Li Yicong, Sui Xinbing, Su Zeqi, Yu Chunyue, Shi Xiaoguang, Johnson Nadia L, Chu Fuhao, Li Yuan, Li Kexin, Ding Xia
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Front Pharmacol. 2020 Feb 27;11:132. doi: 10.3389/fphar.2020.00132. eCollection 2020.
This study aimed to compare the efficacy and safety of traditional Chinese medicines (TCMs) combined with paclitaxel-based chemotherapy and paclitaxel-based chemotherapy alone for gastric cancer treatment. Literature searches (up to September 25, 2019) were performed using the Cochrane Library, EMBASE, PubMed, Chinese Science and Technology Journals (CQVIP), Wanfang, and China Academic Journals (CNKI) databases. Data from 14 randomized controlled trials (RCTs), with 1,109 participants, were included. The results indicated that, compared with paclitaxel-based chemotherapy alone, the combination of TCMs and paclitaxel-based chemotherapy significantly improved the tumor response rate (TRR; RR: 1.39; 95% CI: 1.24-1.57; < 0.001, = 12%), increased the quality of life based on the Karnofsky Performance Scale score (RR: 1.53; 95% CI: 1.19-1.96; < 0.001, = 0%), and reduced the side effects, such as neutropenia (RR: 0.68; 95% CI: 0.55-0.84; < 0.001, = 44%), leukopenia (RR: 0.69; 95% CI: 0.54-0.90; < 0.01, = 40%), thrombocytopenia (RR: 0.66; 95% CI: 0.46-0.96; < 0.05, = 32%), and nausea and vomiting (RR: 0.50; 95% CI: 0.32-0.80; < 0.01, = 85%). Hepatic dysfunction (RR: 0.63; 95% CI: 0.33-1.20; = 0.16, = 0%), neurotoxicity (RR: 0.64; 95% CI: 0.26-1.55; = 0.32, = 0%), and anemia (RR: 0.65; 95% CI: 0.40-1.04; = 0.07, = 0%) were similar between the two groups. Evidence from the meta-analysis suggested that compared with paclitaxel-based chemotherapy alone, the combination of TCMs and paclitaxel-based chemotherapy may increase the TRR, improve quality of life, and reduce multiple chemotherapy-related side effects in gastric cancer patients. Additional rigorously designed large RCTs are required to confirm the efficacy and safety of this treatment.
本研究旨在比较中药联合紫杉醇类化疗与单纯紫杉醇类化疗治疗胃癌的疗效和安全性。使用Cochrane图书馆、EMBASE、PubMed、中国科技期刊数据库(维普)、万方和中国学术期刊全文数据库(知网)进行文献检索(截至2019年9月25日)。纳入了14项随机对照试验(RCT)的数据,共1109名参与者。结果表明,与单纯紫杉醇类化疗相比,中药联合紫杉醇类化疗显著提高了肿瘤缓解率(TRR;RR:1.39;95%CI:1.24 - 1.57;P<0.001,I² = 12%),基于卡氏功能状态评分提高了生活质量(RR:1.53;95%CI:1.19 - 1.96;P<0.001,I² = 0%),并减少了副作用,如中性粒细胞减少(RR:0.68;95%CI:0.55 - 0.84;P<0.001,I² = 44%)、白细胞减少(RR:0.69;95%CI:0.54 - 0.90;P<0.01,I² = 40%)、血小板减少(RR:0.66;95%CI:0.46 - 0.96;P<0.05,I² = 32%)以及恶心和呕吐(RR:0.50;95%CI:0.32 - 0.80;P<0.01,I² = 85%)。两组间肝功能障碍(RR:0.63;95%CI:0.33 - 1.20;P = 0.16,I² = 0%)、神经毒性(RR:0.64;95%CI:0.26 - 1.55;P = 0.32,I² = 0%)和贫血(RR:0.65;95%CI:0.40 - 1.04;P = 0.07,I² = 0%)相似。荟萃分析的证据表明,与单纯紫杉醇类化疗相比,中药联合紫杉醇类化疗可能提高胃癌患者的肿瘤缓解率,改善生活质量,并减少多种化疗相关副作用。需要更多严格设计的大型随机对照试验来证实这种治疗方法的疗效和安全性。