title: The use of adjunctive traditional Chinese medicine therapy and survival outcome in patients with head and neck cancer: a nationwide population-based cohort study.
abstract: BACKGROUND
  Traditional Chinese medicine (TCM) is widely used in the treatment of patients with several types of cancer. However, no large-scale clinical studies have evaluated whether TCM is associated with better survival in patients with head and neck cancer (HNC).
  
  
  METHODS
  The Taiwan National Health Insurance Research Database was used to conduct a retrospective cohort study of patients with HNC between 2001 and 2011. The patients with HNC were separated into TCM users and non-users, and Cox regression models were applied to determine the association between the use of TCM and survival outcome.
  
  
  RESULTS
  The TCM and comparison cohorts comprised data for 2966 and 2670 patients, respectively. The mean age was 51.3 years in the TCM cohort and 51.7 years in the comparison cohort. Multivariate analysis demonstrated that the use of TCM was significantly associated with lower risk of all-cause mortality by 32% (adjusted hazard ratio, 0.68; 95% confidence interval, 0.62-0.75). Patients with longer TCM use had a lower mortality rate (P for trend < 0.001).
  
  
  CONCLUSIONS
  Our study showed that adjunctive therapy with TCM is associated with higher survival outcome. However, some limitations exist, such as the lack of information of cancer stage. In addition, causality cannot be assessed with this retrospective study. A randomized controlled trial to test the effect of adjunctive TCM therapy in HNC patients is needed.
authors: From the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Hung-Che
authors: HC
authors: Lin
authors: Office for Health Data, China Medical University Hospital, Taichung, Taiwan, College of Medicine, China Medical University, Taichung, Taiwan.
authors: Cheng-Li
authors: CL
authors: Lin
authors: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Wen-Yen
authors: WY
authors: Huang
authors: Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Wei-Chuan
authors: WC
authors: Shangkuan
authors: From the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Bor-Hwang
authors: BH
authors: Kang
authors: From the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Yueng-Hsiang
authors: YH
authors: Chu
authors: From the Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Department of Biological Science and Technology, Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan.
authors: Jih-Chin
authors: JC
authors: Lee
authors: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Hueng-Chuen
authors: HC
authors: Fan
authors: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan d10040@mail.cmuh.org.tw.
authors: Chia-Hung
authors: CH
authors: Kao
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D016208:Databases, Factual; D004334:Drug Administration Schedule; D004341:Drug Evaluation / Q000379:methods; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal