and Related Natural Products as an Adjunct Therapy for Cancers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Cancer incidence and mortality rates keep rising globally. and related natural products are commonly applied as a complementary therapeutic option for different stages and types of cancers. The aim of this study is to evaluate the efficacy and safety of the products for cancer therapy. Randomized controlled trials were identified by systematic search over seven databases from inceptions to May 10, 2019. Two independent reviewers extracted data and assessed the study quality. Meta-analyses were performed to pool hazard ratio (), risk ratio (), mean differences (), and 95% using random-effects models. The sources of heterogeneity were explored by subgroup analyses and sensitivity analyses. Publication bias was detected by Funnel plots, Begg's test, and Egger's test. Twenty-three trials involving 4,246 cancer patients were included in this work. and related natural products were significantly associated with lower risks of mortality (: 0.82; 95% : 0.72, 0.94) and higher total efficacy (: 1.30; 95% : 1.09, 1.55), but not associated with control rate (: 1.05; 95% : 0.96, 1.14) compared with control treatment. There was no significant difference between related natural products and control treatment in the effect on relapse-free survival (: 1.19; 95% : 0.91, 1.55). Compared with control treatment, and related natural products had a favorable effect on elevated levels of CD3 (: 9.03%; 95% : 2.10, 16.50) and CD4 (: 9.2%; 95% : 1.01, 17.39), but had no effect on the levels of CD8 (: -5.52%; 95% : -23.17, 12.13), CD4/CD8 (: 0.73; 95% :-0.45, 1.91), or NK(: 5.87%; 95% : -1.06, 12.8). In this meta-analysis, we found that and related natural products might have potential benefits on the overall survival and quality of life in cancer patients.