The efficacy of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer: a systematic review and meta-analysis.

Monday, 03/06/2013  |   Uncategorized  |  no comments

Herbs frequently used for non-small cell lung cancer.

Chinese herbal medicine Frequency

Count %

Radix Astragalus 10 52.6
Radix Adenophoraeabc 8 42.1
Radix Ophiopogonisabc 7 36.8
Radix Glycyrrhizaeabc 5 26.3
Poriaabc 5 26.3
Herba Oldenlandia Diffusaabc 5 26.3
Radix Asparagiabc 4 21.1
Semen Persicaeabc 4 21.1
Radix Notoginseng 4 21.1

Many published studies reflect the growing application of complementary and alternative medicine, particularly Chinese herbal medicine (CHM) use in combination with conventional cancer therapy for advanced non-small cell lung cancer (NSCLC), but its efficacy remains largely unexplored. The purpose of this study is to evaluate the efficacy of CHM combined with conventional chemotherapy (CT) in the treatment of advanced NSCLC.
Publications in 11 electronic databases were extensively searched, and 24 trials were included for analysis. A sum of 2,109 patients was enrolled in these studies, at which 1,064 patients participated in CT combined CHM and 1,039 in CT (six patients dropped out and were not reported the group enrolled). Compared to using CT alone, CHM combined with CT significantly increase one-year survival rate (RR?=?1.36, 95% CI?=?1.15-1.60, p?=?0.0003). Besides, the combined therapy significantly increased immediate tumor response (RR?=?1.36, 95% CI?=?1.19-1.56, p<1.0E-5) and improved Karnofsky performance score (KPS) (RR?=?2.90, 95% CI?=?1.62-5.18, p?=?0.0003).
Combined therapy remarkably reduced the nausea and vomiting at toxicity grade of III-IV (RR?=?0.24, 95% CI?=?0.12-0.50, p?=?0.0001) and prevented the decline of hemoglobin and platelet in patients under CT at toxicity grade of I-IV (RR?=?0.64, 95% CI?=?0.51-0.80, p<0.0001). Moreover, the herbs that are frequently used in NSCLC patients were identified. This systematic review suggests that CHM as an adjuvant therapy can reduce CT toxicity, prolong survival rate, enhance immediate tumor response, and improve KPS in advanced NSCLC patients. However, due to the lack of large-scale randomized clinical trials in the included studies, further larger scale trials are needed.
In conclusion, the evidence from the meta-analysis of the included studies shows that CHM as adjuvant therapy has advantages in NSCLC patients. However, due to the complex nature of CHM interventions, particular attention should be paid to apply appropriate and rigorous research methodologies to investigate CHM as a holistic system (Flower et al, 2012). Therefore a large scale RCT integrated the Chinese Medicine methodology of pattern diagnosis and treatment is warranted for further study.
Flower A, Witt C, Liu JP, Ulrich-Merzenich G, Yu H, et al. (2012) Guidelines for randomised controlled trials investigating Chinese herbal medicine. J Ethnopharmacol 140: 550–554.
Li SG, Chen HY, Ou-Yang CS, Wang XX, Yang ZJ, Tong Y, Cho WC. PLoS One. 2013;8(2):e57604. doi: 10.1371/journal.pone.0057604. Epub 2013 Feb 28.

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