title: 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.
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 (chi (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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oncology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing (100091), China. yyf93@vip.sina.com
authors.forename: Yu-fei
authors.initials: YF
authors.lastname: YANG
authors.forename: Jian-zhong
authors.initials: JZ
authors.lastname: GE
authors.forename: Yu
authors.initials: Y
authors.lastname: WU
authors.forename: Yun
authors.initials: Y
authors.lastname: XU
authors.forename: Bi-yan
authors.initials: BY
authors.lastname: LIANG
authors.forename: Lin
authors.initials: L
authors.lastname: LUO
authors.forename: Xian-wen
authors.initials: XW
authors.lastname: WU
authors.forename: Duan-qi
authors.initials: DQ
authors.lastname: LIU
authors.forename: Xia
authors.initials: X
authors.lastname: ZHANG
authors.forename: Fei-xiang
authors.initials: FX
authors.lastname: SONG
authors.forename: Zhen-ying
authors.initials: ZY
authors.lastname: GENG
mesh_terms: D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D009367:Neoplasm Staging; D055502:Secondary Prevention
chemical_list: D004365:Drugs, Chinese Herbal