Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis
Background: 25% to 30% of primary stage IV pulmonary adenocarcinomas (PUAD-IV) die within 3 months. Many ≥3 months survivors at long follow-up are alive with disease (AWD). Platinum-based chemotherapy (PBC), tyrosine kinase inhibitors- targeted therapy (TKI-TT), and Chinese herbal medicines (oral CH...
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SAGE Publishing
2025-06-01
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| Series: | Integrative Cancer Therapies |
| Online Access: | https://doi.org/10.1177/15347354251342739 |
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| author | Hegen Li MD Veronika Lindberg MSc Lihua Zhu MD, PhD Xiange Huang MD Jiali Feng MD Jan P. A. Baak MD, PhD, FICP, FRCPath, FIAC, DrHC(Antwerp), MScTCM |
| author_facet | Hegen Li MD Veronika Lindberg MSc Lihua Zhu MD, PhD Xiange Huang MD Jiali Feng MD Jan P. A. Baak MD, PhD, FICP, FRCPath, FIAC, DrHC(Antwerp), MScTCM |
| author_sort | Hegen Li MD |
| collection | DOAJ |
| description | Background: 25% to 30% of primary stage IV pulmonary adenocarcinomas (PUAD-IV) die within 3 months. Many ≥3 months survivors at long follow-up are alive with disease (AWD). Platinum-based chemotherapy (PBC), tyrosine kinase inhibitors- targeted therapy (TKI-TT), and Chinese herbal medicines (oral CHM) improve prognosis. In China, moxibustion treatment (Moxa) is also used, without prognostic proof. Methods: Prospective observational Moxa evaluation in 412 first-onset consecutive PUAD-IV performance score 0 to 1 patients with 3 to 120 months follow-up. All received oral CHM with PBC, TKI-TT, or PBC + TKI-TT. Moxa was given as indicated at the start of the treatment (and eventually adapted in the follow-up period by de novo development) of well-established TCM syndromes and symptoms. Survival was analyzed using Kaplan-Meier and Cox regression. Propensity score analysis (PSA) with matching and inverse probability of treatment weighting (IPTW) were used to adjust for baseline covariate imbalances. Results: Of 412 patients, 117 received no Moxa, 239 had 1 to 4 treatments, and 56 received >4 treatments alongside conventional treatments. Tumor-Node-Metastasis (TNM) stage IVB and male sex increased dead of disease (DOD)-risk, while TKI-TT, ≥4 Chemotherapy cycles, and Moxa improved survival ( P < .05). Median survival (MST): Reference group (PBC + CHM) 20.0 months; Moxa 32.0; TKI-TT 33.0; TKI-TT+1–4 Moxa 33.0; TKI-TT+>4 Moxa 40.0 months (all P < .05). Cox regression indicated a dosage-dependent Moxa effect ( P = .0004). Restricted Mean Survival Time (RMST) at 36 months favored >4 Moxa+TKI-TT over TKI-TT (+6.2 months, P = .01). PSA confirmed results were not due to baseline covariate imbalance. Conclusions: Moxibustion may dosage-dependently improve survival in PUAD-IV, both in TKI- and non-TKI-treated patients. Randomized clinical trials (RCT) are needed to confirm this. |
| format | Article |
| id | doaj-art-71bae2c318544a669e004a1134bc8d8a |
| institution | OA Journals |
| issn | 1552-695X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SAGE Publishing |
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| series | Integrative Cancer Therapies |
| spelling | doaj-art-71bae2c318544a669e004a1134bc8d8a2025-08-20T02:09:29ZengSAGE PublishingIntegrative Cancer Therapies1552-695X2025-06-012410.1177/15347354251342739Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score AnalysisHegen Li MD0Veronika Lindberg MSc1Lihua Zhu MD, PhD2Xiange Huang MD3Jiali Feng MD4Jan P. A. Baak MD, PhD, FICP, FRCPath, FIAC, DrHC(Antwerp), MScTCM5Longhua University Hospital, Shanghai, ChinaLintech AS, Kristiansand, NorwayLonghua University Hospital, Shanghai, ChinaLonghua University Hospital, Shanghai, ChinaLonghua University Hospital, Shanghai, ChinaStavanger University Hospital, NorwayBackground: 25% to 30% of primary stage IV pulmonary adenocarcinomas (PUAD-IV) die within 3 months. Many ≥3 months survivors at long follow-up are alive with disease (AWD). Platinum-based chemotherapy (PBC), tyrosine kinase inhibitors- targeted therapy (TKI-TT), and Chinese herbal medicines (oral CHM) improve prognosis. In China, moxibustion treatment (Moxa) is also used, without prognostic proof. Methods: Prospective observational Moxa evaluation in 412 first-onset consecutive PUAD-IV performance score 0 to 1 patients with 3 to 120 months follow-up. All received oral CHM with PBC, TKI-TT, or PBC + TKI-TT. Moxa was given as indicated at the start of the treatment (and eventually adapted in the follow-up period by de novo development) of well-established TCM syndromes and symptoms. Survival was analyzed using Kaplan-Meier and Cox regression. Propensity score analysis (PSA) with matching and inverse probability of treatment weighting (IPTW) were used to adjust for baseline covariate imbalances. Results: Of 412 patients, 117 received no Moxa, 239 had 1 to 4 treatments, and 56 received >4 treatments alongside conventional treatments. Tumor-Node-Metastasis (TNM) stage IVB and male sex increased dead of disease (DOD)-risk, while TKI-TT, ≥4 Chemotherapy cycles, and Moxa improved survival ( P < .05). Median survival (MST): Reference group (PBC + CHM) 20.0 months; Moxa 32.0; TKI-TT 33.0; TKI-TT+1–4 Moxa 33.0; TKI-TT+>4 Moxa 40.0 months (all P < .05). Cox regression indicated a dosage-dependent Moxa effect ( P = .0004). Restricted Mean Survival Time (RMST) at 36 months favored >4 Moxa+TKI-TT over TKI-TT (+6.2 months, P = .01). PSA confirmed results were not due to baseline covariate imbalance. Conclusions: Moxibustion may dosage-dependently improve survival in PUAD-IV, both in TKI- and non-TKI-treated patients. Randomized clinical trials (RCT) are needed to confirm this.https://doi.org/10.1177/15347354251342739 |
| spellingShingle | Hegen Li MD Veronika Lindberg MSc Lihua Zhu MD, PhD Xiange Huang MD Jiali Feng MD Jan P. A. Baak MD, PhD, FICP, FRCPath, FIAC, DrHC(Antwerp), MScTCM Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis Integrative Cancer Therapies |
| title | Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis |
| title_full | Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis |
| title_fullStr | Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis |
| title_full_unstemmed | Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis |
| title_short | Moxibustion Treatment, Alongside Conventional Western and Chinese Herbal Medical Therapies, May Improve Survival in Stage-IV Pulmonary Adenocarcinomas in a Dosage-Dependent Manner: A Prospective Observational Study With Propensity Score Analysis |
| title_sort | moxibustion treatment alongside conventional western and chinese herbal medical therapies may improve survival in stage iv pulmonary adenocarcinomas in a dosage dependent manner a prospective observational study with propensity score analysis |
| url | https://doi.org/10.1177/15347354251342739 |
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