title: Adjunctive traditional Chinese medicine therapy improves survival of liver cancer patients.
abstract: BACKGROUND
  Traditional Chinese medicine (TCM) is an alternative treatment for cancer with its effect by stimulating host immune response for cytotoxic activity against liver cancer. No studies evaluated TCM treatment on survival of liver cancer patients.
  
  
  METHODS
  This study determined whether the combination of TCM and conventional cancer treatment affects the survival of liver cancer patients. A retrospective cohort study was conducted in 127 237 newly diagnosed liver cancer patients from 2000 to 2009 in the National Health Insurance Program database.
  
  
  RESULTS
  Among these patients, 30 992 (24.36%) used TCM for liver cancer care. All patients were followed up until 2011. The mean follow-up was 5.67 years (SD 1.47) for TCM users and 5.49 years (SD 3.64) for non-TCM users. Compared with patients without TCM use, patients with TCM use were significantly associated with a decreased risk of death [hazard ratio (HR) = 0.65, 95% confidence interval (CI) = 0.64-0.66] with multivariate adjustment. A similar significant protective effect of TCM use across various subgroups of chronic liver diseases was also observed. Jia Wei Xiao Yao San (HR = 0.89, 95% CI = 0.81-0.96) and Chai Hu Shu Gan Tang (HR = 0.86, 95% CI = 0.78-0.95) were the most effective TCM agents that improved survival.
  
  
  CONCLUSIONS
  This cohort study provided information that adjunctive therapy with TCM may improve the survival in liver cancer patients. Further studies are needed to confirm the potential role of TCM in HCC.
authors: School of Chinese Medicine, China Medical University, Taichung, Taiwan.|School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan.
authors: Yueh-Hsiang
authors: YH
authors: Liao
authors: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.|School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors: Cheng-Chieh
authors: CC
authors: Lin
authors: School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors: Hsueh-Chou
authors: HC
authors: Lai
authors: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan.|Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan.
authors: Jen-Huai
authors: JH
authors: Chiang
authors: School of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors: Jaung-Geng
authors: JG
authors: Lin
authors: Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan.|Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan.|Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
authors: Tsai-Chung
authors: TC
authors: Li
mesh_terms: D000368:Aged; D024221:Antineoplastic Protocols; D003131:Combined Modality Therapy; D003602:Cytotoxicity, Immunologic / Q000187:drug effects*; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000276:immunology / Q000401:mortality / Q000628:therapy; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal; C103354:kamisyoyo san
keywords: liver cancer; respective cohort study; traditional Chinese medicine