Integrative Cancer Therapies · 2011 · 24 citations · 81 references
MedicineOncologyPharmacotherapyCancer PharmacologyChemotherapyOncology PharmacotherapyCancer Survival AnalysisLung Cancer PharmacotherapySupportive Care In CancerCancer Combination TherapyCox RegressionLong-term Medication UseLung Cancer MortalityMarginal Survival ModelsNon-small Cell Lung Cancer TherapyPopulation Cancer RegistriesSurvival Rates
Complementary and alternative medicines are used by up to 48% of lung cancer patients but have seen little formal assessment of survival efficacy. In this 10-year retrospective survival study, the authors investigated Pan-Asian medicine + vitamins (PAM+V) therapy in a consecutive case series of all non-small-cell lung cancer patients (n = 239) presenting at a San Francisco Bay Area Chinese medicine center (Pine Street Clinic). They compared short-term treatment lasting the duration of chemotherapy/radiotherapy with long-term therapy continuing beyond conventional therapy. They also compared PAM+V plus conventional therapy with conventional therapy alone, using concurrent controls from the Kaiser Permanente Northern California and California Cancer Registries. They adjusted for confounding with Kaplan-Meier, Cox regression, and newer methods - propensity score and marginal structural models (MSMs), which when analyzing data from observational studies or clinical practice records can provide results comparable with randomized trials. Long-term use of PAM+V beyond completion of chemotherapy reduced stage IIIB deaths by 83% and stage IV by 72% compared with short-term use only for the duration of chemotherapy. Long-term PAM+V combined with conventional therapy reduced stage IIIA deaths by 46%, stage IIIB by 62%, and stage IV by 69% compared with conventional therapy alone. Survival rates for stage IV patients treated with PAM+V were 82% at 1 year, 68% at 2 years, and 14% at 5 years. PAM+V combined with conventional therapy improved survival in stages IIIA, IIIB, and IV, compared with conventional therapy alone. Prospective trials using PAM+V with conventional therapy for lung cancer patients are justified.
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Erik von Elm, Douglas G. Altman, Matthias Egger et al. · PLoS Medicine · 2007 · 21.6K citations · Full text
Public Health, Public Health Practice, Epidemiologic Methods +10
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