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Chinese herbal medicine for myelosuppression induced by chemotherapy or radiotherapy: a systematic review of randomized controlled trials.

Jia Y, Du H, Yao M, Cui X, Shi Q, Wang Y, Yang Y - Evid Based Complement Alternat Med (2015)

Bottom Line: Objectives.Conclusions.There were no significant protective effects on peripheral RBCs, hemoglobin, or platelets, which may be related to low quality and small sample of included studies.

View Article: PubMed Central - PubMed

Affiliation: Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China ; Institute of Spine, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.

ABSTRACT
Background. Myelosuppression is one of the major side effects of chemo- and radiotherapy in cancer patients and there are no effective interventions to prevent it currently. Chinese herbal medicine (CHM) may be helpful due to its multidrug targets. Objectives. This study was designed to evaluate effectiveness of CHM on preventing patients from experiencing myelosuppression by chemo- or radiotherapy. Search Methods. Randomized controlled trials (RCTs) were retrieved from seven different databases from the date of database creation to April 2014. We assessed all included studies using Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and performed statistical analysis using RevMan 5.2.1. Results. Eight RCTs were included (818 patients). Pooled data showed that increase of white blood cells (WBCs) is higher with CHM plus chemotherapy/radiotherapy than with chemotherapy/radiotherapy only. Both CHM compared to placebo and CHM combined with chemotherapy/radiotherapy compared to chemotherapy/radiotherapy lacked significant differences in the peripheral platelets, red blood cells (RBCs), and hemoglobin changes. Conclusions. Our results demonstrated that CHM significantly protected peripheral blood WBCs from a decrease caused by chemotherapy or radiotherapy. There were no significant protective effects on peripheral RBCs, hemoglobin, or platelets, which may be related to low quality and small sample of included studies.

No MeSH data available.


Related in: MedlinePlus

Meta-analysis of studies evaluating the effect of CHM on preventing WBC loss in cancer patients undergoing chemotherapy or radiotherapy after one study was dropped.
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fig4: Meta-analysis of studies evaluating the effect of CHM on preventing WBC loss in cancer patients undergoing chemotherapy or radiotherapy after one study was dropped.

Mentions: There were 6 RCTs [34–39] that studied the protective effects of CHM combined with chemotherapy/radiotherapy versus chemotherapy/radiotherapy treatment alone on decreasing the WBCs in clinical cancer patients. The studies were combined in a meta-analysis and showed a high degree of heterogeneity (Chi2 = 12.24, P = 0.03, I2 = 59%) with a total of 319 subjects in the intervention arm and 318 in the control arm. The high heterogeneity may be caused by the existing issues with WBC examination and the SD value in one of the studies performed by Li et al. 2012 [38], which was obviously different from the others, while the change of increased WBCs is higher in patients treated with CHM than placebo at 0.59 (95% CI: 0.25 to 0.93) (Figure 3). When this study was excluded for the sensitivity analysis, the degree of heterogeneity dropped (Chi2 = 4.68, P = 0.32, I2 = 14%), resulting in 209 patients in the intervention arm and 211 in the control arm. The overall effect estimate continuously showed a significant trend, supporting the treatment of CHM at 0.46 (95% CI: 0.31 to 0.61) (Figure 4).


Chinese herbal medicine for myelosuppression induced by chemotherapy or radiotherapy: a systematic review of randomized controlled trials.

Jia Y, Du H, Yao M, Cui X, Shi Q, Wang Y, Yang Y - Evid Based Complement Alternat Med (2015)

Meta-analysis of studies evaluating the effect of CHM on preventing WBC loss in cancer patients undergoing chemotherapy or radiotherapy after one study was dropped.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4352943&req=5

fig4: Meta-analysis of studies evaluating the effect of CHM on preventing WBC loss in cancer patients undergoing chemotherapy or radiotherapy after one study was dropped.
Mentions: There were 6 RCTs [34–39] that studied the protective effects of CHM combined with chemotherapy/radiotherapy versus chemotherapy/radiotherapy treatment alone on decreasing the WBCs in clinical cancer patients. The studies were combined in a meta-analysis and showed a high degree of heterogeneity (Chi2 = 12.24, P = 0.03, I2 = 59%) with a total of 319 subjects in the intervention arm and 318 in the control arm. The high heterogeneity may be caused by the existing issues with WBC examination and the SD value in one of the studies performed by Li et al. 2012 [38], which was obviously different from the others, while the change of increased WBCs is higher in patients treated with CHM than placebo at 0.59 (95% CI: 0.25 to 0.93) (Figure 3). When this study was excluded for the sensitivity analysis, the degree of heterogeneity dropped (Chi2 = 4.68, P = 0.32, I2 = 14%), resulting in 209 patients in the intervention arm and 211 in the control arm. The overall effect estimate continuously showed a significant trend, supporting the treatment of CHM at 0.46 (95% CI: 0.31 to 0.61) (Figure 4).

Bottom Line: Objectives.Conclusions.There were no significant protective effects on peripheral RBCs, hemoglobin, or platelets, which may be related to low quality and small sample of included studies.

View Article: PubMed Central - PubMed

Affiliation: Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China ; Institute of Spine, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.

ABSTRACT
Background. Myelosuppression is one of the major side effects of chemo- and radiotherapy in cancer patients and there are no effective interventions to prevent it currently. Chinese herbal medicine (CHM) may be helpful due to its multidrug targets. Objectives. This study was designed to evaluate effectiveness of CHM on preventing patients from experiencing myelosuppression by chemo- or radiotherapy. Search Methods. Randomized controlled trials (RCTs) were retrieved from seven different databases from the date of database creation to April 2014. We assessed all included studies using Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and performed statistical analysis using RevMan 5.2.1. Results. Eight RCTs were included (818 patients). Pooled data showed that increase of white blood cells (WBCs) is higher with CHM plus chemotherapy/radiotherapy than with chemotherapy/radiotherapy only. Both CHM compared to placebo and CHM combined with chemotherapy/radiotherapy compared to chemotherapy/radiotherapy lacked significant differences in the peripheral platelets, red blood cells (RBCs), and hemoglobin changes. Conclusions. Our results demonstrated that CHM significantly protected peripheral blood WBCs from a decrease caused by chemotherapy or radiotherapy. There were no significant protective effects on peripheral RBCs, hemoglobin, or platelets, which may be related to low quality and small sample of included studies.

No MeSH data available.


Related in: MedlinePlus