Comparative efficacy of Chinese herbal injections for treating endometrial carcinoma: A Bayesian network meta-analysis

BACKGROUND: In view of the limitations of chemotherapy (CT) for endometrial carcinoma (EC) and the extensive use of Chinese herbal injections (CHIs), this network meta-analysis (NMA) compared the efficacy and safety of 6 CHIs combined with CT for EC. METHODS: Several electronic databases were searched for randomized controlled trials (RCTs). The retrieval period was from the establishment of the databases to September 18, 2022. The quality of the literature was assessed after data extraction using Review Manager version 5.4. The Stata 13.1 and OpenBUGS3.2.3 software were used for data analysis. Cluster analysis was performed to compare the effect of CHIs between 2 different outcomes. RESULTS: A total of 25 RCTs with 2023 patients were included. The findings demonstrated that when combined with CT, Aidi, Compound Kushen, Kangai, Eshuyou injection, and Shenmai injection can increase clinical efficacy compared to chemotherapy alone. The KPS level can be raised with aidi injection. Combining CT with injections of Aidi, Shenmai, Huangqi, and Compound Kushen can improve immunological performance. Combining CT with injections of Aidi, Huangqi, and Compound Kushen can lower serum amounts of tumor markers. Kangai injection was regarded as a good option for minimizing negative responses. According to the cluster analysis, the clinical effective rate, the KPS score, the level of CA125, and the clinical effective rate of Kangai injection and Aidi injection combined with CT were all better. CONCLUSION: Current evidence revealed that CHIs combined with CT have a better impact on patients with EC than CT alone. It’s possible that KangAi, Aidi, and Eshuyou infusion are the best CHIs for EC. Additionally, more high-quality RCTs are required in order to further corroborate the findings due to NMA’s limitations.