2011 Vol.23(1)

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Contribution from Cancer Epidemiological Studies in China
Wei-cheng You
2011, 23(1): 1-2. doi: 10.1007/s11670-011-0001-y
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Original Article
Cancer Incidence And Mortality in China, 2006
Wan-qing Chen, Si-wei Zhang, Xiao-nong Zou, Ping Zhao
2011, 23(1): 3-9. doi: 10.1007/s11670-011-0003-9
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ObjectiveTo describe the cancer incidence and mortality rates in 2006 and evaluate the cancer burden in China.MethodsCancer registration data in 2006 from 34 cancer registries were collected, evaluated and pooled to calculate cancer incidence and mortality rates. The data analyses included mortality to incidence ratio (MI), morphological verification percentage (MV%) and proportion of death certification only (DCO%). Cumulative incidence and mortality rates were calculated using crude data, age-standardized data, and specific data for cancer site, age, sex and area (urban or rural).ResultsIn 2006, 34 registries with qualified registration data covered a total population of 59,567,322 (46,558,108 in urban areas and 13,009,214 in rural areas). The crude and age-standardized cancer incidence rates were 273.66 per 100,000 and 190.54 per 100,000, respectively. The crude and age-standardized cancer mortality rates were 175.70 per 100,000 and 117.67 per 100,000, respectively. Cancers of lung, stomach, colon and rectum, liver, and breast in female were the five most common forms of cancer in China, which accounted for 58.99% of all new cancer cases. Lung cancer was the leading cause of cancer death, followed by stomach cancer, liver cancer, esophageal cancer and colorectal cancer.ConclusionCancer is still an important public health issue in China with an increasing disease burden. Specifically, the incidence rates for lung cancer, colorectal cancer and breast cancer were increasing, but those for stomach cancer and esophageal cancer were decreasing. However, age-specific incidence rate remained stable, indicating that the aging population was the major source of the increasing cancer burden.
Incidence And Mortality Trend of Cervical Cancer in 11 Cancer Registries of China
Tao Lei, Wei-min Mao, Tong-hai Lei, Li-qiong Dai, Luo Fang, Wan-qing Chen, Si-wei Zhang
2011, 23(1): 10-14. doi: 10.1007/s11670-011-0010-x
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ObjectiveIn many countries, the cervical cancer prevalence has declined but less information about the changes is available in China. This study aims to understand the epidemiological characteristics and trend of cervical cancer in China.MethodsCervical cancer data of 11 cancer registries during 1988-2002 in China were analyzed. The age and urban/rural differences and trend of cervical cancer incidence and mortality were described and discussed.ResultsDuring 1988-2002, a total of 6007 incidence cases and 3749 mortality cases of cervical cancer were reported in the 11 cancer registries. The incidence crude rate of cervical cancer was 3.80/100,000 and the world age adjusted rate was 2.78/100,000. In the same period, the mortality crude rate was 2.37/100,000 and the world age adjusted rate was 1.66/100,000. Declined incidence and mortality trends were observed during this period in urban as well as in rural areas. When calculating the rates by age group, we found that the declining trends were only for older women and increasing trends for younger women, especially for women in the rural areas.ConclusionThe incidence and mortality rates declined during the period of 1988-2002 in China for older women. The younger women showed an increasing trend during the same period, especially for women in rural area.
Time Trends of Cancer Incidence in Urban Beijing, 1998-2007
Ning Wang, Wei-xing Zhu, Xiu-mei Xing, Lei Yang, Ping-ping Li, Wei-cheng You
2011, 23(1): 15-20. doi: 10.1007/s11670-011-0015-5
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ObjectiveTo report the time trends of cancer incidence in urban Beijing from 1998 to 2007.MethodsAll data were obtained from Beijing Cancer Registry from 1998-2007 in urban Beijing. Time trends of incidence rate of cancer were assessed by annual percentage change (APC) of age-standardized incidence rate (ASR) of world standard population during this 10-year period.ResultsFor all 156851 cancer cases combined, the incidence rate rose in both males and females, with an APC of 2.23% and 3.74%, respectively. The incidence rate of upper gastrointestinal cancers declined significantly, with an APC of -2.83% in esophageal cancer and -1.37% in male gastric cancer, while lower gastrointestinal cancer, such as colorectal cancer, increased with an APC of 4.08%. The rates of kidney and bladder cancer increased with an APC of 7.93% and 5.57%, respectively. For women, the APC continued to rise in breast cancer (4.98%), ovary cancer (6.16%), cervix uteri cancer (11.74%), corpus uteri cancer (6.96%) and thyroid gland cancer (13.39%). The rate of prostate cancer among men increased with an APC of 8.58%; the rate of lymphoma and leukemia increased with APC of 5.48% and 5.44%, respectively.ConclusionBecause of population aging and urban modernization, the cancer burden in Beijing has become more and more severe and similar to the western developed countries.
Health Economic Assessment for Screening of Gastric Cancer in A High Risk Population in Northeastern China
Ling Zhou, Peng Guan, Li-ping Sun, Qin-cheng He, Yuan Yuan, Bao-sen Zhou
2011, 23(1): 21-24. doi: 10.1007/s11670-011-0021-7
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ObjectiveTo assess economic cost-effects for the screening programs of gastric cancer in a high risk population in northeastern China.MethodsThe data were collected from November 2001 to December 2003. The multi-stage sampling to define the screening group and the control group was applied in this study. Two stage screening programs were used in the study. An epidemiological survey and serum PG test were carried out in the first stage. The endoscopy and pathological examination were performed in the second stage screening. Effectiveness was assessed by the increased quality adjusted life-year (QALY) because of reduced gastric cancer deaths in screening.ResultsA total of 27,970 participants (n=7,128 screening group, n=20,842 control group) were enrolled in the survey. Twenty nine gastric cancer cases were detected in the screening group with 20 cases in the early stage and 9 cases in the advanced stage, respectively. Eighty six gastric cancer cases were detected in the control group, all of whom were in the advanced stage and had died before the study finished. The screening and treatment of 29 cases cost $152,227 and $5,249 per each case, respectively. The costs were $459 to gain per QALY.ConclusionThe screening program of gastric cancer used in our study is an economic and society-beneficial measure to detect gastric cancer in high risk area. The methods fit China's present economic development level.
Prevalence of HPV Infection And Cervical Intraepithelial Neoplasia And Attitudes towards HPV Vaccination among Chinese Women Aged 18-25 in Jiangsu Province
Shang-ying Hu, Ying Hong, Fang-hui Zhao, Adam K. Lewkowitz, Feng Chen, Wen-hua Zhang, Qin-jing Pan, Xun Zhang, Cindy Fei, Hui Li, You-lin Qiao
2011, 23(1): 25-32. doi: 10.1007/s11670-011-0025-3
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ObjectiveFew data are available on the epidemiology of HPV and cervical cancer among Chinese women younger than 25 years old. This study aimed to estimate the HPV infection rate and the prevalence of cervical intraepithelial neoplasia (CIN) in women aged 18-25, as well as their knowledge of and attitudes towards HPV vaccination.MethodsA population-based cervical cancer screening study was conducted on women aged 18-25 in Jiangsu province in 2008. Participants provided socio-demographic, reproductive and behavioral information and completed a survey about their knowledge of and attitudes towards HPV vaccination. Women then underwent a gynecologic exam to provide two cervical exfoliated cell samples for high risk HPV DNA testing and liquid-based cytology (LBC) as well as visual inspection with acetic acid (VIA). Women testing positive for any test were referred to colposcopy and biopsy. The gold standard for diagnosis of cervical lesions was directed or random biopsies.ResultsWithin the sample of 316 women, 3.4% of them were diagnosed with CIN grade 2 or worse lesions and 17.1% were found to be positive for HPV DNA. Among these young women, extra-marital sexual behavior of them (OR=2.0, 95%CI: 1.1-3.8) or their husbands (OR=2.6, 95%: 1.4-4.7) were associated with an increased risk of HPV positivity. Although overall HPV awareness was low, after a brief educational intervention, 98.4% reported they would electively receive HPV vaccination and would also recommend that their daughters be vaccinated. However, most urban and rural women reported their ideal maximum out-of-pocket contribution for HPV vaccination to be less than 500 RMB and 50-100 RMB, respectively.ConclusionOur study indicates cervical disease burden is relatively high among sampled Chinese women aged 18-25. Appropriate educational interventions for female adolescents and strategies to subsidize vaccine costs are definitely needed to ensure the effectiveness of vaccination campaigns in China.
Plasma Vitamin D Levels And Vitamin D Receptor Polymorphisms Are Associated with Survival of Non-small Cell Lung Cancer
Yao Liu, Wei Chen, Zhi-bin Hu, Lin Xu, Yong-qian Shu, Shi-yang Pan, Jun-cheng Dai, Guang-fu Jin, Hong-xia Ma, Hong-bing Shen
2011, 23(1): 33-37. doi: 10.1007/s11670-011-0033-3
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ObjectiveVitamin D and its receptor (VDR) involve in multiple cellular processes and play an important role in the initiation and progression of malignancy. Thus we hypothesized that plasma vitamin D levels and single nucleotide polymorphisms (SNPs) in VDR may be of prognostic significance in non-small cell lung cancer (NSCLC).MethodsWe examined plasma 25-hydroxyvitamin D [25(OH)D] levels in 87 patients diagnosed with NSCLC using enzyme-linked immunosorbent assay (ELISA) and genotyped seven potentially functional SNPs in VDR in 568 NSCLC patients on Illumina Golden Gate platform.ResultsPatients with higher plasma 25(OH)D levels had worse survival than patients with lower ones (P for trend = 0.048). The SNPs of rs1544410 and rs739837 were independently associated with NSCLC survival (adjusted HR = 1.61, 95% CIs = 1.06-2.45 for rs739837 AA vs AC/CC and adjusted HR = 1.51, 95% CIs = 1.06-2.16 for rs1544410 AG/AA vs GG). A joint effect was observed between rs1544410 and rs739837 and the risk of death elevated as the number of unfavourable genotypes patients carried increased (P for trend = 0.003). There were no significant associations between VDR polymorphisms and plasma 25(OH)D levels.ConclusionOur findings indicate that plasma 25(OH)D levels and genetic variants of VDR may serve as prognostic markers for NSCLC in this Chinese population.
Current Status of Diagnosis And Treatment of Primary Breast Cancer in Beijing, 2008
Xiao-mei Yuan, Ning Wang, Tao Ouyang, Lei Yang, Ming-yang Song, Ben-yao Lin, Yun-tao Xie, Jin-feng Li, Kai-feng Pan, Wei-cheng You, Lian Zhang
2011, 23(1): 38-42. doi: 10.1007/s11670-011-0038-y
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ObjectiveTo investigate the status of diagnosis and treatment of primary breast cancer in Beijing, 2008.MethodsAll the patients who were diagnosed as primary breast cancer in Beijing in 2008 were enrolled in this study. Information of these patients, including the features of tumors, clinical diagnosis and treatment was collected, and filled in the well-designed questionnaire forms by trained surveyors. The missing data was partly complemented through telephone interviews.ResultsA total of 3473 Beijing citizens were diagnosed as primary breast cancer (25 patients with synchronal bilateral breast cancer) in Beijing, 2008. Of them 82.09% were symptomatic. 19.02% and 34.11% were diagnosed using fine needle aspiration biopsy (FNAB) and core needle biopsy (CNB), respectively. 15.92% received sentinel lymph node biopsy (SLNB) and 24.27% received breast conserving surgery (BCS). Among 476 cases with Her-2 positive, only 96 received anti-Her-2 therapy. We found that the standardization level varied in hospitals of different grades, with higher level in Grade-III hospitals. Of note, some breast cancer patients received non-standard primary tumor therapy: 65.63% of the patients with ductal carcinoma in situ (DCIS) received axillary lymph node dissection and 36.88% received chemotherapy; 25.89% of the patients underwent breast conserving surgery without margin status; 12.10% of the patients received chemotherapy less than 4 cycles.ConclusionAlthough most breast cancer patients received basic medical care, the mode of diagnosis and treatment should be improved and should be standardized in the future in Beijing.
Factors Affecting Mesenchymal Stromal Cells Yield from Bone Marrow Aspiration
Jing Li, Wilfred Hing-Sang Wong, Shing Chan, James Chor San Chim, Kenneth Man-Chee Cheung, Tsz-Leung Lee, Wing-Yan Au, Shau-Yin Ha, Albert Kwok-Wei Lie, Yu-Lung Lau, Raymond Hin-Suen Liang, Godfrey Chi-Fung Chan
2011, 23(1): 43-48. doi: 10.1007/s11670-011-0043-1
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ObjectiveThis study was to investigate the variables in bone marrow harvesting procedure and individual donor factors which can potentially affect the yield of mesenchymal stromal cells (MSC).MethodsWe determined the yield of MSC from bone marrow under different clinical conditions by comparing the MSC colony numbers from: (1) donors of different ages; (2) healthy donors and patients with leukemia; (3) bone marrow aspirated at different time points during marrow harvesting; (4) bone marrow harvested by different needles.ResultsDuring the process of harvesting, the number of MSC significantly decreased with increase number of aspiration, from 675/ml at the initial decreased to 60/ml after 100 ml bone marrow aspirated, and 50/ml after 200 ml bone marrow aspirated. The number of MSC retrieved from leukemia patients (99/ml bone marrow) was significantly lower than that of healthy donors (708/ml bone marrow). However, there was no significant difference in growth rate. There was no significant age-related difference of MSC yielded from donors <55 years. And there was no significant difference in MSC number between the samples from single end-holed needle and those from multiple-side-hole needle.ConclusionThe optimal bone marrow samples for MSC collection should be obtained earlier in the process of harvesting procedure. Bone marrow from donors <55 years was equally good as MSC sources. The autologous MSC from leukemia patients can be utilized for in-vitro MSC expansion.
Mobilization of Peripheral Blood Stem Cells Using Regimen Combining Docetaxel with Granulocyte Colony-stimulating Factor in Breast Cancer Patients
Jing Yu, Jun Ren, Li-jun Di, Guo-hong Song, Yu-lin Zhu, Jie Zhang, Xu Liang, Li Che, Han-fang Jiang, Jun Jia, Chun-rong Zhang
2011, 23(1): 49-53. doi: 10.1007/s11670-011-0049-8
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ObjectiveTo evaluate the effectiveness and safety of the mobilization of peripheral blood hematopoietic stem cells by combining docetaxel with granulocyte colony-stimulating factor (G-CSF) in breast cancer patients.MethodsA total of 57 breast cancer patients were treated with docetaxel 120 mg/m2. When the white blood cell (WBC) count decreased to 1.0×109/L, patients were given G-CSF 5 μg/kg daily by subcutaneous injection until the end of apheresis. Peripheral blood mononuclear cells (MNC) were isolated by Cobe Spectra Apheresis System. The percentage of CD34+ cell was assayed by flow cytometry.ResultsAt a median 6 of days (range 3-8) after the administration of docetaxel, the median WBC count decreased to 1.08×109/L (range 0.20-2.31). The median duration of G-CSF mobilization was 3 days (range 2-7). The MNC collection was conducted 8-12 days (median 10 days) after docetaxel treatment. The median MNC was 5.35×108/kg (range 0.59-14.07), the median CD34+ cell count was 2.43×106/kg (range 0.16-16.69). The CD34+ cell count was higher than 1.00×106/kg in 47 of 57 cases (82.46%) and higher than 2.00×106/kg in 36 cases (63.16%). The CD34+ cell count was higher than 2.00×106/kg in 27 collections (23.68%). The MNC count and the CD34+ cell count were correlated with the bottom of WBC after docetaxel chemotherapy (r=0.364, 0.502, P=0.005, 0.000). The CD34+ cell count was correlated with the MNC count (r=0.597, P=0.000). The mobilization and apheresis were well tolerated in all patients. Mild perioral numbness and numbness of hand or feet were observed in 3 cases. No serious adverse events were reported.ConclusionMobilization of peripheral blood hematopoietic stem cell by combining docetaxel with G-CSF was effective and safety in breast cancer patients.
Validation And Reliability of Distress Thermometer in Chinese Cancer Patients
Li-li Tang, Ye-ning Zhang, Ying Pang, Hai-wei Zhang, Li-li Song
2011, 23(1): 54-58. doi: 10.1007/s11670-011-0054-y
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ObjectiveTo examine the validation and reliability of the distress thermometer (DT) recommended by National Comprehensive Cancer Network (NCCN) in Chinese cancer patients.MethodsA total of 574 Chinese cancer patients from Beijing Cancer Hospital completed the detection of DT, the Hospital Anxiety and Depression Scale (HADS) and Symptom Checklist 90 (SCL-90), Receiver Operating Characteristic (ROC) curve and Area Under the Curve (AUC) were used to analyze the validation relative to HADS and SCL-90. The patients with DT≥4 and whose distress caused by emotional problems were interviewed with the MiNi International Neuro-psychiatric Interview (MINI) (Chinese Version 5.0). This version was used to analyze cancer patients’ psychological and Psychiatric symptoms during the cancer process; 3. Another 106 cancer patients in rehabilitation stage and stable condition were asked to fill in DT two times, at the base time and after 7-10 days.ResultsData of ROC indicates that a DT cutoff score of 4 yielded AUC of 0.80 with a optimal sensitivity (0.80) and specificity (0.70) relative to HADS, and AUC of 0.83 with the greatest sensitivity (0.87) and specificity (0.72) against SCL-90. The DT also has acceptable test-retest reliability (r=0.800, P=0.000); According to the interview results, the most common psychiatric problems cancer patients have adjustment disorder, depression, and anxiety.ConclusionThe data suggest that DT has acceptable overall accuracy and reliability as a screening tool for testing distress severity and specific problems causing distress in Chinese cancer patients. It is worth being used in oncology clinic, the rapid screening and interview could help caregivers to identify psychological and psychiatric problems of cancer patients and provide useful information for further treatment.
Correlation Between Hyaluronic Acid,Hyaluronic Acid Synthase And Human Renal Clear Cell Carcinoma
Jian-liang Cai, Ming Li, Yan-qun Na
2011, 23(1): 59-63. doi: 10.1007/s11670-011-0059-6
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ObjectiveTo study the correlation between hyaluronic acid (HA), hyaluronic acid synthase (HAS) and human renal clear cell carcinoma (RCCC).MethodsThe expression of three HAS isoforms’ gene and HA in 93 RCCC tissues, 27 nephridial tissues by the side of RCCC from two hospitals were measured with Real-Time RT-PCR、Western Blot and immunohistochemical methods and analyzed.ResultsAll RCCC and adjacent normal tissues expressed three HASs’ mRNA & protein; at the mRNA level, both RCCC and adjacent normal tissues, expressed more HAS3 than HAS1 or HAS2, their differences were statistically significant (all P values <0.05); but, at the protein level, all HAS isoforms presented the equivalent expression. Compared with the adjacent non-neoplastic kidney tissues, the expression of all HAS isoforms’ mRNA in RCCC tissues were increased evidently and their differences were significant (all P values <0.0001); but at the protein level, only the expression of HAS3 increased evidently (P=0.022). In all adjacent normal tissues, more than 80% renal tubular cells strongly expressed HA, however, only the minority RCCC cases (16/93) presented weakly positive HA staining in few cancer nests (5%-30%), the difference were significant (P<0.0001). In RCCC tissues subgrouped according to clinical stage, pathological grade, lymphatic metastasis or not and distant metastasis or not, the HASs’ mRNA & protein differential expression all had no statistical significance (all P values >0.05).ConclusionDifferent from other malignancy, HA and HASs (except for HAS3) may not play important roles in the biological progress of human RCCC.
Elevated Circulating Levels of Osteopontin Are Associated with Metastasis in Advanced Non-Small Cell Lung Cancer
Yong Liang, Hui Li, Bin Hu, Xing Chen, Jin-bai Miao, Tong Li, Bin You, Qi-rui Chen, Yi-li Fu, Yang Wang, Sheng-cai Hou
2011, 23(1): 64-68. doi: 10.1007/s11670-011-0064-9
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ObjectiveTo investigate the relationship between postoperative metastasis and circulating levels of osteopontin in non-small cell lung cancer (NSCLC).MethodsThe expression of osteopontin mRNA were detected with RT-PCR technique. The circulating levels of osteopontin were measured through ELASA in 46 NSCLC cases that had not been received any anti-cancer treatment at the time of sampling. The tissues from fifteen patients with benign pulmonary diseases were studied as control group.ResultsThe overall median mRNA expression level of osteopontin was approximately 70-fold higher in tumor tissues than in matched normal lung tissues (P<0.001). Over-expression of osteopontin mRNA was significantly associated with clinical stage (P=0.009). Advanced disease states had higher circulating level of osteopontin (stage I+II versus stage III+VI). In multivariate analysis, stage was the only independent factor influencing circulating levels of osteopontin. All patients were followed up for 12 months, 2 of the 46 patients with both osteopontin mRNA expression and elevated plasma osteopontin levels had local recurrence and 10 had distant metastasis. There was a significant difference in the osteopontin levels between metastasis group and non-metastasis group.ConclusionPreoperative plasma levels of osteopontin are significantly associated with post-operative metastasis in advanced NSCLC.
Reversion of Multidrug-Resistance by Proteasome Inhibitor Bortezomib in K562/DNR Cell Line
Hui-han Wang, Ying-chun Li, Ai-jun Liao, Bei-bei Fu, Wei Yang, Zhuo-gang Liu, Xiao-bin Wang
2011, 23(1): 69-73. doi: 10.1007/s11670-011-0069-4
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ObjectiveTo observe the reversion of multi-drug resistance by proteasome inhibitor bortezomib in K562/DNR cell line and to analyze the possible mechanism of reversion of multidrug-resistance.MethodsMTT method was used to determine the drug resistance of K562/DNR cells and the cellular toxicity of bortezomib. K562/DNR cells were cultured for 12 hours, 24 hours and 36 hours with 100 μg/ml DNR only or plus 4 μg/L bortezomib. The expressions of NF-κB, IκB and P-gp of K562/DNR were detected with Western blot method, the activity of NF-κB was tested by ELISA method and the apoptosis rate was observed in each group respectively.ResultsThe IC50 of DNR on cells of K562/S and K562/DNR groups were 1.16 μg/ml and 50.43 μg/mL, respectively. The drug-resistant fold was 43.47. The IC10 of PS-341 on Cell strain K562/DNR was 4 μg/L. Therefore, 4 μg/L was selected as the concentration for PS-341 to reverse drug-resistance in this study. DNR induced down-regulation of IκB expression, up-regulation of NF-κB and P-gp expression. After treatment with PS-341, a proteasome inhibitor, the IκB degradation was inhibited, IκB expression increased, NF-κB and P-gp expression decreased in a time dependent manner. Compared to DNR group, the NF-κB p65 activity of DNR+PS-341 group was decreased. Compared to corresponding DNR group, DNR induced apoptosis rate increases after addition of PS-341 in a time dependent manner.ConclusionProteasome inhibitor bortezomib can convert the leukemia cell drug resistance. The mechanism may be that bortezomib decreases the degradation of IκB and the expression of NF-κB and P-gp, therefore induces the apoptosis of multi-drug resistant cells.
Long-Term Chinese Herbs Decoction Administration for Management of Hot Flashes Associated with Endocrine Therapy in Breast Cancer Patients
Dong Xue, Hong Sun, Ping-ping Li
2011, 23(1): 74-78. doi: 10.1007/s11670-011-0074-7
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ObjectiveTo evaluate the effect of Chinese herbs decoction Shu-Gan-Liang-Xue on endocrine therapy- associated hot flashes symptom in breast cancer patients.MethodsSixty-six patients with breast cancer receiving adjuvant endocrine therapy were categorized to two groups, the control group received endocrine therapy alone, the other group is administered with Chinese herbs decoction Shu-Gan-Liang-Xue besides the endocrine therapy: Shu-Gan-Liang-Xue decoction was administered above 6 months per year for more than 2 years. Frequency of hot flashes per day was recorded, and the effect of Shu-Gan-Liang-Xue decoction on hot flashes symptom being assessed with Kupperman Scoring Index.ResultsSixty cases were analyzed, 32 cases in endocrine therapy combining Chinese herbs decoction group, 28 cases in mere endocrine therapy group. For hot flashes symptom, in Chinese herbs decoction administration group, 7 cases (21.9%) reported symptom disappeared, 22 cases (68.7%) reported symptom alleviated, 3 cases (9.4%) reported symptom not changed; in endocrine therapy alone group, 5 cases (17.9%) reported symptom disappeared, 13 cases (46.4%) reported symptom alleviated, 10 cases (10/28, 35.7%) reported symptom not changed. The difference between two groups was statistically significant (P=0.013). For sleeping disorder, in Chinese herbs decoction administration group, 27 cases (84.4%) reported symptom improved, 5 cases (15.6%) reported no change; in endocrine therapy alone group, 16 cases (57.1%) symptom improved, 12 cases (42.9%) reported no change in sleeping disorder (P=0.019), the difference was also of significance statistically.ConclusionLong-term Chinese herbs decoction administration remarkably improved hot flashes symptom and sleeping disorder associated with endocrine therapy, meanwhile without definite toxicity and influence on the risk of recurrence of tumor.