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Published in: Trials 1/2019

Open Access 01-12-2019 | Breast Cancer | Study protocol

Chemotherapy in conjunction with traditional Chinese medicine for survival of patients with early female breast cancer: protocol for a non-randomized, single center prospective cohort study

Authors: Chien-Ting Liu, Yen-Hao Chen, Yu-Chuen Huang, Shih-Yu Chen, Ming-Yen Tsai

Published in: Trials | Issue 1/2019

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Abstract

Background

Chemotherapy after surgery for breast cancer plays a fundamental role in reducing the risk of distant and local recurrence. An increasing number of patients seek traditional Chinese medicine (TCM) during adjuvant chemotherapy to relieve symptom discomfort and side effects as well as to strengthen the body’s defenses. However, evidence on how concurrent TCM treatment affects prognosis is scarce. This trial aims to evaluate the association between TCM treatment and disease-free survival outcomes for patients with early breast cancer who are undergoing adjuvant chemotherapy.

Methods/design

This is a non-randomized, single center, prospective cohort study begun in November 2018 in Kaohsiung, Taiwan. A sample of 310 participants diagnosed with early breast cancer was recruited from the Breast Cancer Research Team and will be followed up every 3 to 6 months until October 2023. Detailed information of the participants, including general information, history of cancer, quality of life, side effects and safety of treatment, TCM body constitution, and meridian energy analysis, was collected face to face at baseline.

Discussion

This is the first prospective observational cohort study on TCM in patients with early breast cancer who are receiving adjuvant chemotherapy to evaluate the prognosis. Through this trial, we hope to assess the feasibility of a larger-scale clinical trial in the future and formulate an integrated TCM care program.

Trial registration

ClinicalTrials.gov, NCT03797248. Registered on 5 January 2019.
Appendix
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Literature
1.
go back to reference Ghoncheh M, Pournamdar Z, Salehiniya H. Incidence and mortality and epidemiology of breast cancer in the world. Asian Pac J Cancer Prev. 2016;17:43–6.CrossRef Ghoncheh M, Pournamdar Z, Salehiniya H. Incidence and mortality and epidemiology of breast cancer in the world. Asian Pac J Cancer Prev. 2016;17:43–6.CrossRef
2.
go back to reference Liu FC, Lin HT, Kuo CF, See LC, Chiou MJ, Yu HP. Epidemiology and survival outcome of breast cancer in a nationwide study. Oncotarget. 2017;8:16939–50.PubMedPubMedCentral Liu FC, Lin HT, Kuo CF, See LC, Chiou MJ, Yu HP. Epidemiology and survival outcome of breast cancer in a nationwide study. Oncotarget. 2017;8:16939–50.PubMedPubMedCentral
3.
go back to reference Del Mastro L, Fabi A, Mansutti M, De Laurentiis M, Durando A, Merlo DF, Bruzzi P, La Torre I, Ceccarelli M, Kazeem G, et al. Randomised phase 3 open-label trial of first-line treatment with gemcitabine in association with docetaxel or paclitaxel in women with metastatic breast cancer: a comparison of different schedules and treatments. BMC Cancer. 2013;13:164.CrossRef Del Mastro L, Fabi A, Mansutti M, De Laurentiis M, Durando A, Merlo DF, Bruzzi P, La Torre I, Ceccarelli M, Kazeem G, et al. Randomised phase 3 open-label trial of first-line treatment with gemcitabine in association with docetaxel or paclitaxel in women with metastatic breast cancer: a comparison of different schedules and treatments. BMC Cancer. 2013;13:164.CrossRef
4.
go back to reference Peto R, Davies C, Godwin J, Gray R, Pan HC, Clarke M, Cutter D, Darby S, McGale P, Taylor C, et al. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet. 2012;379:432–44.CrossRef Peto R, Davies C, Godwin J, Gray R, Pan HC, Clarke M, Cutter D, Darby S, McGale P, Taylor C, et al. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet. 2012;379:432–44.CrossRef
5.
go back to reference Paradiso A, Schittulli F, Cellamare G, Mangia A, Marzullo F, Lorusso V, De Lena M. Randomized clinical trial of adjuvant fluorouracil, epirubicin, and cyclophosphamide chemotherapy for patients with fast-proliferating, node-negative breast cancer. J Clin Oncol. 2001;19:3929–37.CrossRef Paradiso A, Schittulli F, Cellamare G, Mangia A, Marzullo F, Lorusso V, De Lena M. Randomized clinical trial of adjuvant fluorouracil, epirubicin, and cyclophosphamide chemotherapy for patients with fast-proliferating, node-negative breast cancer. J Clin Oncol. 2001;19:3929–37.CrossRef
6.
go back to reference Mackey JR, Martin M, Pienkowski T, Rolski J, Guastalla JP, Sami A, Glaspy J, Juhos E, Wardley A, Fornander T, et al. Adjuvant docetaxel, doxorubicin, and cyclophosphamide in node-positive breast cancer: 10-year follow-up of the phase 3 randomised BCIRG 001 trial. Lancet Oncol. 2013;14:72–80.CrossRef Mackey JR, Martin M, Pienkowski T, Rolski J, Guastalla JP, Sami A, Glaspy J, Juhos E, Wardley A, Fornander T, et al. Adjuvant docetaxel, doxorubicin, and cyclophosphamide in node-positive breast cancer: 10-year follow-up of the phase 3 randomised BCIRG 001 trial. Lancet Oncol. 2013;14:72–80.CrossRef
7.
go back to reference Calderon C, Carmona-Bayonas A, Hernandez R, Ghanem I, Castelo B, Martinez de Castro E, Ferreira E, Ciria L, Muniz M, Jimenez-Fonseca P. Effects of pessimism, depression, fatigue, and pain on functional health-related quality of life in patients with resected non-advanced breast cancer. Breast. 2019;44:108–12.CrossRef Calderon C, Carmona-Bayonas A, Hernandez R, Ghanem I, Castelo B, Martinez de Castro E, Ferreira E, Ciria L, Muniz M, Jimenez-Fonseca P. Effects of pessimism, depression, fatigue, and pain on functional health-related quality of life in patients with resected non-advanced breast cancer. Breast. 2019;44:108–12.CrossRef
8.
go back to reference Lai JN, Wu CT, Wang JD. Prescription pattern of Chinese herbal products for breast cancer in Taiwan: a population-based study. Evid Based Complement Alternat Med. 2012;2012:891893.PubMedPubMedCentral Lai JN, Wu CT, Wang JD. Prescription pattern of Chinese herbal products for breast cancer in Taiwan: a population-based study. Evid Based Complement Alternat Med. 2012;2012:891893.PubMedPubMedCentral
9.
go back to reference Yin SY, Wei WC, Jian FY, Yang NS. Therapeutic applications of herbal medicines for cancer patients. Evid Based Complement Alternat Med. 2013;2013:302426.PubMedPubMedCentral Yin SY, Wei WC, Jian FY, Yang NS. Therapeutic applications of herbal medicines for cancer patients. Evid Based Complement Alternat Med. 2013;2013:302426.PubMedPubMedCentral
10.
go back to reference Sun X, Zhang X, Nian JY, Guo J, Yin Y, Zhang GL, Yu MW, Zhang Y, Wang XM, Yang GW, et al. Chinese herbal medicine as adjunctive therapy to chemotherapy for breast cancer: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2016;2016:3281968.PubMedPubMedCentral Sun X, Zhang X, Nian JY, Guo J, Yin Y, Zhang GL, Yu MW, Zhang Y, Wang XM, Yang GW, et al. Chinese herbal medicine as adjunctive therapy to chemotherapy for breast cancer: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2016;2016:3281968.PubMedPubMedCentral
11.
go back to reference Guo Q, Chen Q. Standardization of syndrome differentiation defined by traditional Chinese medicine in operative breast cancer: a modified Delphi study. Sci World J. 2015;2015:820436.CrossRef Guo Q, Chen Q. Standardization of syndrome differentiation defined by traditional Chinese medicine in operative breast cancer: a modified Delphi study. Sci World J. 2015;2015:820436.CrossRef
12.
go back to reference Ji Q, Luo YQ, Wang WH, Liu X, Li Q, Su SB. Research advances in traditional Chinese medicine syndromes in cancer patients. J Integr Med. 2016;14:12–21.CrossRef Ji Q, Luo YQ, Wang WH, Liu X, Li Q, Su SB. Research advances in traditional Chinese medicine syndromes in cancer patients. J Integr Med. 2016;14:12–21.CrossRef
13.
go back to reference Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, Deasy S, Cobleigh M, Shiomoto G. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol. 1997;15:974–86.CrossRef Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, Deasy S, Cobleigh M, Shiomoto G. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol. 1997;15:974–86.CrossRef
14.
go back to reference Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–55.CrossRef Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–55.CrossRef
15.
go back to reference Chen LL, Lin JD, Huang YC, Lin JS, Huang CH, Su YC. Scale descriptor selection for a Taiwan-version of a Body Constitution Questionnaire in traditional Chinese medicine. Mid-Taiwan J Med. 2008;13:35–42. Chen LL, Lin JD, Huang YC, Lin JS, Huang CH, Su YC. Scale descriptor selection for a Taiwan-version of a Body Constitution Questionnaire in traditional Chinese medicine. Mid-Taiwan J Med. 2008;13:35–42.
16.
go back to reference Tsai MY, Chen SY, Lin CC. Theoretical basis, application, reliability, and sample size estimates of a Meridian Energy Analysis Device for traditional Chinese medicine research. Clinics (Sao Paulo). 2017;72:254–7.CrossRef Tsai MY, Chen SY, Lin CC. Theoretical basis, application, reliability, and sample size estimates of a Meridian Energy Analysis Device for traditional Chinese medicine research. Clinics (Sao Paulo). 2017;72:254–7.CrossRef
17.
go back to reference Chien TJ, Liu CY, Ko PH, Hsu CH. A Chinese decoction, Kuan-Sin-Yin, improves autonomic function and cancer-related symptoms of metastatic colon cancer. Integr Cancer Ther. 2016;15:113–23.CrossRef Chien TJ, Liu CY, Ko PH, Hsu CH. A Chinese decoction, Kuan-Sin-Yin, improves autonomic function and cancer-related symptoms of metastatic colon cancer. Integr Cancer Ther. 2016;15:113–23.CrossRef
18.
go back to reference Lee CT, Chang YH, Lin WY, Xu JM, Chen HY, Chou PL, Cheng CW, Chen YL, Lin FY, Tsai FJ, et al. Applications of meridian electrical conductance for renal colic: a prospective study. J Altern Complement Med. 2010;16:861–6.CrossRef Lee CT, Chang YH, Lin WY, Xu JM, Chen HY, Chou PL, Cheng CW, Chen YL, Lin FY, Tsai FJ, et al. Applications of meridian electrical conductance for renal colic: a prospective study. J Altern Complement Med. 2010;16:861–6.CrossRef
20.
go back to reference Abraham JE, Hiller L, Dorling L, Vallier A-L, Dunn J, Bowden S, Ingle S, Jones L, Hardy R, Twelves C, et al. A nested cohort study of 6,248 early breast cancer patients treated in neoadjuvant and adjuvant chemotherapy trials investigating the prognostic value of chemotherapy-related toxicities. BMC Med. 2015;13:306.CrossRef Abraham JE, Hiller L, Dorling L, Vallier A-L, Dunn J, Bowden S, Ingle S, Jones L, Hardy R, Twelves C, et al. A nested cohort study of 6,248 early breast cancer patients treated in neoadjuvant and adjuvant chemotherapy trials investigating the prognostic value of chemotherapy-related toxicities. BMC Med. 2015;13:306.CrossRef
21.
go back to reference Muss HB, Berry DA, Cirrincione CT, Theodoulou M, Mauer AM, Kornblith AB, Partridge AH, Dressler LG, Cohen HJ, Becker HP, et al. Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med. 2009;360:2055–65.CrossRef Muss HB, Berry DA, Cirrincione CT, Theodoulou M, Mauer AM, Kornblith AB, Partridge AH, Dressler LG, Cohen HJ, Becker HP, et al. Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med. 2009;360:2055–65.CrossRef
22.
go back to reference Kuo YT, Chang TT, Muo CH, Wu MY, Sun MF, Yeh CC, Yen HR. Use of complementary traditional Chinese medicines by adult cancer patients in Taiwan: a nationwide population-based study. Integr Cancer Ther. 2018;17:531–41.CrossRef Kuo YT, Chang TT, Muo CH, Wu MY, Sun MF, Yeh CC, Yen HR. Use of complementary traditional Chinese medicines by adult cancer patients in Taiwan: a nationwide population-based study. Integr Cancer Ther. 2018;17:531–41.CrossRef
23.
go back to reference Lee YW, Chen TL, Shih YR, Tsai CL, Chang CC, Liang HH, Tseng SH, Chien SC, Wang CC. Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: a population-based study. Cancer. 2014;120:1338–44.CrossRef Lee YW, Chen TL, Shih YR, Tsai CL, Chang CC, Liang HH, Tseng SH, Chien SC, Wang CC. Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: a population-based study. Cancer. 2014;120:1338–44.CrossRef
24.
go back to reference Wang W, Xu L, Shen C. Effects of traditional Chinese medicine in treatment of breast cancer patients after mastectomy: a meta-analysis. Cell Biochem Biophys. 2015;71:1299–306.CrossRef Wang W, Xu L, Shen C. Effects of traditional Chinese medicine in treatment of breast cancer patients after mastectomy: a meta-analysis. Cell Biochem Biophys. 2015;71:1299–306.CrossRef
25.
go back to reference Cheng YY, Hsieh CH, Tsai TH. Concurrent administration of anticancer chemotherapy drug and herbal medicine on the perspective of pharmacokinetics. J Food Drug Anal. 2018;26:S88–95.CrossRef Cheng YY, Hsieh CH, Tsai TH. Concurrent administration of anticancer chemotherapy drug and herbal medicine on the perspective of pharmacokinetics. J Food Drug Anal. 2018;26:S88–95.CrossRef
26.
go back to reference Huang SM, Chien LY, Tai CJ, Chen PH, Lien PJ, Tai CJ. Effects of symptoms and complementary and alternative medicine use on the yang deficiency pattern among breast cancer patients receiving chemotherapy. Complement Ther Med. 2015;23:233–41.CrossRef Huang SM, Chien LY, Tai CJ, Chen PH, Lien PJ, Tai CJ. Effects of symptoms and complementary and alternative medicine use on the yang deficiency pattern among breast cancer patients receiving chemotherapy. Complement Ther Med. 2015;23:233–41.CrossRef
27.
go back to reference Mason S, Tovey P, Long AF. Evaluating complementary medicine: methodological challenges of randomised controlled trials. BMJ. 2002;325:832–4.CrossRef Mason S, Tovey P, Long AF. Evaluating complementary medicine: methodological challenges of randomised controlled trials. BMJ. 2002;325:832–4.CrossRef
28.
go back to reference Parveen A, Parveen B, Parveen R, Ahmad S. Challenges and guidelines for clinical trial of herbal drugs. J Pharm Bioallied Sci. 2015;7:329–33.CrossRef Parveen A, Parveen B, Parveen R, Ahmad S. Challenges and guidelines for clinical trial of herbal drugs. J Pharm Bioallied Sci. 2015;7:329–33.CrossRef
29.
go back to reference Lakdawalla DN, Shafrin J, Hou N, Peneva D, Vine S, Park J, Zhang J, Brookmeyer R, Figlin RA. Predicting real-world effectiveness of cancer therapies using overall survival and progression-free survival from clinical trials: empirical evidence for the ASCO Value Framework. Value Health. 2017;20:866–75.CrossRef Lakdawalla DN, Shafrin J, Hou N, Peneva D, Vine S, Park J, Zhang J, Brookmeyer R, Figlin RA. Predicting real-world effectiveness of cancer therapies using overall survival and progression-free survival from clinical trials: empirical evidence for the ASCO Value Framework. Value Health. 2017;20:866–75.CrossRef
30.
go back to reference Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, Dickersin K, Hrobjartsson A, Schulz KF, Parulekar WR, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586.CrossRef Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, Dickersin K, Hrobjartsson A, Schulz KF, Parulekar WR, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586.CrossRef
Metadata
Title
Chemotherapy in conjunction with traditional Chinese medicine for survival of patients with early female breast cancer: protocol for a non-randomized, single center prospective cohort study
Authors
Chien-Ting Liu
Yen-Hao Chen
Yu-Chuen Huang
Shih-Yu Chen
Ming-Yen Tsai
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3848-8

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