Can Chinese medicine reduce the recurrence of metastasis after colorectal cancer surgery?

Currently, western medical treatment for colorectal cancer is based on surgery, chemotherapy, radiotherapy, targeted therapy and biological therapy. The 5-year survival rates for stages I-IV are 97.1% for stage I, 87.5% for stage IIa, 71.5% for stage IIb, 87.7% for stage IIIa, 68.7%-75% for stage IIIb, and 27.1%-47.3% for stage IV, respectively. After radical surgery, stage II patients with risk factors and stage III patients often received conventional chemotherapy and radiotherapy, while certain patients who were too old and poor to tolerate radiotherapy, as well as stage I and low-risk stage II patients, entered the follow-up phase. Even with conventional radiotherapy, 20-40% of stage II and III colorectal cancer patients will still fail to achieve long-term survival due to tumor recurrence and metastasis. According to the survey, about 2/3 of colorectal cancer patients will receive TCM treatment after surgery, and TCM treatment has become an important part of the comprehensive treatment of colorectal cancer. The treatment of colorectal cancer after surgery mainly focuses on the following two aspects: First, the reduction of toxicity and efficiency during radiotherapy: modern medicine surgery and radiotherapy can shrink the tumor body and reduce the tumor load in a short period of time for early stage tumors, but at the same time, they also damage the proliferating normal cells such as hematopoietic system, gastrointestinal mucosa epithelium, hair follicles and germ cells to a certain extent, and at the same time of the therapeutic effect, they are often accompanied by different degrees of toxic reactions. Chinese medicine is mainly used to reduce the adverse effects of radiotherapy and ensure the completion of chemotherapy cycles. Second, postoperative anti-tumor metastasis recurrence: for the long-term follow-up of stage II and III colorectal cancer patients after surgery, due to the limitations of surgery, the occult lesions cannot be completely eradicated. Once the residual paracancer tissue and subclinical cancer foci cells are released from dormancy and enter the proliferative stage, they can become the cause of cancer recurrence and metastasis. This stage is an important period for TCM to play a role in preventing recurrence and metastasis of tumors, thus prolonging disease-free survival and improving the eradication rate. So, can the application of TCM after surgery reduce the metastasis recurrence of colorectal cancer? How long does the treatment course need? This is a frequently encountered question in clinical practice. In order to answer these questions, we conducted a series of prospective cohort studies to investigate the clinical value of long-term application of TCM to reduce recurrence and metastasis in colorectal cancer patients based on conventional Western medical treatment (including radical surgery, chemotherapy and/or radiotherapy). As early as 2002, we selected 222 patients from Xiyuan Hospital of the Chinese Academy of Traditional Chinese Medicine and Beijing Military General Hospital after radical surgery for a cohort study of colorectal cancer, and all patients were exposed to grouping based on whether they received TCM treatment on the basis of conventional Western medical treatment, and the results showed that in the conventional Western medical treatment group, the recurrence and metastasis rates at 1, 2, 3, 4, and 5 years were 6.09%, 26.79%, 33.93%, 41.28%, 43.93%, while the combined Chinese and Western medicine treatment group was 0, 1.89%, 11.32%, 12.62%, 12.75%. It is obvious that Chinese medicine treatment can reduce the recurrence and metastasis rate of stage II and III colorectal cancer from 1 to 5 years after surgery to some extent, prolong the time of recurrence and metastasis, and may have an effect on colorectal cancer liver metastasis or local recurrence has been effectively intervened. During the 11th Five-Year Plan period, with the support of the International Cooperation Program of the Ministry of Science and Technology, we selected patients from eight hospitals in China and the Norwegian National Cancer Registry with stage II and III colorectal cancer after radical surgery from April 1, 2007 to February 28, 2009 as the study population, using a prospective cohort study, and all patients were treated with a combination of Western medicine and followed up according to NCCN guidelines In the study, the exposure factor was whether or not to take Chinese medicine, and the level of exposure was determined according to the length of the treatment course of receiving Chinese medicine. RESULTS: A total of 312 cases were enrolled in China, including 175 men and 137 women, and after 5 years of follow-up, the results showed that more than 1 year of discriminatory herbal soup treatment could reduce the metastatic recurrence rate of stage II and III colorectal cancer by about 12.62%, while the survival curve showed that the survival time of patients with long-term application of herbal medicine (green line) was much longer than that of patients without regular application of herbal medicine and those who had not The survival curves showed that the survival time of patients who used Chinese medicine for a long time (green line) was much longer than those who did not use Chinese medicine regularly and those who did not use Chinese medicine. From the above findings, it can be seen that the long course of application of Chinese medicine discriminative therapy tonics for at least one year for early and mid-stage colorectal cancer patients on the basis of conventional Western medical treatment after radical surgery can lead to a lower risk of metastatic recurrence and death and improve the prognosis of patients. In addition, the application of TCM not only improved the disease-free survival of patients, but also prolonged the overall survival more significantly, which reflected the comprehensive therapeutic effect of TCM on human body from certain side, not only inhibited the recurrence of tumor, but also may improve the overall physiological status and function of patients, thus achieving the effect of benefiting life and prolonging life.