title: Oral Chinese herbal medicine (CHM) as an adjuvant treatment during chemotherapy for non-small cell lung cancer: A systematic review.
abstract: BACKGROUND
  Non-small cell lung cancer (NSCLC) remains a major global health problem because of its prevalence and poor prognosis. Treatment options are limited and there is a need to explore alternatives. This systematic review evaluates the role of Chinese herbal medicine (CHM) in association with chemotherapy for NSCLC.
  
  
  METHODS
  English and Chinese databases were searched for RCTs comparing CHM with conventional biomedical treatment or placebo. Papers were reviewed systematically and data were analysed using standard Cochrane software Revman 5.
  
  
  RESULTS
  Fifteen Chinese trials involving 862 participants met the inclusion criteria. All trials were of poor quality with a considerable risk of bias. There was a significant improvement in quality of life (QoL) (increased Karnofsky Performance Status) (RR 1.83, 95% CI 1.41-2.38, p<0.00001 for both stages III, IV only NSCLC and all stages NSCLC) and less anaemia (RR 0.37, 95% CI 0.15-0.91, p=0.03 for stages III, IV only NSCLC; p=0.005 for all stages NSCLC) and neutropenia (RR 0.42, 95% CI 0.22-0.82, p=0.01 for stages III, IV only NSCLC; p<0.00001 for all stages NSCLC) when CHM is combined with chemotherapy compared to chemotherapy alone. There was no significant difference in short term effectiveness and limited inconclusive data concerning long term survival. Five promising herbs have been identified.
  
  
  CONCLUSIONS
  It is possible that oral CHM used in conjunction with chemotherapy may improve QoL in NSCLC. This needs to be examined further with more rigorous methodology.
authors.affiliation: School of Medicine, University of Southampton, Southampton, UK.
authors.forename: Sisi
authors.initials: S
authors.lastname: Chen
authors.forename: Andrew
authors.initials: A
authors.lastname: Flower
authors.forename: Andrew
authors.initials: A
authors.lastname: Ritchie
authors.forename: Jianping
authors.initials: J
authors.lastname: Liu
authors.forename: Alex
authors.initials: A
authors.lastname: Molassiotis
authors.forename: He
authors.initials: H
authors.lastname: Yu
authors.forename: George
authors.initials: G
authors.lastname: Lewith
mesh_terms: D000284:Administration, Oral; D000740:Anemia / Q000209:etiology / Q000517:prevention & control; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D064420:Drug-Related Side Effects and Adverse Reactions; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D009367:Neoplasm Staging; D009503:Neutropenia / Q000209:etiology / Q000517:prevention & control; D011788:Quality of Life
chemical_list: D004365:Drugs, Chinese Herbal