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Received May 3, 2017; Revised Dec 16, 2017; Accepted Dec 26, 2017
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1. Introduction
Colorectal cancer (CRC), including colon and rectal cancer, is typically a malignancy of the intestinal epithelial mucosa and is one of the most common gastrointestinal malignancies. CRC is the third most common type of malignant tumor in China [1]. Worldwide, after lung and breast cancer, CRC is the most prominent cancer impacting disability-adjusted life years (DALY) [2]. According to the International Agency for Research on Cancer (IARC), in 2012, there were estimated to be 1.36 million new cases and 0.69 million deaths from CRC worldwide [3]. Currently, CRC treatment options include surgery, chemotherapy, radiotherapy, or a combination of the three [4, 5]. Surgery is usually the first option, with the excision rate reaching 60–70% [6]. However, more than half of these patients relapse or present with metastases in 5 years, ultimately succumbing to the disease. In China, CRC is most prevalent in those aged 40–60 years. Due to its occult onset and poor patient awareness of the disease, most are diagnosed at an advanced stage [7]. In such cases, it is usually too late for surgery, with chemotherapy being the main form of adjuvant therapy [8]. Chemotherapy can prolong survival and a randomized crossover trial has shown that patients receiving chemotherapy, in any sequence, survive a median period of over 20 months [9]. Unfortunately, chemotherapy of CRC is often ineffective due to the intrinsic chemoresistance of the tumor [10]. Overall CRC survival rates are unsatisfactory, especially for late-stage disease [11]. Hence, it is imperative to develop more effective treatments for CRC.
Multiple studies [12–14] have demonstrated traditional Chinese medicine (TCM) to enhance efficacy and to decrease the toxicity of chemotherapy. TCM has been shown to alleviate symptoms, improve quality of life, enhance immune function, and relieve the adverse effects of chemotherapy [15]. According to TCM, tumor formation results from the accumulation of toxicants from Zang-Fu. The rise and fall of healthy qi is the key factor, playing an important role in the occurrence, development, and turnover of disease. In CRC, a...