Chinese Herbal Medicine Is Associated With Improved Survival in Patients With Advanced Lung Cancer Receiving Standard Treatment: A Nationwide Population-Based Propensity Score Matching Study

Purpose: There is a lack of large-scale evidence regarding the prognostic impact of Chinese herbal medicine (CHM) on patients with lung cancer. This paper aimed to conduct a nationwide population-based study to investigate the role of CHM for patients with lung cancer with standard treatment. Methods: Patients diagnosed with lung cancer and treated with standard therapy between 2013 and 2015 were retrospectively identified from National Health Insurance Research Database and Taiwan Cancer Registry. Patients were classified into a CHM group and a non-CHM group based on prior medical records. Kaplan-Meier analysis was performed to estimate overall survival (OS) between each group. Results: A total of 7351 matched patients were included in the outcome analysis and comparison, with 3677 patients in the CHM cohort and 3674 patients in the non-CHM cohort. The mean age of our patients was 60.68 ± 11.26 years, and 56% of our patients were female. Our results demonstrates that patients who received CHM had significantly longer OS compared to those who did not receive CHM (HR: 0.59, 95% CI: 0.556-0.625, P < .0001). In subgroup analysis, survival differences were not significant for stage I-II disease, whereas OS was significantly better in the CHM group among patients with stage III-IV disease. Multivariable analysis showed CHM usage was found to significantly influence OS. The most commonly used single CHM was Hedyotis diffusa Willd and compound CHM was San-Zhong-Kui-Jian-Tang. Conclusion: Our nationwide population-based study suggested that CHM in conjugation with standard treatment was associated with improved survival in patients with advanced lung cancer. Integrating cancer treatment with CHM could be adopted in the treatment of lung cancer to improve prognosis.