RESUMEN

OBJECTIVE: To evaluate the association between Chinese medicine (CM) therapy and disease-free survival (DFS) outcomes in postoperative patients with non-small cell lung cancer (NSCLC). METHODS: This multiple-center prospective cohort study was conducted in 13 medical centers in China. Patients with stage I, II, or IIIA NSCLC who had undergone radical resection and received conventional postoperative treatment according to the National Comprehensive Cancer Network (NCCN) guidelines were recruited. The recruited patients were divided into a CM treatment group and a control group according to their wishes. Patients in the CM treatment group received continuous CM therapy for more than 6 months or until disease progression. Patients in the control group received CM therapy for less than 1 month. Follow-up was conducted over 3 years. The primary outcome was DFS, with recurrence/metastasis rates as a secondary outcome. RESULTS: Between May 2013 and August 2016, 503 patients were enrolled into the cohort; 266 were classified in the CM treatment group and 237 in the control group. Adjusting for covariates, high exposure to CM was associated with better DFS [hazard ratio (HR) = 0.417, 95% confidential interval (CI): 0.307-0.567)]. A longer duration of CM therapy (6-12 months, 12-18 months, >24 months) was associated with lower recurrence and metastasis rates (HR = 0.225, 0.119 and 0.083, respectively). In a subgroup exploratory analysis, CM therapy was also a protective factor of cancer recurrence and metastasis in both stage I-IIIA (HR=0.50, 95% CI: 0.37-0.67) and stage IIIA NSCLC postoperative patients (HR = 0.48, 95% CI: 0.33-0.71), DFS was even longer among CM treatment group patients. CONCLUSIONS: Longer duration of CM therapy could be considered a protective factor of cancer recurrence and metastasis. CM treatment is associated with improving survival outcomes of postoperative NSCLC patients in China. (Registration No. ChiCTR-OOC-14005398).

Asunto(s)

Carcinoma de Pulmón de Células no Pequeñas/terapia , Neoplasias Pulmonares/terapia , Medicina Tradicional China , Cuidados Posoperatorios/métodos , Adulto , Anciano , Carcinoma de Pulmón de Células no Pequeñas/epidemiología , Carcinoma de Pulmón de Células no Pequeñas/cirugía , China/epidemiología , Estudios de Cohortes , Terapia Combinada/estadística & datos numéricos , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/cirugía , Masculino , Medicina Tradicional China/métodos , Medicina Tradicional China/estadística & datos numéricos , Persona de Mediana Edad , Cuidados Posoperatorios/estadística & datos numéricos , Periodo Posoperatorio , Resultado del Tratamiento

RESUMEN

The formation of laser-induced periodic surface structures (LIPSS) on two different dielectrics of K9 glass and fused silica upon irradiation in ambient conditions and in vacuum with multiple femtosecond (fs) laser pulse sequences at different pulse durations (35 fs, 260 fs, and 500 fs) was studied experimentally. Three types of LIPSS, so-called high-spatial-frequency LIPSS (HSFL), low-spatial-frequency LIPSS (LSFL), and supra-wavelength periodic surface structures (SWPSS) with different spatial periods and orientations were identified. The appearance was characterized with respect to the experimental parameters of laser fluence and number of laser pulses per spot. The crater morphologies - including nanoripples, periodic microgrooves, quasiperiodic microspikes, and central smooth zone - were observed by scanning electron microscope (SEM). The supra-wavelength structures exhibit periodicities, which are markedly, even multiple times, higher than the laser excitation wavelength. The SWPSS were formed with a broader range of laser fluences, upon the longer laser pulse durations (260 fs and 500 fs) and/or on the lower band-gap dielectrics (K9 glass), due to the deeper effective light penetration depths and thicker viscous surface layers formation. The HSFL were observed on the higher band-gap dielectrics (fused silica) and within a certain narrow laser parameter window. The formation mechanisms of LIPSS were also discussed.