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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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Reduction of adverse effects.Reduction of adverse effects estimated from meta-analysis of pairwise comparisons in patients with Chinese herbal medicine (CHM, treatment group) versus patients without CHM (control group). (A) Number of patients with nausea and vomiting at toxicity grade of III-IV. (B) Number of patients with hemoglobin decline at the toxicity grade of I-IV with CTC therapy. (C) Number of patients with hemoglobin decline at the toxicity grade III–IV with CTC therapy.
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pone-0057604-g005: Reduction of adverse effects.Reduction of adverse effects estimated from meta-analysis of pairwise comparisons in patients with Chinese herbal medicine (CHM, treatment group) versus patients without CHM (control group). (A) Number of patients with nausea and vomiting at toxicity grade of III-IV. (B) Number of patients with hemoglobin decline at the toxicity grade of I-IV with CTC therapy. (C) Number of patients with hemoglobin decline at the toxicity grade III–IV with CTC therapy.

Mentions: Nausea and vomiting are common AEs of CT. A significant reduction of nausea and vomiting at toxicity grade of III–IV in CTC compared to CT therapy was found (RR = 0.24, 95% CI = 0.12–0.50, p = 1.0E−4, five studies, 350 patients) [19], [24], [25], [30], [31] (Figure 5A). However, there was significant heterogeneity in the studies with reduction of nausea and vomiting at toxicity grade of I–IV (data not shown). One study reported a significant reduction of nausea and vomiting in CTC compared to CT at the 10th day of second treatment, based on the questionnaire EORTC QLQ-LC43 (combination of EORTC QLQ-C30 and QLQ-LC13) [38]. The study was not pooled due to the different data types.


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)

Reduction of adverse effects.Reduction of adverse effects estimated from meta-analysis of pairwise comparisons in patients with Chinese herbal medicine (CHM, treatment group) versus patients without CHM (control group). (A) Number of patients with nausea and vomiting at toxicity grade of III-IV. (B) Number of patients with hemoglobin decline at the toxicity grade of I-IV with CTC therapy. (C) Number of patients with hemoglobin decline at the toxicity grade III–IV with CTC therapy.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0057604-g005: Reduction of adverse effects.Reduction of adverse effects estimated from meta-analysis of pairwise comparisons in patients with Chinese herbal medicine (CHM, treatment group) versus patients without CHM (control group). (A) Number of patients with nausea and vomiting at toxicity grade of III-IV. (B) Number of patients with hemoglobin decline at the toxicity grade of I-IV with CTC therapy. (C) Number of patients with hemoglobin decline at the toxicity grade III–IV with CTC therapy.
Mentions: Nausea and vomiting are common AEs of CT. A significant reduction of nausea and vomiting at toxicity grade of III–IV in CTC compared to CT therapy was found (RR = 0.24, 95% CI = 0.12–0.50, p = 1.0E−4, five studies, 350 patients) [19], [24], [25], [30], [31] (Figure 5A). However, there was significant heterogeneity in the studies with reduction of nausea and vomiting at toxicity grade of I–IV (data not shown). One study reported a significant reduction of nausea and vomiting in CTC compared to CT at the 10th day of second treatment, based on the questionnaire EORTC QLQ-LC43 (combination of EORTC QLQ-C30 and QLQ-LC13) [38]. The study was not pooled due to the different data types.

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