Author:
Cao Kangdi,Hu Shuaihang,Wang Dandan,Qiao Chenxi,Wang Zhuo,Wang Jinkun,Hou Wei
Abstract
Background and aimChinese herbal injection (CHI) is a widely used preparation for advanced non-small cell lung cancer (NSCLC) treatment to alleviate the adverse drug reactions and enhance the clinical efficacy of chemotherapy. However, its efficacy and safety in combination with platinum-based chemotherapy (PBC) remain poorly understood owing to the lack of high-level evidence in the face of a wide variety of CHIs. Therefore, in this study, we aimed to explore the efficacy and safety of CHIs in combination with PBC regimens in the treatment of mid- and advanced NSCLC.MethodsSystematic evaluation and meta-analysis were conducted as per the Preferred Reporting Project for Systematic Evaluation and Meta-Analysis Protocols (PRISMA-P). Seven databases were comprehensively searched for relevant randomized controlled trials (RCTs) through August 1, 2022. The quality of each study was evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. Statistical analysis was performed using Revman 5.3, with dichotomies expressed as risk ratio (RR) and 95% confidence interval (CI). Objective response rate (ORR) and disease control rate (DCR) were selected as the primary outcomes, with quality of life (QoL) and toxic side effects as secondary outcomes.ResultsA total of 140 RCTs were included in this study. The results of the meta-analysis suggested that, compared with PBC alone, PBC combined with CHIs significantly improved the ORR (RR=1.35, 95% CI: 1.30–1.41, P<0.001), DCR (RR=1.15, 95% CI: 1.13–1.18, P<0.001) and QoL (RR=1.29, 95% CI: 1.24–1.33, P<0.001). Moreover, the combination treatment reduced chemotherapy-induced leukopenia (RR=0.69, 95% CI: 0.64–0.75, P<0.001), anemia (RR=0.70, 95% CI: 0.62–0.79, P<0.001), thrombocytopenia (RR=0.68, 95% CI: 0.62–0.75, P<0.001), nausea and vomiting (RR=0.69, 95% CI: 0.63–0.76, P<0.001), diarrhea (RR=0.59, 95% CI: 0.48–0.73, P<0.001), and constipation (RR=0.68, 95% CI: 0.54–0.86, P=0.001).ConclusionAccording to the available evidence, CHIs in combination with PBC can improve clinical efficacy and reduce the toxic side effects in the treatment of advanced NSCLC. However, considering the study’s limitations, more rigorous and high-quality studies are needed to further confirm the results.Systematic review registrationhttps://inplasy.com/inplasy-2022-1-0104/, identifier INPLASY202210104.
Funder
Foundation for Innovative Research Groups of the National Natural Science Foundation of China
State Administration of Traditional Chinese Medicine of the People's Republic of China
China Academy of Chinese Medical Sciences