Wang Jian, Qiu Dan, Dong Xinying, Liu Yangxin, Chen Jianxin
The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Department of Medical Oncology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, China.
Medicine (Baltimore). 2024 Dec 6;103(49):e40779. doi: 10.1097/MD.0000000000040779.
Acute radiation esophagitis (ARE) is a frequently observed complication of radiotherapy for malignant tumors. QingReJieDu (QRJD) therapy is commonly used for the prevention and treatment of ARE. There is a lack of evidence regarding the effectiveness and safety of traditional Chinese medicine in preventing ARE. Therefore, the objective of this study was to comprehensively evaluate the efficacy and safety of QRJD therapy in preventing ARE.
Systematic searches were conducted across 8 databases from their inception to December 30, 2023. This study included randomized controlled trials that assessed the effectiveness of QRJD therapy in preventing ARE. The methodological quality of the included studies was evaluated using the Cochrane collaboration tool. Data analysis was conducted using RevMan 5.3 and Stata 15.
Eleven randomized controlled studies involving 754 participants were included in this analysis. The results demonstrated that QRJD therapy effectively prevented the occurrence of ARE (relative risk = 0.84, 95% CI: 0.80-0.89, P < .001), as well as the development of grade ≥ 3 ARE (relative risk = 0.41, 95% CI: 0.28-0.59, P < .001). Furthermore, QRJD therapy delayed the time of the first episode of ARE (weighted mean difference = 5.67, 95% CI: 5.33-6.02, P < .001). No significant increase in adverse events was observed with the QRJD therapy.
Our results indicate that QRJD therapy has a significant preventive effect on ARE in clinical practice. However, it is important to note that these findings should be confirmed through more rigorously designed, multicenter, large-sample, and large-scale randomized controlled trials.
急性放射性食管炎(ARE)是恶性肿瘤放疗中常见的并发症。清热解毒(QRJD)疗法常用于预防和治疗ARE。关于中药预防ARE的有效性和安全性缺乏证据。因此,本研究的目的是全面评估QRJD疗法预防ARE的疗效和安全性。
对8个数据库从建库至2023年12月30日进行系统检索。本研究纳入评估QRJD疗法预防ARE有效性的随机对照试验。采用Cochrane协作工具评估纳入研究的方法学质量。使用RevMan 5.3和Stata 15进行数据分析。
本分析纳入了11项涉及754名参与者的随机对照研究。结果表明,QRJD疗法有效预防了ARE的发生(相对风险=0.84,95%CI:0.80-0.89,P<.001),以及≥3级ARE的发生(相对风险=0.41,95%CI:0.28-0.59,P<.001)。此外,QRJD疗法延迟了ARE首次发作的时间(加权平均差=5.67,95%CI:5.33-6.02,P<.001)。未观察到QRJD疗法导致不良事件显著增加。
我们的结果表明,QRJD疗法在临床实践中对ARE有显著的预防作用。然而,需要注意的是,这些发现应通过更严格设计的多中心、大样本和大规模随机对照试验来证实。