Combined Treatment of Non-Small-Cell Lung Cancer Using Shenyi Capsule and Platinum-Based Chemotherapy: A Meta-Analysis and Systematic Review

Abstract

Background.The efficacy and safety of combined treatment of non-small-cell lung cancer (NSCLC) using Shenyi capsules and platinum-based chemotherapy were comprehensively evaluated. Methods. A computer-based search was used to identify reports on clinical randomized controlled trials (RCTs) on this combined treatment for NSCLC from the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, China Biomedical (CBM), and Wanfang Data electronic databases. The databases were searched from their start to February 2020. The quality of the included studies was evaluated and then crosschecked by two independent evaluators. A meta-analysis was conducted using RevMan5.3. Results. A total of 27 RCTs involving 2,663 patients were included in the meta-analysis, including 1,380 and 1,283 patients in the treatment and control groups, respectively. The results of the meta-analysis showed that, compared to platinum-based chemotherapy alone, the 1-year survival rate (relative risk (RR) = 1.27, 95% confidence interval (CI) [1.10, 1.47], $P<0.01$ ), 2-year survival rate (RR = 1.35, 95% CI [1.10, 1.65], $P<0.01$ ), objective tumour remission rate (RR = 1.52, 95% CI [1.35, 1.71], $P<0.01$ ), and body CD4+/CD8+ ratio (standardized mean difference (SMD) = 0.12, 95% CI [0.07, 0.17], $P<0.01$ ) were increased for the combined treatment of NSCLC using Shenyi capsules and platinum-based chemotherapy; moreover, quality of life was also improved (RR = 2.09, 95%CI [1.75, 2.50], $P<0.01$ ) and it reduced leukocyte toxicity (RR = 0.49, 95%CI [0.39, 0.63], $P<0.01$ ), haemoglobin toxicity (RR = 0.48, 95% CI [0.28, 0.81], $P<0.01$ ), platelet toxicity (RR = 0.44, 95% CI [0.28, 0.70], $P<0.01$ ), vomiting reaction (RR = 0.60, 95% CI [0.45, 0.78], $P<0.01$ ), and serum vascular endothelial growth factor level (SMD = −63.67, 95% CI [−67.59, −59.75], $P<0.01$ ). Conclusions. The treatment of NSCLC using Shenyi capsules together with routine platinum-based chemotherapy could enhance short- and long-term efficacy, improve patient quality of life, alleviate toxicity and side-effects of platinum-based chemotherapeutic drugs, boost body immune function, and inhibit tumour neovascularisation. These findings require further validation in large-sample, high-quality RCTs.