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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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Quality of life.The quality of life changes on Karnofsky performance scale (KPS) were estimated from meta-analysis of pairwise comparisons in patients with Chinese herbal medicine (CTC, treatment group) versus patients in chemotherapy (CT, control group). KPS improvement (the increase of KPS ≥10).
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pone-0057604-g004: Quality of life.The quality of life changes on Karnofsky performance scale (KPS) were estimated from meta-analysis of pairwise comparisons in patients with Chinese herbal medicine (CTC, treatment group) versus patients in chemotherapy (CT, control group). KPS improvement (the increase of KPS ≥10).

Mentions: Two types of KPS data were reported in the studies, the improvement of KPS (ten-point cutoff) and the value of KPS in pre- and post-treatment. Six studies of the 24 studies, with evaluation of 526 patients were being analyzed. 35.1% and 10.9% of patients reported improved (the increase of KPS≥10) in CTC (n = 270) and in CT (n = 256), respectively. Significant findings with improvement were shown in the CTC (RR = 2.90, 95% CI = 1.62–5.18, p = 0.0003, six studies, 526 patients) (Figure 4) [21], [26], [29], [30], [35], [36]. There was no significant heterogeneity among these studies (I2 = 51%). Dropping one of any studies did not alter the result that favor of CTC. The value of KPS was reported with pre-treatment in seven studies [19], [24]–[26], [30], [34], [37] and post-treatment in four studies [24], [25], [34], [37]. The pooled studies showed that the KPS of pre-treatment had no significant difference in CTC and CT (SMD = −0.04, 95% CI = −0.20-0.12, p = 0.64, I2 = 0%). However, the pooled studies indicated the heterogeneity in the four studies of post-treatment (SMD = 1.03, 95% CI = −0.09–2.14, p = 0.07, I2 = 95%). Interestingly, these four studies all claimed significant improvement in CTC compared to CT.


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)

Quality of life.The quality of life changes on Karnofsky performance scale (KPS) were estimated from meta-analysis of pairwise comparisons in patients with Chinese herbal medicine (CTC, treatment group) versus patients in chemotherapy (CT, control group). KPS improvement (the increase of KPS ≥10).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0057604-g004: Quality of life.The quality of life changes on Karnofsky performance scale (KPS) were estimated from meta-analysis of pairwise comparisons in patients with Chinese herbal medicine (CTC, treatment group) versus patients in chemotherapy (CT, control group). KPS improvement (the increase of KPS ≥10).
Mentions: Two types of KPS data were reported in the studies, the improvement of KPS (ten-point cutoff) and the value of KPS in pre- and post-treatment. Six studies of the 24 studies, with evaluation of 526 patients were being analyzed. 35.1% and 10.9% of patients reported improved (the increase of KPS≥10) in CTC (n = 270) and in CT (n = 256), respectively. Significant findings with improvement were shown in the CTC (RR = 2.90, 95% CI = 1.62–5.18, p = 0.0003, six studies, 526 patients) (Figure 4) [21], [26], [29], [30], [35], [36]. There was no significant heterogeneity among these studies (I2 = 51%). Dropping one of any studies did not alter the result that favor of CTC. The value of KPS was reported with pre-treatment in seven studies [19], [24]–[26], [30], [34], [37] and post-treatment in four studies [24], [25], [34], [37]. The pooled studies showed that the KPS of pre-treatment had no significant difference in CTC and CT (SMD = −0.04, 95% CI = −0.20-0.12, p = 0.64, I2 = 0%). However, the pooled studies indicated the heterogeneity in the four studies of post-treatment (SMD = 1.03, 95% CI = −0.09–2.14, p = 0.07, I2 = 95%). Interestingly, these four studies all claimed significant improvement in CTC compared to CT.

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