The First Department of Surgery, Shenzhen Traditional Chinese Medicine Hospital/The fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Futian District, Shenzhen, Guangdong, China.
The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Futian District, Shenzhen, Guangdong, China.
Integr Cancer Ther. 2024 Jan-Dec;23:15347354241293790. doi: 10.1177/15347354241293790.
Ginsenosides (GS), including total GS, Rh2, Rg3 and compound K (CK), have been utilized as adjuvants in transarterial chemoembolization (TACE), surgery, and chemotherapy for hepatocellular carcinoma (HCC) therapy. However, the safety and efficacy of such combination treatments have been contradictory across different studies. This study aims to systematically evaluate the efficacy and safety of GS as adjuvant therapy for HCC. : A literature search of PubMed, CNKI, Wanfang Data, Cochrane Library, Embase, and Web of Science was conducted up to May 2024 for clinical randomized controlled trials (RCTs) on GS-based adjuvant treatments for HCC. Two researchers independently screened the literature, extracted relevant data, and assessed study quality. Meta-analysis was conducted using RevMan 5.4. : Nineteen articles involving 1448 patients were included. Meta-analysis showed that GS as an adjuvant therapy for HCC improved disease control rate (risk ratio (RR) = 1.42, 95% CI [1.26, 1.60]), objective response rate (RR = 1.20, 95% CI [1.09, 1.32]), life quality (RR = 1.49, 95% CI [1.23, 1.79]), 1-year overall survival rate (RR = 1.27, 95% CI [1.06, 1.52]), 2-year overall survival rate (RR = 1.43, 95% CI [1.06, 1.95]), ehanced Child-Pugh in A level (RR = 1.59, 95% CI [1.08, 2.34]), Child-Pugh in B level (RR = 1.28, 95% CI [1.08, 1.52]); increased CD3 (MD = 8.81, 95% CI [3.91, 13.71]), NKC (MD = 8.00, 95% CI [6.76, 9.24]) and CD4 (MD = 9.38, 95% CI [8.04, 10.72]), and reduced incidence of adverse reactions including nausea and vomiting (RR = 0.66, 95% CI [0.57, 0.77]), anorexia (RR = 0.33, 95% CI [0.21, 0.50]), leukopenia (RR = 0.55, 95% CI [0.46, 0.67]) and myelosuppression (RR = 0.54, 95% CI [0.40, 0.74]); decreased Child-Pugh in C level (RR = 0.43, 95% CI [0.27, 0.68]) and CD4/CD8 ratio (MD = 0.50, 95% CI [0.47, 0.57]). : In summary, GS combined with Western medical approaches (TACE, surgery, chemotherapy) for the treatment of HCC can improve clinical efficacy, increase overall survival rates, enhance patient life quality, and reduce the occurrence of adverse reactions. However, due to the generally low quality of the included studies, more large-sample, multi-center, high-quality, RCTs are warranted to further consolidate these findings.
人参皂苷（GS），包括总 GS、Rh2、Rg3 和化合物 K（CK），已被用作肝细胞癌（HCC）治疗的经动脉化疗栓塞（TACE）、手术和化疗的辅助剂。然而，不同研究之间此类联合治疗的安全性和疗效存在矛盾。本研究旨在系统评估 GS 作为 HCC 辅助治疗的疗效和安全性。
对截至 2024 年 5 月的 PubMed、CNKI、万方数据、Cochrane 图书馆、Embase 和 Web of Science 进行文献检索，以获取关于基于 GS 的 HCC 辅助治疗的临床随机对照试验（RCT）。两名研究人员独立筛选文献、提取相关数据并评估研究质量。使用 RevMan 5.4 进行荟萃分析。
共纳入 19 篇文章，涉及 1448 名患者。荟萃分析显示，GS 作为 HCC 的辅助治疗可提高疾病控制率（风险比[RR] = 1.42，95%置信区间[1.26，1.60]）、客观缓解率（RR = 1.20，95%置信区间[1.09，1.32]）、生活质量（RR = 1.49，95%置信区间[1.23，1.79]）、1 年总生存率（RR = 1.27，95%置信区间[1.06，1.52]）、2 年总生存率（RR = 1.43，95%置信区间[1.06，1.95]）、提高 A 级 Child-Pugh 评分（RR = 1.59，95%置信区间[1.08，2.34]）、B 级 Child-Pugh 评分（RR = 1.28，95%置信区间[1.08，1.52]）；增加 CD3（MD = 8.81，95%置信区间[3.91，13.71]）、NKC（MD = 8.00，95%置信区间[6.76，9.24]）和 CD4（MD = 9.38，95%置信区间[8.04，10.72]），降低不良反应发生率，包括恶心和呕吐（RR = 0.66，95%置信区间[0.57，0.77]）、厌食症（RR = 0.33，95%置信区间[0.21，0.50]）、白细胞减少症（RR = 0.55，95%置信区间[0.46，0.67]）和骨髓抑制（RR = 0.54，95%置信区间[0.40，0.74]）；降低 C 级 Child-Pugh 评分（RR = 0.43，95%置信区间[0.27，0.68]）和 CD4/CD8 比值（MD = 0.50，95%置信区间[0.47，0.57]）。
总之，GS 联合西医方法（TACE、手术、化疗）治疗 HCC 可提高临床疗效，提高总生存率，提高患者生活质量，降低不良反应发生率。然而，由于纳入研究的总体质量较低，需要更多的大样本、多中心、高质量、RCT 进一步证实这些发现。
