Clinical Research on Integrated Chinese and Western Medicine for Colorectal Cancer with Lung Metastases.

OBJECTIVE: To evaluate the impact of integrated traditional Chinese and Western medicine (TCM-WM) treatment on survival outcomes in patients with colorectal cancer (CRC) lung metastases. METHODS: A retrospective cohort study was conducted utilizing medical records of patients diagnosed with CRC lung metastases from four tertiary Grade A hospitals between August 2013 and December 2022. Patients were stratified based on exposure to continuous traditional Chinese medicine treatment for ≥3 months. Patients meeting this exposure criterion were assigned to the TCM-WM cohort; those not meeting the criterion were assigned to the Western medicine (WM) cohort. Overall survival (OS) and 3-, 4-, and 5-year cumulative survival rates were compared between cohorts. RESULTS: The study included 286 patients with CRC lung metastases: 122 in the TCM-WM cohort and 164 in the WM cohort. Median OS was 35.0 months in the TCM-WM cohort versus 28.5 months in the WM cohort, representing a statistically significant extension of 6.5 months [HR= 0.67, 95% CI:0.514-0.871, P=0.003]. The 3-, 4-, and 5-year cumulative survival rates were 45.08%, 29.51%, and 18.03% for the TCM-WM cohort, respectively, compared to 32.93%, 21.34%, and 11.59% for the WM cohort. The 3-year survival rate was significantly higher in the TCM-WM cohort (P < 0.05), whereas differences at 4 and 5 years were not statistically significant (both P > 0.05). Median PFS after first-line therapy was 10.0 months in the TCM-WM cohort and 6.0 months in the WM cohort, representing a statistically significant difference [HR=0.67, 95% CI:0.516-0.875, P=0.002]. Subgroup analyses demonstrated significantly prolonged survival with TCM-WM treatment versus WM treatment among females [HR=0.55, 95% CI:0.363-0.810, P=0.002], patients aged <65 years [HR=0.60, 95% CI:0.426-0.846, P=0.003], those with right-sided primary tumors [HR=0.36, 95% CI:0.201-0.648, P<0.000], patients harboring RAS/BRAF mutations [HR=0.65, 95% CI:0.445-0.941, P=0.021], and patients without local therapy for lung metastases [HR=0.56, 95% CI:0.410-0.756, P<0.000]. Multivariable Cox regression analysis showed that integrated TCM-WM treatment, local treatment for lung metastases, and age <65 years were protective factors, reducing the risk of death by 42%, 31%, and 29%, respectively. CONCLUSION: Integrated TCM-WM treatment significantly prolongs survival and reduces mortality risk in patients with CRC lung metastases. (Trial registration No. ITMCTR2025001663).