Effectiveness and safety of combined treatment with herbal medicines and palliative chemotherapy for advanced gastric cancer: A systematic review, and meta-analysis

IF 2.8 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research Pub Date : 2024-11-22 DOI:10.1016/j.imr.2024.101098

Dong-Hyeon Kim , Soo-Dam Kim , Hyeong-Joon Jun , Eun-Bin Kwag , Sang-Won Shin , Hwa-Seung Yoo , So-Jung Park

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引用次数: 0

Abstract

Background

Advanced gastric cancer (AGC) is a leading cause of cancer-related deaths worldwide, with its treatment complicated by challenges such as high recurrence rates, severe side effects, and limited effectiveness of current therapies. Herbal medicine (HM) has emerged as an adjunct to palliative chemotherapy (PC), potentially improving tumor response and reducing side effects. This study conducted a meta-analysis to evaluate the effectiveness and safety of HM in palliative therapy for inoperable stage Ⅲ and Ⅳ AGC patients.

Methods

Databases were searched until August 2023, encompassing 10 electronic databases, including PubMed, Embase, Cochrane Library, CNKI, and ScienceON. The inclusion criteria focused on randomized controlled trials (RCTs) combining herbal medicine with palliative therapy for patients with AGC. Primary outcomes assessed were tumor response rates, overall survival, adverse drug reactions (ADRs), and patients' quality of life (QoL).

Results

In our analysis of 101 RCTs comparing PC alone to PC combined with HM, the meta-analysis demonstrated statistically significant improvements in overall response rate (ORR), disease control rate (DCR), survival rates, as well as a reduction in adverse drug reactions (ADRs) and an enhancement in quality of life (QoL) for patients receiving HM in combination with PC (p < 0.00001, I² = 0 %).

Conclusion

The combination of HM with PC significantly enhances tumor response and survival rates while reducing overall adverse drug reactions (ADRs) and improving quality of life (QoL) in patients with stage Ⅲ and Ⅳ AGC. HMs not only improve the efficacy of PC but also help alleviate side effects, including myelosuppression, digestive symptoms, nausea, vomiting, diarrhea, liver and renal injuries, and neurotoxicity.

Protocol registration: PROSPERO, CRD 42022354133.

查看原文本刊更多论文

中草药和姑息性化疗联合治疗晚期胃癌的有效性和安全性：一项系统综述和荟萃分析

晚期胃癌（AGC）是全球癌症相关死亡的主要原因之一，其治疗面临着诸如高复发率、严重副作用和现有治疗方法有效性有限等挑战。草药（HM）已成为姑息性化疗（PC）的辅助手段，可能改善肿瘤反应并减少副作用。本研究进行了一项荟萃分析，以评估HM在不能手术期Ⅲ和ⅣAGC患者姑息治疗中的有效性和安全性。方法检索数据库至2023年8月，包括PubMed、Embase、Cochrane Library、中国知网、ScienceON等10个电子数据库。纳入标准侧重于随机对照试验（rct），将草药与姑息治疗相结合用于AGC患者。评估的主要结局是肿瘤缓解率、总生存期、药物不良反应（adr）和患者生活质量（QoL）。结果我们对101项rct进行了分析，比较了PC与PC联合HM，荟萃分析显示，HM联合PC患者在总缓解率（ORR）、疾病控制率（DCR）、生存率、药物不良反应（adr）减少和生活质量（QoL）提高方面具有统计学意义(p <；0.00001, i²= 0 %)。结论HM联合PC可显著提高Ⅲ期和Ⅳ期AGC患者的肿瘤应答率和生存率，降低总药物不良反应（adr），改善生活质量（QoL）。HMs不仅提高了PC的疗效，而且还有助于减轻副作用，包括骨髓抑制、消化症状、恶心、呕吐、腹泻、肝肾损伤和神经毒性。协议注册：PROSPERO， CRD 42022354133。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Integrative Medicine Research Medicine-Complementary and Alternative Medicine

CiteScore

6.50

自引率

2.90%

发文量

审稿时长

12 weeks

期刊介绍： Integrative Medicine Research (IMR) is a quarterly, peer-reviewed journal focused on scientific research for integrative medicine including traditional medicine (emphasis on acupuncture and herbal medicine), complementary and alternative medicine, and systems medicine. The journal includes papers on basic research, clinical research, methodology, theory, computational analysis and modelling, topical reviews, medical history, education and policy based on physiology, pathology, diagnosis and the systems approach in the field of integrative medicine.