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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Baohe Pingwei power plus neoadjuvant chemotherapy for gastric cancer
Hong-Yu Ma, Xin Liu, Yuan-Wu Chen, Jing Liang, Jie Wang, Ming-Ming Zhang, Qian Yang
Hong-Yu Ma, Jie Wang, Qian Yang, Department of Spleen and Stomach Diseases, First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang 050011, Hebei Province, China
Hong-Yu Ma, Department of Traditional Chinese Medicine, Hebei General Hospital, Shijiazhuang 050011, Hebei Province, China
Xin Liu, Graduate School of Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
Xin Liu, Ming-Ming Zhang, Clinical Medicine Research Center, Hebei General Hospital, Shijiazhuang 050011, Hebei Province, China
Xin Liu, Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang 050011, Hebei Province, China
Yuan-Wu Chen, Department of Rehabilitation, Hebei General Hospital, Shijiazhuang 050011, Hebei Province, China
Jing Liang, Guang’anmen Hospital South Campus, China Academy of Chinese Medical Sciences, Beijing 102600, China
Qian Yang, Hebei Key Laboratory of Turbidity Toxin Syndrome, Shijiazhuang 050011, Hebei Province, China
Co-corresponding authors: Ming-Ming Zhang and Qian Yang.
Author contributions: Ma HY designed the research; Liu X performed the research; Chen YW, Liang J, and Wang J contributed new reagents or analytical tools; Ma HY analyzed the data; Ma HY and Wang J wrote the paper; The designation of Yang Q and Zhang MM as co-corresponding authors is justified by their equal and complementary contributions to the study; Yang Q, as Head Doctor of the Department of Spleen and Stomach Diseases, provided critical clinical expertise and oversight in patient management, particularly in integrating traditional Chinese medicine with modern therapeutic approaches Zhang MM from the Clinical Medicine Research Center contributed essential methodological rigor, experimental design, and data analysis, ensuring the study’s scientific validity; Their collaboration bridged traditional Chinese medicine theory and contemporary research standards, enhancing the study’s interdisciplinary impact. Additionally, by representing two key institutions (the First Affiliated Hospital of Hebei University of Chinese Medicine and Hebei General Hospital), their joint leadership underscored the multicenter nature of the research, bolstering its credibility and applicability; Both authors also shared responsibilities in ethical oversight, communication with stakeholders, and manuscript dissemination, reflecting their shared accountability for the study’s integrity and success; This dual correspondence acknowledges their synergistic roles in guiding the project to completion; All authors read and approved the final manuscript.
Supported by Scientific Research Project of Hebei Administration of Traditional Chinese Medicine, No. 2025271; the Construction Project of National Clinical Research Base of Traditional Chinese Medicine, Science Letter[2018], No. 131; Natural Science Foundation of Hebei Province, No. H2023423001; Key Research Project of the Ministry of Science and Technology, No. 2018YFC1704100 and No. 2018YFC1704102; Provincial Science and Technology Program of Hebei Province, No. 21377724D and No. 21377740D; Scientific Research Project of Hebei Administration of Traditional Chinese Medicine, No. 2021034, No. 2022026, No. 2022032, and No. 2023022; and Medical Science Research Project of Hebei Province, No. 20190756.
Institutional review board statement: The study was reviewed and approved by the Harbin Medical University Cancer Hospital Institutional Review Board.
Informed consent statement: All subjects understood and agreed to the study protocol and voluntarily signed the informed consent form.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Qian Yang, Chief Physician, Department of Spleen and Stomach Diseases, First Affiliated Hospital of Hebei University of Chinese Medicine, No. 389 Zhong
shan East Road, Shijiazhuang 050011, Hebei Province, China.
yang0311qian@126.com
Received: March 5, 2025
Revised: March 25, 2025
Accepted: April 18, 2025
Published online: July 27, 2025
Processing time: 140 Days and 4.2 Hours
BACKGROUND
Neoadjuvant chemotherapy improves the resection rate and reduces postoperative recurrence in gastric cancer (GC) but is often associated with significant toxicity. Traditional Chinese medicine has unique advantages in the treatment of cancer, and Baohe Pingwei powder can help alleviate the side effects of chemotherapy and enhance the therapeutic effect. However, there is no clinical evidence supporting its use in patients who underwent surgery for GC treatment.
AIM
To evaluate the safety and efficacy of Baohe Pingwei powder combined with neoadjuvant chemotherapy in postoperative patients with GC and to provide evidence-based medical evidence for the treatment of postoperative patients with GC with integrated traditional Chinese and Western medicine.
METHODS
A retrospective analysis was conducted on 80 postoperative patients with GC admitted to the Department of Gastroenterology of our hospital and treated between May 2024 and November 2024. According to different treatment methods, they were divided into a control group (54 patients received S-1 + oxaliplatin chemotherapy 4 weeks after surgery) and a study group (26 cases were combined with Baohe Pingwei powder combined with S-1 + oxaliplatin). Clinical data were collected to compare the differences in objective response rate (ORR), disease control rate (DCR), progression-free survival, overall survival, and adverse reactions of patients with GC after surgery under different treatment methods. Further based on the control of GC, patients were divided into an effective group (62 cases) and an ineffective group (18 cases). The relationship between Baohe Pingwei powder and clinical efficacy was analyzed through univariate and multivariate logistic regression analysis as well as a multivariate Cox risk model.
RESULTS
The baseline characteristics including age, gender, and other demographic factors showed no significant differences between the control and observation groups (P > 0.05). In the observation group, there were 24 cases of effective treatment and 2 cases of ineffective treatment, with an ORR of 84.62% and a DCR of 92.31%. In the control group, there were 38 cases of effective treatment and 16 cases of ineffective treatment, with an ORR of 46.30% and a DCR of 70.37%. The treatment effect of the observation group was significantly higher than that of the control group (P < 0.05). The Kaplan Meier curve showed that the risk of tumor recurrence and death in the observation group was significantly reduced compared to the control group (log rank P = 0.030 and P = 0.035, respectively). Subsequent stratification based on treatment response identified 62 patients in the effective group and 18 in the ineffective group. Intergroup comparison showed that the effective group had a higher proportion of Baohe Pingwei powder (P = 0.000), and there were statistically significant differences in tumor size, differentiation degree, and post-treatment levels of CD3+, CD4+, CA19-9, CA242, IL-6, IL-10, and TNF-α between the groups (P < 0.05). Further univariate and multivariate logistic analysis revealed that CD3+ and CD4+ T cell levels were significantly associated with treatment efficacy. The use of Baohe Pingwei powder was a protective factor for effective treatment, while CA19-9 and IL-6 levels were independent risk factors for ineffective treatment (P < 0.05). Multivariate Cox proportional hazards model analysis found that without adjusting the model, the risk of ineffective treatment in patients significantly decreased with the increase of CD3+ and CD4+ and the decrease of CA19-9 and IL-6 (group 1 as a reference; group 2 hazard ratio: 0.624, 95% confidence interval: 0.437-0.986, P = 0.019). After adjusting for confounding factors such as Baohe Pingwei powder in Model 3, Cox regression results showed an increased risk of treatment failure. With the decrease of CD3+ and CD4+ and the increase of CA19-9 and IL-6, the risk of treatment failure in patients significantly increased (Group 1 as a reference; Group 2 hazard ratio: 1.439, 95% confidence interval: 1.208-1.614, P = 0.006).
CONCLUSION
The combination therapy of Baohe Pingwei powder with neoadjuvant chemotherapy demonstrated significant clinical benefits in postoperative patients with GC, including improved the ORR, DCR, extended progression-free survival, and overall survival as well as a reduced incidence of treatment-related adverse events. Furthermore, our finding indicated that decreased CD3+ and CD4+ levels along with evaluated CA199 and IL-6 levels served as important biomarkers predicting increased risk of treatment failure in this patient population.
Core Tip: Baohe Pingwei powder when combined with neoadjuvant chemotherapy exhibited significant efficacy in postoperative patients with gastric cancer. This study revealed that the addition of Baohe Pingwei powder enhanced treatment outcomes, improved immune function, and reduced adverse reactions compared with chemotherapy alone. The most innovative finding was the ability of the powder to prolong recurrence-free survival, highlighting its potential as an adjuvant therapy for patients with gastric cancer undergoing surgery.
