Chinese researchers evaluated the effect of Chinese medicine (CM) on survival time and quality of life (QoL) in patients with small-cell lung cancer (SCLC). They conducted an exploratory and prospective clinical observation. Patients diagnosed with SCLC receiving CM treatment as an add-on to conventional cancer therapies were included and followed up every 3 months. The primary outcome was overall survival (OS), and the secondary outcomes were progression-free survival (PFS) and QoL.
A total of 136 patients including 65 limited-stage SCLC (LS-SCLC) patients and 71 extensive-stage SCLC (ES-SCLC) patients were analyzed. The median OS of ES-SCLC patients was 17.27 months, and the median OS of LS-SCLC was 40.07 months. The survival time was 16.27 months for SCLC patients with brain metastasis, 9.83 months for liver metastasis, 13.43 months for bone metastasis, and 18.13 months for lung metastasis. Advanced age, pleural fluid, liver, and brain metastasis were risk factors, while longer CM treatment duration was a protective factor. QoL assessment indicated that after 6 months of CM treatment, scores increased in function domains and decreased in symptom domains.
The authors concluded that CM treatment might help prolong OS of SCLC patients. Moreover, CM treatment brought the trend of symptom amelioration and QoL improvement. These results provide preliminary evidence for applying CM in SCLC multi-disciplinary treatment.
Sorry, but these results provide NO evidence for applying CM in SCLC multi-disciplinary treatment! Even if the findings were a bit better than those reported for SCLC in the literature – and I am not sure they are – it is simply not possible to say with any degree of certainty what effect the CM had. For that, we would obviously need a proper control group.
The study was supported by the National Natural Science Foundation of China (No. 81673797), and Beijing Municipal Natural Science Foundation (No. 7182142). In my view, this paper is an example for showing how the relentless promotion of dubious Traditional Chinese Medicine by Chinese officials might cost lives.
I feel that it is time to do something about it.
But what precisely?
Any ideas anyone?
5 Responses to “Chinese Medicine Treatment Prolonged Survival in Small Cell Lung Cancer Patients” … true or false?
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All we can do is to try to prevent this nonsense from becoming established in developed countries. China might be developed economically, but it certainly is not developed intellectually.
Given that CM is a highly political issue, this is likely the sort of thing we will continue to see from China. CM should continue to be critically evaluated outside of political control and any lack of results widely publicized.
It is difficult to know what this study is really saying as the paper is behind a paywall, so we know very little about how it was conducted. The abstract that we can read for free isn’t very informative and is hardly what I would regard as an abstract at all.
An observational study of this nature is never going yield conclusive results as we don’t know whether the groups using Chinese medicine are comparable to the groups that were not, or whether any of the factors influencing the choice of treatment may themselves have been associated with differences in survival.
As an oncologist who has seen many cases of small cell lung cancer over the course of my career (even though lung cancer has never been my subspecialty) the median survival figures quoted seem much longer than I would expect from this disease, leading me to wonder whether the study used a representative sample of patients in the first place.
So yes, I agree with you, this appears to be nonsense.
Thanks to Dr Julian Money-Kyrle!
An uncontrolled, observational study isn’t trying to establish a treatment anyway – there’s no null hypothesis to test. Basically the aim is to see whether the add-on intervention is making things glaringly, obviously worse. From your description of this observational study, it sounds like adding TCM to the oncology patients’ treatment didn’t make them shrivel up and die. That may not seem like much, but it is definitely something to check before planning a full-scale RCT. It also sounds like the title is really, really overhyping the study, but I’m afraid that’s not unusual…