Hegen Li, Veronika Lindberg, Lihua Zhu, Xiange Huang, Jiali Feng, Jan P A Baak
{"title":"艾灸治疗与传统的中西医结合治疗可能以剂量依赖的方式提高iv期肺腺癌患者的生存率：一项前瞻性观察性倾向评分分析研究。","authors":"Hegen Li, Veronika Lindberg, Lihua Zhu, Xiange Huang, Jiali Feng, Jan P A Baak","doi":"10.1177/15347354251342739","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>25% to 30% of primary stage IV pulmonary adenocarcinomas (PUAD-IV) die within 3 months. Many ≥3 months survivors at long follow-up are alive with disease (AWD). Platinum-based chemotherapy (PBC), tyrosine kinase inhibitors- targeted therapy (TKI-TT), and Chinese herbal medicines (oral CHM) improve prognosis. In China, moxibustion treatment (Moxa) is also used, without prognostic proof.</p><p><strong>Methods: </strong>Prospective observational Moxa evaluation in 412 first-onset consecutive PUAD-IV performance score 0 to 1 patients with 3 to 120 months follow-up. All received oral CHM with PBC, TKI-TT, or PBC + TKI-TT. Moxa was given as indicated at the start of the treatment (and eventually adapted in the follow-up period by de novo development) of well-established TCM syndromes and symptoms. Survival was analyzed using Kaplan-Meier and Cox regression. Propensity score analysis (PSA) with matching and inverse probability of treatment weighting (IPTW) were used to adjust for baseline covariate imbalances.</p><p><strong>Results: </strong>Of 412 patients, 117 received no Moxa, 239 had 1 to 4 treatments, and 56 received >4 treatments alongside conventional treatments. Tumor-Node-Metastasis (TNM) stage IVB and male sex increased dead of disease (DOD)-risk, while TKI-TT, ≥4 Chemotherapy cycles, and Moxa improved survival (<i>P</i> < .05). Median survival (MST): Reference group (PBC + CHM) 20.0 months; Moxa 32.0; TKI-TT 33.0; TKI-TT+1-4 Moxa 33.0; TKI-TT+>4 Moxa 40.0 months (all <i>P</i> < .05). Cox regression indicated a dosage-dependent Moxa effect (<i>P</i> = .0004). Restricted Mean Survival Time (RMST) at 36 months favored >4 Moxa+TKI-TT over TKI-TT (+6.2 months, <i>P</i> = .01). PSA confirmed results were not due to baseline covariate imbalance.</p><p><strong>Conclusions: </strong>Moxibustion may dosage-dependently improve survival in PUAD-IV, both in TKI- and non-TKI-treated patients. Randomized clinical trials (RCT) are needed to confirm this.</p>","PeriodicalId":13734,"journal":{"name":"Integrative Cancer Therapies","volume":"24 ","pages":"15347354251342739"},"PeriodicalIF":2.8000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179449/pdf/","citationCount":"0","resultStr":"{\"title\":\"Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis.\",\"authors\":\"Hegen Li, Veronika Lindberg, Lihua Zhu, Xiange Huang, Jiali Feng, Jan P A Baak\",\"doi\":\"10.1177/15347354251342739\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>25% to 30% of primary stage IV pulmonary adenocarcinomas (PUAD-IV) die within 3 months. Many ≥3 months survivors at long follow-up are alive with disease (AWD). Platinum-based chemotherapy (PBC), tyrosine kinase inhibitors- targeted therapy (TKI-TT), and Chinese herbal medicines (oral CHM) improve prognosis. In China, moxibustion treatment (Moxa) is also used, without prognostic proof.</p><p><strong>Methods: </strong>Prospective observational Moxa evaluation in 412 first-onset consecutive PUAD-IV performance score 0 to 1 patients with 3 to 120 months follow-up. All received oral CHM with PBC, TKI-TT, or PBC + TKI-TT. Moxa was given as indicated at the start of the treatment (and eventually adapted in the follow-up period by de novo development) of well-established TCM syndromes and symptoms. Survival was analyzed using Kaplan-Meier and Cox regression. Propensity score analysis (PSA) with matching and inverse probability of treatment weighting (IPTW) were used to adjust for baseline covariate imbalances.</p><p><strong>Results: </strong>Of 412 patients, 117 received no Moxa, 239 had 1 to 4 treatments, and 56 received >4 treatments alongside conventional treatments. Tumor-Node-Metastasis (TNM) stage IVB and male sex increased dead of disease (DOD)-risk, while TKI-TT, ≥4 Chemotherapy cycles, and Moxa improved survival (<i>P</i> < .05). Median survival (MST): Reference group (PBC + CHM) 20.0 months; Moxa 32.0; TKI-TT 33.0; TKI-TT+1-4 Moxa 33.0; TKI-TT+>4 Moxa 40.0 months (all <i>P</i> < .05). Cox regression indicated a dosage-dependent Moxa effect (<i>P</i> = .0004). Restricted Mean Survival Time (RMST) at 36 months favored >4 Moxa+TKI-TT over TKI-TT (+6.2 months, <i>P</i> = .01). PSA confirmed results were not due to baseline covariate imbalance.</p><p><strong>Conclusions: </strong>Moxibustion may dosage-dependently improve survival in PUAD-IV, both in TKI- and non-TKI-treated patients. Randomized clinical trials (RCT) are needed to confirm this.</p>\",\"PeriodicalId\":13734,\"journal\":{\"name\":\"Integrative Cancer Therapies\",\"volume\":\"24 \",\"pages\":\"15347354251342739\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179449/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Integrative Cancer Therapies\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/15347354251342739\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"INTEGRATIVE & COMPLEMENTARY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Integrative Cancer Therapies","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15347354251342739","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis.
Background: 25% to 30% of primary stage IV pulmonary adenocarcinomas (PUAD-IV) die within 3 months. Many ≥3 months survivors at long follow-up are alive with disease (AWD). Platinum-based chemotherapy (PBC), tyrosine kinase inhibitors- targeted therapy (TKI-TT), and Chinese herbal medicines (oral CHM) improve prognosis. In China, moxibustion treatment (Moxa) is also used, without prognostic proof.
Methods: Prospective observational Moxa evaluation in 412 first-onset consecutive PUAD-IV performance score 0 to 1 patients with 3 to 120 months follow-up. All received oral CHM with PBC, TKI-TT, or PBC + TKI-TT. Moxa was given as indicated at the start of the treatment (and eventually adapted in the follow-up period by de novo development) of well-established TCM syndromes and symptoms. Survival was analyzed using Kaplan-Meier and Cox regression. Propensity score analysis (PSA) with matching and inverse probability of treatment weighting (IPTW) were used to adjust for baseline covariate imbalances.
Results: Of 412 patients, 117 received no Moxa, 239 had 1 to 4 treatments, and 56 received >4 treatments alongside conventional treatments. Tumor-Node-Metastasis (TNM) stage IVB and male sex increased dead of disease (DOD)-risk, while TKI-TT, ≥4 Chemotherapy cycles, and Moxa improved survival (P < .05). Median survival (MST): Reference group (PBC + CHM) 20.0 months; Moxa 32.0; TKI-TT 33.0; TKI-TT+1-4 Moxa 33.0; TKI-TT+>4 Moxa 40.0 months (all P < .05). Cox regression indicated a dosage-dependent Moxa effect (P = .0004). Restricted Mean Survival Time (RMST) at 36 months favored >4 Moxa+TKI-TT over TKI-TT (+6.2 months, P = .01). PSA confirmed results were not due to baseline covariate imbalance.
Conclusions: Moxibustion may dosage-dependently improve survival in PUAD-IV, both in TKI- and non-TKI-treated patients. Randomized clinical trials (RCT) are needed to confirm this.
期刊介绍：
ICT is the first journal to spearhead and focus on a new and growing movement in cancer treatment. The journal emphasizes scientific understanding of alternative medicine and traditional medicine therapies, and their responsible integration with conventional health care. Integrative care includes therapeutic interventions in diet, lifestyle, exercise, stress care, and nutritional supplements, as well as experimental vaccines, chrono-chemotherapy, and other advanced treatments. Contributors are leading oncologists, researchers, nurses, and health-care professionals.
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