title: The efficacy of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer: a systematic review and meta-analysis.
abstract: 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.
authors.affiliation: Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China.
authors.forename: Shi Guang
authors.initials: SG
authors.lastname: Li
authors.forename: Hai Yong
authors.initials: HY
authors.lastname: Chen
authors.forename: Chen Sheng
authors.initials: CS
authors.lastname: Ou-Yang
authors.forename: Xi-Xin
authors.initials: XX
authors.lastname: Wang
authors.forename: Zhen-Jiang
authors.initials: ZJ
authors.lastname: Yang
authors.forename: Yao
authors.initials: Y
authors.lastname: Tong
authors.forename: William C S
authors.initials: WC
authors.lastname: Cho
mesh_terms: D000277:Adjuvants, Pharmaceutic / Q000494:pharmacology*; D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology*; D004365:Drugs, Chinese Herbal / Q000494:pharmacology*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000277:Adjuvants, Pharmaceutic; D000970:Antineoplastic Agents; D004365:Drugs, Chinese Herbal