title: WITHDRAWN: Chinese herbal medicines for induction of remission in advanced or late gastric cancer.
abstract: BACKGROUND
  Gastric cancer is difficult to cure once it progresses into an advanced or late stage. Although some chemotherapies or bio-therapies have made progress in the remission of this disease, mortality remains high. A variety of Chinese medicinal herbs have been used to treat gastric cancer.
  
  
  OBJECTIVE
  To assess the effectiveness of Chinese medicinal herbs in the short term remission of advanced or late gastric cancer.
  
  
  METHODS
  We searched the Cochrane Library, MEDLINE, EMBASE, AHMED (Allied and Complementary Medicine Database) and CBM (Chinese Biomedical Database) from the first year of the databases to May, 2008. We handsearched a number of journals.
  
  
  METHODS
  All randomised clinical trials of Chinese herbs for advanced or late gastric cancer were included.
  
  
  METHODS
  Two authors independently extracted the data, which were analysed by RevMan 5.0 software. For dichotomous data, we estimated the relative risk. For continuous data, we calculated the weighted mean difference.
  
  
  RESULTS
  Fifty-five qualified trials with 5261 advanced or late gastric cancer patients were identified, most of which were of low quality and used TCMHs plus chemotherapy compared with the same chemotherapy alone (41 trials). Except for four trials of Huachansu, we could not pool the results because no more than two used the same intervention or outcomes. TCMHs combined with or without chemotherapy in the 51 trials showed statistically significant difference for the improvement of mortality in six trials, quality of life in 13 trials, rate of remission in ten trials, discontinuation from treatment in three trials, leukopenia in one trial, vomiting/nausea in one trial. The pooled results from the four trials of Huachansu showed statistically significant difference for the improvement of leukopenia, but no significant difference for the improvement of adverse events in the digestive system or rate of short-term remission.
  
  
  CONCLUSIONS
  This review did not provide assured evidence concerning the effectiveness of TCMHs in improving the quality of life or rate of remission, alleviating the toxic and side effects caused by the chemotherapy, or reducing short-term mortality. Limited and weak evidence showed that Huachansu, when used together with chemotherapy, improved leukopenia caused by chemotherapy, but did not improve rate of short-term remission. Large, well designed clinical trials are required urgently before any confident conclusions can be drawn about the value of TCMHs for advanced or late gastric cancer.
authors.affiliation: Department of Gastroenterology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, China, 610041.
authors.forename: Tao
authors.initials: T
authors.lastname: Gan
authors.forename: Zongying
authors.initials: Z
authors.lastname: Wu
authors.forename: Ling
authors.initials: L
authors.lastname: Tian
authors.forename: Yiping
authors.initials: Y
authors.lastname: Wang
mesh_terms: D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006801:Humans; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction / Q000379:methods; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology
chemical_list: D004365:Drugs, Chinese Herbal