Use of Chinese Medicine Among Survivors of Nasopharyngeal Carcinoma in Taiwan: A Population-Based Study
1China Medical University Hospital. Integrative Cancer Therapies
(Impact Factor: 2.36).
04/2011; 11(3):221-31. DOI: 10.1177/1534735411403308
Hypotheses. The authors hypothesized that the use of alternative medicine, in the form of Chinese medicine (CM), among patients in the continuing care phase of nasopharyngeal carcinoma (NPC) in Taiwan is higher than the use in a matched control group of noncancer individuals.
This was a case-control study.
Using a population-based claim database, the authors identified 181 long-term survivors of NPC and 905 matched controls. They obtained information on CM use and associated cost as outcome measures. Descriptive analysis and regression models were applied to examine the association between NPC and the outcome measures.
The unadjusted CM initiation (34% vs 32%; P = .54), intensity of use (2.15 vs 1.73 visits; P = .37), and cost (US$79 vs US$58; P = .16) were higher for patients in the NPC group than for those in the control group. Regression analyses suggested that the NPC group had significantly more CM visits (1.01; 95% confidence interval = 0.07-1.96), and more than 50% of these visits were related to cancer.
The authors confirmed their hypotheses that the use of CM in the continuing care phase by patients with NPC in Taiwan was higher than the use in their matched, noncancer counterparts. These findings suggest that current clinical surveillance strategies for NPC might not meet patients' physical and emotional needs.
Available from: Ping-Ho Chen
- "The prevalence of using complementary and alternative medicine among patients with cancer is high (19.5–85%)     . A significant number of patients with cancer concurrently receive modern anticancer treatments and traditional Chinese medicine (TCM) in Taiwan. "
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ABSTRACT: Aim. The objectives of this study were to compare yang-xu, yin-xu, and yu among patients with breast cancer right before, one month after, and three months after receiving target, chemo, or combined therapy. Method. After recruiting 126 patients from 4 hospitals in northern Taiwan, a longitudinal study was carried out with 61 patients receiving chemotherapy, 30 receiving target therapy, and 35 receiving combined therapy. Yang-xu, yin-xu, and yu were assessed using the Traditional Chinese Medical Constitutional Scale (TCMCS), with higher scores indicating more xu and yu. Results. There were significant increases in yang-xu, yin-xu, and yu at 1 month and 3 months after than before the start of the chemotherapy, target, or combined therapy. Patients receiving combined therapy had significantly higher scores in yang-xu and yin-xu than patients receiving chemo or target therapy. A history of coronary heart disease was associated with more yin-xu. Those patients who had undergone a mastectomy were associated with less yu zheng than those patients who had not. Conclusion and Implications. TCM doctors should focus their treatment on dealing with xu and yu in order to support their patients, as they complete their modern anticancer treatments.
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The addition of thoracic radiotherapy improves the outcome of limited stage small cell lung cancer (LS-SCLC). The cost-effectiveness has never been reported. We aimed to estimate the short-term cost-effectiveness of chemotherapy combined with thoracic radiotherapy (C-TRT) vs chemotherapy alone (C/T) for LS-SCLC patients from the payer's perspective (Taiwan National Health Insurance).Methods
We identified LS-SCLC patients diagnosed within 2007-2009 through a comprehensive population-based database containing cancer registry, death registry, and reimbursement data. The duration of interest was one year within diagnosis. We included potential confounding covariables though literature searching and our own experiences and used propensity score (PS) to construct a 1:1 population for adjustment. We used net benefit (NB) approach to evaluate the cost-effectiveness at various willingness-to-pay (WTP) levels. Sensitivity analysis regarding potential unmeasured confounder(s) was performed.ResultsOur study population constituted 74 patients. The mean cost (2013 USD) and survival (year) was higher for C-TRT (42437 vs 28357 for cost; 0.94 vs 0.88 for survival). At the common WTP level (50,000 USD/life-year), T-CRT was not cost effective (incremental NB -11,082) and the probability for T-CRT to be cost effective (i.e., positive net benefit) was 0.005. The result was moderate sensitive to potential unmeasured confounder(s) in sensitivity analysis.Conclusions
We provide the first evidence that when compared to C/T, C-TRT is effective in improving survival but is not cost-effective in the short-term at common WTP level from payer's perspective. This information would be considered for clinicians when discussing with their LS-SCLC patients regarding thoracic radiotherapy.
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