Hu Jiaqi, Jiang Juling, Liu Rui, Cheng Mengqi, Zhu Guanghui, He Shulin, Shi Bolun, Zhao Yuwei, He Zhongning, Yu Huibo, Zhang Xing, Zheng Honggang, Hua Baojin
Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Front Oncol. 2022 Feb 23;12:828450. doi: 10.3389/fonc.2022.828450. eCollection 2022.
Traditional medicine preparations (TMPs) combined with chemotherapy is widely used for patients with advanced pancreatic cancer (APC); however, its efficacy and safety are still unclear. The purpose of this meta-analysis was to evaluate the clinical efficacy and safety of TMPs combined with chemotherapy for the treatment of APC.
A systematic search of eight electronic databases for randomized controlled trials (RCTs) was conducted from inception to October 15, 2021. Tumor response was identified as primary outcome, whereas quality of life (QoL), cancer biomarkers, and adverse drug reactions (ADRs) were identified as secondary outcomes. Quality of the evidence for each outcome was evaluated by GRADE profiler.
In total, 31 RCTs involving 1,989 individuals were included. This meta-analysis showed that TMPs combined with chemotherapy significantly improved the objective response rate (ORR) (RR=1.64, 95% CI [1.43 to 1.88], p <0.00001), disease control rate (DCR) (RR=1.29, 95% CI [1.21 to 1.38], p <0.00001), and QoL (continuous data: SMD=0.81, 95% CI [0.44 to 1.18], p <0.0001, dichotomous data: RR=1.44, 95% CI [1.22 to 1.70], p<0.0001), compared to those with chemotherapy alone. In addition, the combined treatment group also had lower levels of CA19-9 (SMD=-0.46, 95% CI [-0.90 to -0.02], =0.04) and CEA (SMD=-0.55, 95% CI [-0.93 to -0.17], =0.004). Moreover, TMPs reduced the ADRs during chemotherapy.
This systematic review suggests that TMPs combined with chemotherapy might be a potential option to enhance therapeutic effects and reduce ADRs during the treatment of APC. However, more high-quality randomized controlled trials with more participants are needed.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209825, identifier PROSPERO Number: CRD42021264938.
传统医学制剂（TMPs）联合化疗广泛应用于晚期胰腺癌（APC）患者；然而，其疗效和安全性仍不明确。本荟萃分析的目的是评估TMPs联合化疗治疗APC的临床疗效和安全性。
从数据库建立至2021年10月15日，对8个电子数据库进行系统检索，以查找随机对照试验（RCTs）。肿瘤反应被确定为主要结局，而生活质量（QoL）、癌症生物标志物和药物不良反应（ADRs）被确定为次要结局。每个结局的证据质量由GRADE分析软件评估。
共纳入31项RCTs，涉及1989名个体。本荟萃分析表明，与单纯化疗相比，TMPs联合化疗显著提高了客观缓解率（ORR）（RR = 1.64，95%CI [1.43至1.88]，p < 0.00001）、疾病控制率（DCR）（RR = 1.29，95%CI [1.21至1.38]，p < 0.00001）和QoL（连续数据：SMD = 0.81，95%CI [0.44至1.18]，p < 0.0001，二分数据：RR = 1.44，95%CI [1.22至1.70]，p < 0.0001）。此外，联合治疗组的CA19-9（SMD = -0.46，95%CI [-0.90至-0.02]，p = 0.04）和CEA（SMD = -0.55，95%CI [-0.93至-0.17]，p = 0.004）水平也较低。而且，TMPs降低了化疗期间的ADRs。
本系统评价表明，TMPs联合化疗可能是增强APC治疗效果并减少ADRs的一种潜在选择。然而，需要更多参与者的高质量随机对照试验。
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209825，标识符PROSPERO编号：CRD42021264938。
