A Study on the Improvement of Quality of Survival in Cervical Cancer Patients after Chemoradiotherapy through an Integrated Traditional Chinese and Western Medicine Therapy Based on a Syndrome Differentiation-Driven Dynamic Intervention Strategy.
Shuangshuang Wang, Chang She, Guo Xu, Xiaolin Hu, Weina Yan
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Abstract
Introduction: Cervical cancer patients frequently experience impaired quality of life (QoL) and treatment-related toxicities following chemoradiotherapy. This study assessed whether a dynamic integrated Chinese and Western medicine (CWM) intervention, guided by traditional Chinese medicine (TCM) syndrome differentiation, improves QoL and outcomes in these patients.
Methods: A total of 176 post-chemoradiotherapy cervical cancer patients were randomized to a control group (conventional Western care) or an intervention group (conventional care + dynamic TCM intervention). QoL (EORTC QLQ-C30), psychological resilience (CD-RISC), immune function (CD4+, CD8+, CD4+/CD8+ ratio), cancer-related fatigue, myelosuppression, gastrointestinal symptoms, and radiation enteritis incidence were evaluated pre-and post-intervention. Multivariable Cox proportional hazards regression analysis was used to analyze the independent impact of the integrated Chinese-Western medicine dynamic intervention on the overall survival (OS) of cervical cancer patients after chemoradiotherapy. The 5-year OS rate was analyzed using Kaplan-Meier.
Results: Post-intervention, the intervention group showed significantly better QLQ-C30 and CD-RISC scores than controls (p < 0.05). Survival analysis revealed a higher 5-year OS rate in the intervention group (73.10% vs. 52.74%; p = 0.0179). Multivariable Cox proportional hazards regression analysis showed that after adjusting for confounding factors such as age, clinical stage, pathological type, treatment type, and TCM syndrome type, the intervention group significantly reduced the risk of death in cervical cancer patients after chemoradiotherapy compared to the control group (HR = 0.523, 95% CI: 0.291-0.942, p = 0.028). Immune function improved significantly in the intervention group (higher CD4+, CD4+/CD8+ ratio; lower CD8+; p < 0.05). While acute gastrointestinal symptom relief and acute radiation enteritis incidence showed no significant difference, the intervention group demonstrated significantly lower fatigue, reduced myelosuppression severity, fewer delayed gastrointestinal symptoms, and lower chronic radiation enteritis incidence (p < 0.05).
Conclusion: The dynamic integrated CWM approach, through stage-specific precise intervention based on syndrome differentiation, synergistically improves QoL and survival while reducing specific toxicities in cervical cancer patients post-chemoradiotherapy.
期刊介绍：
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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