0.001).

Conclusions:

In real-world practice for AGC in China

therapy choices consisted with guidelines. Two-drug regimen was the main first-line choice. Standardized CM treatment was an independent prognostic factor and could prolong the OS of Chinese patients with AGC. (Registration No. NCT02781285)

关键词

晚期胃癌真实世界研究治疗模式生存分析中医

Keywords

advanced gastric cancerreal-world studytreatment patternsurvival analysisChinese medicine

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