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The efficacy of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer: a systematic review and meta-analysis.

Li SG, Chen HY, Ou-Yang CS, Wang XX, Yang ZJ, Tong Y, Cho WC - PLoS ONE (2013)

Bottom Line: Compared to using CT alone, CHM combined with CT significantly increase one-year survival rate (RR = 1.36, 95% CI = 1.15-1.60, p = 0.0003).Besides, the combined therapy significantly increased immediate tumor response (RR = 1.36, 95% CI = 1.19-1.56, p<1.0E-5) and improved Karnofsky performance score (KPS) (RR = 2.90, 95% CI = 1.62-5.18, p = 0.0003).Combined therapy remarkably reduced the nausea and vomiting at toxicity grade of III-IV (RR = 0.24, 95% CI = 0.12-0.50, p = 0.0001) and prevented the decline of hemoglobin and platelet in patients under CT at toxicity grade of I-IV (RR = 0.64, 95% CI = 0.51-0.80, p<0.0001).

View Article: PubMed Central - PubMed

Affiliation: Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China.

ABSTRACT
Many published studies reflect the growing application of complementary and alternative medicine, particularly Chinese herbal medicine (CHM) use in combination with conventional cancer therapy for advanced non-small cell lung cancer (NSCLC), but its efficacy remains largely unexplored. The purpose of this study is to evaluate the efficacy of CHM combined with conventional chemotherapy (CT) in the treatment of advanced NSCLC. Publications in 11 electronic databases were extensively searched, and 24 trials were included for analysis. A sum of 2,109 patients was enrolled in these studies, at which 1,064 patients participated in CT combined CHM and 1,039 in CT (six patients dropped out and were not reported the group enrolled). Compared to using CT alone, CHM combined with CT significantly increase one-year survival rate (RR = 1.36, 95% CI = 1.15-1.60, p = 0.0003). Besides, the combined therapy significantly increased immediate tumor response (RR = 1.36, 95% CI = 1.19-1.56, p<1.0E-5) and improved Karnofsky performance score (KPS) (RR = 2.90, 95% CI = 1.62-5.18, p = 0.0003). Combined therapy remarkably reduced the nausea and vomiting at toxicity grade of III-IV (RR = 0.24, 95% CI = 0.12-0.50, p = 0.0001) and prevented the decline of hemoglobin and platelet in patients under CT at toxicity grade of I-IV (RR = 0.64, 95% CI = 0.51-0.80, p<0.0001). Moreover, the herbs that are frequently used in NSCLC patients were identified. This systematic review suggests that CHM as an adjuvant therapy can reduce CT toxicity, prolong survival rate, enhance immediate tumor response, and improve KPS in advanced NSCLC patients. However, due to the lack of large-scale randomized clinical trials in the included studies, further larger scale trials are needed.

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Number of patients with survival >one-year.Overall survivals estimated from meta-analysis of pairwise comparisons in the patients with chemotherapy combined Chinese herbal medicine (CTC, treatment group) versus patients in chemotherapy (CT, control group).
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pone-0057604-g002: Number of patients with survival >one-year.Overall survivals estimated from meta-analysis of pairwise comparisons in the patients with chemotherapy combined Chinese herbal medicine (CTC, treatment group) versus patients in chemotherapy (CT, control group).

Mentions: One-year survival was analyzed as shown in Figure 2. One-year survival in pooled studies showed a significant rise in CTC compared to CT alone (RR = 1.36, 95% CI = 1.15–1.60, p = 0.0003, seven studies, 608 patients), with low heterogeneity (I2 = 0%) [16]–[22]. A half-year survival also demonstrated a favor of CTC compared to CT alone (RR = 1.18, 95% CI = 1.04–1.33, p = 0.008, two studies, 157 patients) as shown in Figure S1.


The efficacy of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer: a systematic review and meta-analysis.

Li SG, Chen HY, Ou-Yang CS, Wang XX, Yang ZJ, Tong Y, Cho WC - PLoS ONE (2013)

Number of patients with survival >one-year.Overall survivals estimated from meta-analysis of pairwise comparisons in the patients with chemotherapy combined Chinese herbal medicine (CTC, treatment group) versus patients in chemotherapy (CT, control group).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585199&req=5

pone-0057604-g002: Number of patients with survival >one-year.Overall survivals estimated from meta-analysis of pairwise comparisons in the patients with chemotherapy combined Chinese herbal medicine (CTC, treatment group) versus patients in chemotherapy (CT, control group).
Mentions: One-year survival was analyzed as shown in Figure 2. One-year survival in pooled studies showed a significant rise in CTC compared to CT alone (RR = 1.36, 95% CI = 1.15–1.60, p = 0.0003, seven studies, 608 patients), with low heterogeneity (I2 = 0%) [16]–[22]. A half-year survival also demonstrated a favor of CTC compared to CT alone (RR = 1.18, 95% CI = 1.04–1.33, p = 0.008, two studies, 157 patients) as shown in Figure S1.

Bottom Line: Compared to using CT alone, CHM combined with CT significantly increase one-year survival rate (RR = 1.36, 95% CI = 1.15-1.60, p = 0.0003).Besides, the combined therapy significantly increased immediate tumor response (RR = 1.36, 95% CI = 1.19-1.56, p<1.0E-5) and improved Karnofsky performance score (KPS) (RR = 2.90, 95% CI = 1.62-5.18, p = 0.0003).Combined therapy remarkably reduced the nausea and vomiting at toxicity grade of III-IV (RR = 0.24, 95% CI = 0.12-0.50, p = 0.0001) and prevented the decline of hemoglobin and platelet in patients under CT at toxicity grade of I-IV (RR = 0.64, 95% CI = 0.51-0.80, p<0.0001).

View Article: PubMed Central - PubMed

Affiliation: Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China.

ABSTRACT
Many published studies reflect the growing application of complementary and alternative medicine, particularly Chinese herbal medicine (CHM) use in combination with conventional cancer therapy for advanced non-small cell lung cancer (NSCLC), but its efficacy remains largely unexplored. The purpose of this study is to evaluate the efficacy of CHM combined with conventional chemotherapy (CT) in the treatment of advanced NSCLC. Publications in 11 electronic databases were extensively searched, and 24 trials were included for analysis. A sum of 2,109 patients was enrolled in these studies, at which 1,064 patients participated in CT combined CHM and 1,039 in CT (six patients dropped out and were not reported the group enrolled). Compared to using CT alone, CHM combined with CT significantly increase one-year survival rate (RR = 1.36, 95% CI = 1.15-1.60, p = 0.0003). Besides, the combined therapy significantly increased immediate tumor response (RR = 1.36, 95% CI = 1.19-1.56, p<1.0E-5) and improved Karnofsky performance score (KPS) (RR = 2.90, 95% CI = 1.62-5.18, p = 0.0003). Combined therapy remarkably reduced the nausea and vomiting at toxicity grade of III-IV (RR = 0.24, 95% CI = 0.12-0.50, p = 0.0001) and prevented the decline of hemoglobin and platelet in patients under CT at toxicity grade of I-IV (RR = 0.64, 95% CI = 0.51-0.80, p<0.0001). Moreover, the herbs that are frequently used in NSCLC patients were identified. This systematic review suggests that CHM as an adjuvant therapy can reduce CT toxicity, prolong survival rate, enhance immediate tumor response, and improve KPS in advanced NSCLC patients. However, due to the lack of large-scale randomized clinical trials in the included studies, further larger scale trials are needed.

Show MeSH
Related in: MedlinePlus