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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) The inhibition of white blood cells (WBCs) at the toxicity grade of III–IV. (B) The inhibition of WBCs at the toxicity grade of I–IV. (C) The decrease of platelets in numbers at the toxicity grade of III–IV. (D) The decrease of platelets in numbers at the toxicity grade of I–IV.
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pone-0057604-g006: 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) The inhibition of white blood cells (WBCs) at the toxicity grade of III–IV. (B) The inhibition of WBCs at the toxicity grade of I–IV. (C) The decrease of platelets in numbers at the toxicity grade of III–IV. (D) The decrease of platelets in numbers at the toxicity grade of I–IV.

Mentions: The inhibition of white blood cells (WBCs) at the toxicity grade of III–IV or I–IV in patients with CTC therapy was significant reduced (RR = 0.36, 95% CI = 0.26–0.52, p<1.0E−5, nine studies, 666 patients; RR = 0.75, 95% CI = 0.67–0.84, p<1.0E−5, eight studies, 603 patients, respectively) (Figure 6A and Figure 6B) [19], [24], [25], [27], [29]–[31], [36], [39].


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) The inhibition of white blood cells (WBCs) at the toxicity grade of III–IV. (B) The inhibition of WBCs at the toxicity grade of I–IV. (C) The decrease of platelets in numbers at the toxicity grade of III–IV. (D) The decrease of platelets in numbers at the toxicity grade of I–IV.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0057604-g006: 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) The inhibition of white blood cells (WBCs) at the toxicity grade of III–IV. (B) The inhibition of WBCs at the toxicity grade of I–IV. (C) The decrease of platelets in numbers at the toxicity grade of III–IV. (D) The decrease of platelets in numbers at the toxicity grade of I–IV.
Mentions: The inhibition of white blood cells (WBCs) at the toxicity grade of III–IV or I–IV in patients with CTC therapy was significant reduced (RR = 0.36, 95% CI = 0.26–0.52, p<1.0E−5, nine studies, 666 patients; RR = 0.75, 95% CI = 0.67–0.84, p<1.0E−5, eight studies, 603 patients, respectively) (Figure 6A and Figure 6B) [19], [24], [25], [27], [29]–[31], [36], [39].

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