Effect of complementary and alternative medicine on the survival and health-related quality of life among terminally ill cancer patients: a prospective cohort study

BACKGROUND

We evaluated whether complementary and alternative medicine (CAM) use influenced outcomes [survival and health-related quality of life (HRQOL)] of cancer patients whose condition had just been judged terminal.

PATIENTS AND METHODS

From July 2005 to October 2006, we conducted a prospective cohort study of 481 terminally ill cancer patients at 11 university hospitals and the National Cancer Center in Korea. We assessed how the use of CAM affected HRQOL and survival.

RESULTS

In a follow-up of 481 patients and 163.8 person-years, we identified 466 deceased cases. On multivariate analyses, CAM users did not have better survival compared with nonusers [adjusted hazard ratio (aHR), 0.91; 95% confidence interval (CI) 0.74-1.10]. Among mind-body interventions, prayer showed significantly worse survival (aHR, 1.56; 95% CI, 1.00-2.43). Clinically, CAM users reported significantly worse cognitive functioning (-11.6 versus -1.3; P < 0.05) and fatigue (9.9 versus -1.0; P < 0.05) than nonusers. Compared with nonusers in subgroup analysis, users of alternative medical treatments, prayer, vitamin supplements, mushrooms, or rice and cereal reported clinically significant worse changes in some HRQOL subscales.

CONCLUSION

While CAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs.

Excellent color rendering indexes of multi-package white LEDs

This study introduces multi-package white light-emitting diodes (LEDs) system with the ability to realize high luminous efficacy and an excellent color rendering index (CRI, R a) using the R B,M A B,M G B,M C B (R B,M A B,M G B,M denoted as a long-pass dichroic filter (LPDF)-capped, monochromatic red, amber and green phosphor converted-LED (pc-LED) pumped by a blue LED chip, and C B denoted as a cyan and blue mixed pc-LED pumped by a blue LED) system. The luminous efficacy and color rendering index (CRI) of multi-package white LED systems are compared while changing the concentration of the cyan phosphor used in the paste of a cyan-blue LED package and the driving current of individual LEDs in multi-package white LEDs at correlated color temperatures (CCTs) ranging from 6,500 K (cold white) to 2,700 K (warm white) using a set of eight CCTs as specified by the American National Standards Institute (ANSI) standard number C78.377-2008. A R B,M A B,M G B,M C B white LED system provides high luminous efficacy (≥ 96 lm/W) and a color rendering index (≥ 91) encompassing the complete CCT range. We also compare the optical properties of the R B,M A B,M G B,M C B system with those of the R B,M A B,M G B,M B and RAGB (red, amber, green, and blue semiconductor-type narrow-spectrum-band LEDs) systems. It can be expected that the cyan color added to a blue LED in multi-package white LEDs based on LPDF-capped, phosphor-converted monochromatic LEDs will meet the needs of the high-quality, highly efficient, full-color white LED lighting market in the near future.

Improved therapeutic outcomes of DLBCL after introduction of rituximab in Korean patients

The addition of rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) has been shown to improve the outcome in all age groups with newly diagnosed diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective analysis to evaluate the impact of this combination therapy on DLBCL outcomes in Korea. From October 2001 to June 2004, newly diagnosed DLBCL patients in nine Korean institutes were included. All of these 81 patients were treated with three or more cycles of rituximab plus CHOP (R-CHOP) combination chemotherapy (R group), and followed for a minimum of 12 months. For comparison, a historical cohort of patients was used and analyzed for "Clinicopathologic characteristics of Korean non-Hodgkin's lymphomas (NHLs) based on Revised American Lymphoma (REAL) classification" in 1999. Among the 1,098 NHL patients, the data of 214 DLBCL patients, who were treated with CHOP chemotherapy in first-line, were analyzed (C group). We compared outcomes between the C group and the R group. A total of 295 patients were evaluated (C group, 214; R group, 81). The complete response (CR) rate was higher in R group (73 vs 91%, p=0.001). The 2-year event-free survival (EFS) rate was significantly higher in R group (78 vs 85%, p=0.0194). This survival benefit was maintained in high-risk patients according to the international prognostic index (IPI) (p=0.0039), regardless of age. However, there was no significant difference in low-risk patients. The addition of rituximab to CHOP combination chemotherapy for DLBCLs showed improved outcomes, particularly in high-risk group according to the IPI. Long-term follow-up results will be needed to confirm these results.