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Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis
BACKGROUND: Chinese herbal injections (CHIs) have been proven beneficial to patients with gastric cancer for improving clinical efficacy and relieving adverse reactions (ADRs) of chemotherapy. A network meta-analysis (NMA) was conducted in this study to assess the comparative efficacy and safety of...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Impact Journals LLC
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5620304/ https://www.ncbi.nlm.nih.gov/pubmed/28978164 http://dx.doi.org/10.18632/oncotarget.20320 |
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author | Zhang, Dan Zheng, Jiewen Ni, Mengwei Wu, Jiarui Wang, Kuaihuan Duan, Xiaojiao Zhang, Xiaomeng Zhang, Bing |
author_facet | Zhang, Dan Zheng, Jiewen Ni, Mengwei Wu, Jiarui Wang, Kuaihuan Duan, Xiaojiao Zhang, Xiaomeng Zhang, Bing |
author_sort | Zhang, Dan |
collection | PubMed |
description | BACKGROUND: Chinese herbal injections (CHIs) have been proven beneficial to patients with gastric cancer for improving clinical efficacy and relieving adverse reactions (ADRs) of chemotherapy. A network meta-analysis (NMA) was conducted in this study to assess the comparative efficacy and safety of CHIs combined with FOLFOX regimen for treating gastric cancer. RESULTS: A total of 2316 records were searched, and 81 eligible RCTs involving 15 types of CHIs and 5978 patients were included in the NMA. The results showed that patients who received Shengqifuzheng+ FOLFOX, Compound kushen+ FOLFOX, Huachansu+ FOLFOX, Astragalus+ FOLFOX, Kangai+ FOLFOX, and Lentinan injection + FOLFOX could significantly improve clinical efficacy than using FOLFOX single, and their odds ratios (OR) and 95% confidence intervals (CI)s were 1.57 (1.19,2.09), 2.12 (1.62,2.78),1.72 (1.08,2.80), 3.06 (1.01,8.99), 2.01 (1.52,2.70), and 1.99 (1.20,3.38) respectively. Furthermore, the therapy of Aidi+ FOLFOX, Shenqifuzheng+ FOLFOX, Compound Kushen+ FOLFOX, Huachansu+ FOLFOX, Astragalus polysaccharides+ FOLFOX, Kangai+ FOLFOX, Ginseng polysaccharide+ FOLFOX, Lentinan+ FOLFOX, Xiaoaiping+ FOLFOX, and Shenmai injection + FOLFOX could also achieve a higher performance status compared with FOLFOX regimen alone. Similarly, patients who received CHIs combine with FOLFOX regimen were associated with a significantly decrease the incidence of leucopenia, gastrointestinal reaction and hepatic dysfunction. Cluster analysis demonstrated that Astragalus polysaccharides+ FOLFOX, and Kangai+ FOLFOX seemed optimal therapies in improving clinical efficacy and performance status; Astragalus polysaccharides+ FOLFOX was superior in reducing leucopenia and gastrointestinal reaction; Disodium Cantharidinate and Vitamin B6+ FOLFOX was associated with favorable effects in reducing gastrointestinal reaction and hepatic dysfunction. By contrary, receiving FOLFOX regimen single was proved to rank the worst for these outcomes. MATERIALS AND METHODS: A comprehensive literature search was performed in several electronic databases to identify randomized controlled trial (RCTs) regarding CHIs for gastric cancer until January 10, 2017. The quality assessment was accomplished according to the Cochrane risk of bias tool and the methodological section of the CONSORT statement. And a random-effects model NMA was utilized to compare different CHIs combined with FOLFOX regimen with regard to efficacy and safety. Data were analyzed using STATA 12.0 and Win-BUGS 1.4 software. CONCLUSIONS: The results of this NMA suggested that among 15 types of CHIs, Astragalus polysaccharides injection combined with FOLFOX regimen seemed optimal for patients with gastric cancer in improving clinical efficacy and performance status, and relieving ADRs. However, our findings should be confirmed by more prospectively designed, large-sample and multi-center RCTs. |
format | Online Article Text |
id | pubmed-5620304 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Impact Journals LLC |
record_format | MEDLINE/PubMed |
spelling | pubmed-56203042017-10-03 Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis Zhang, Dan Zheng, Jiewen Ni, Mengwei Wu, Jiarui Wang, Kuaihuan Duan, Xiaojiao Zhang, Xiaomeng Zhang, Bing Oncotarget Meta-Analysis BACKGROUND: Chinese herbal injections (CHIs) have been proven beneficial to patients with gastric cancer for improving clinical efficacy and relieving adverse reactions (ADRs) of chemotherapy. A network meta-analysis (NMA) was conducted in this study to assess the comparative efficacy and safety of CHIs combined with FOLFOX regimen for treating gastric cancer. RESULTS: A total of 2316 records were searched, and 81 eligible RCTs involving 15 types of CHIs and 5978 patients were included in the NMA. The results showed that patients who received Shengqifuzheng+ FOLFOX, Compound kushen+ FOLFOX, Huachansu+ FOLFOX, Astragalus+ FOLFOX, Kangai+ FOLFOX, and Lentinan injection + FOLFOX could significantly improve clinical efficacy than using FOLFOX single, and their odds ratios (OR) and 95% confidence intervals (CI)s were 1.57 (1.19,2.09), 2.12 (1.62,2.78),1.72 (1.08,2.80), 3.06 (1.01,8.99), 2.01 (1.52,2.70), and 1.99 (1.20,3.38) respectively. Furthermore, the therapy of Aidi+ FOLFOX, Shenqifuzheng+ FOLFOX, Compound Kushen+ FOLFOX, Huachansu+ FOLFOX, Astragalus polysaccharides+ FOLFOX, Kangai+ FOLFOX, Ginseng polysaccharide+ FOLFOX, Lentinan+ FOLFOX, Xiaoaiping+ FOLFOX, and Shenmai injection + FOLFOX could also achieve a higher performance status compared with FOLFOX regimen alone. Similarly, patients who received CHIs combine with FOLFOX regimen were associated with a significantly decrease the incidence of leucopenia, gastrointestinal reaction and hepatic dysfunction. Cluster analysis demonstrated that Astragalus polysaccharides+ FOLFOX, and Kangai+ FOLFOX seemed optimal therapies in improving clinical efficacy and performance status; Astragalus polysaccharides+ FOLFOX was superior in reducing leucopenia and gastrointestinal reaction; Disodium Cantharidinate and Vitamin B6+ FOLFOX was associated with favorable effects in reducing gastrointestinal reaction and hepatic dysfunction. By contrary, receiving FOLFOX regimen single was proved to rank the worst for these outcomes. MATERIALS AND METHODS: A comprehensive literature search was performed in several electronic databases to identify randomized controlled trial (RCTs) regarding CHIs for gastric cancer until January 10, 2017. The quality assessment was accomplished according to the Cochrane risk of bias tool and the methodological section of the CONSORT statement. And a random-effects model NMA was utilized to compare different CHIs combined with FOLFOX regimen with regard to efficacy and safety. Data were analyzed using STATA 12.0 and Win-BUGS 1.4 software. CONCLUSIONS: The results of this NMA suggested that among 15 types of CHIs, Astragalus polysaccharides injection combined with FOLFOX regimen seemed optimal for patients with gastric cancer in improving clinical efficacy and performance status, and relieving ADRs. However, our findings should be confirmed by more prospectively designed, large-sample and multi-center RCTs. Impact Journals LLC 2017-08-18 /pmc/articles/PMC5620304/ /pubmed/28978164 http://dx.doi.org/10.18632/oncotarget.20320 Text en Copyright: © 2017 Zhang et al. http://creativecommons.org/licenses/by/3.0/ This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/) (CC-BY), which permits unrestricted use and redistribution provided that the original author and source are credited. |
spellingShingle | Meta-Analysis Zhang, Dan Zheng, Jiewen Ni, Mengwei Wu, Jiarui Wang, Kuaihuan Duan, Xiaojiao Zhang, Xiaomeng Zhang, Bing Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis |
title | Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis |
title_full | Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis |
title_fullStr | Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis |
title_full_unstemmed | Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis |
title_short | Comparative efficacy and safety of Chinese herbal injections combined with the FOLFOX regimen for treating gastric cancer in China: a network meta-analysis |
title_sort | comparative efficacy and safety of chinese herbal injections combined with the folfox regimen for treating gastric cancer in china: a network meta-analysis |
topic | Meta-Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5620304/ https://www.ncbi.nlm.nih.gov/pubmed/28978164 http://dx.doi.org/10.18632/oncotarget.20320 |
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