Effect of traditional Chinese medicine combined with Western therapy on primary hepatic carcinoma: a systematic review with meta-analysis

doi:10.1007/s11684-017-0512-0

Front. Med.

2017, Vol. 11

Issue (2) : 191-202 https://doi.org/10.1007/s11684-017-0512-0

REVIEW

Effect of traditional Chinese medicine combined with Western therapy on primary hepatic carcinoma: a systematic review with meta-analysis

Li Ma¹, Bin Wang¹, Yuanxiong Long¹, Hanmin Li²(

)

¹. Hubei University of Chinese Medicine, Wuhan 430065, China
². Hepatopathy Institute, Affiliated Hospital of Hubei University of Chinese Medicine (Chinese Medicine Hospital in Hubei Province), Wuhan 430061, China

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Abstract

Primary hepatic carcinoma (PHC) is a common malignant tumor in China. Cancer is comprehensively treated with various therapeutic regimes, including traditional Chinese medicine (TCM). TCM has been widely used to improve the quality of life, delay the time of cancer progression, and prolong the median survival time. This systematic review with meta-analysis aimed to assess the effect of TCM combined with Western therapy on primary hepatic carcinoma. A comprehensive literature search was conducted in six databases, including CNKI, VIP, Wan-Fang Database, CBM, PubMed, and Cochrane library. A total of 44 randomized controlled trials (RCTs) involving 3429 participants suffering from PHC were selected. Meta-analysis results indicated that the overall effect of TCM and Western integrative treatment on PHC was higher than that of Western intervention alone, which can postpone tumor recurrence and metastasis and prolong the overall survival time of patients with PHC. Although the obtained evidence remained weak because of the poor methodological quality of the included studies, this review provided relevant data supporting the efficacy and safety of TCM combined with Western therapies. In future research, individual RCT studies should incorporate accepted standards for trial design and reporting, proper outcome indicators according to international standards, blinding in allocation concealment, and valid follow-up periods.

Keywords traditional Chinese medicine primary hepatic carcinoma meta-analysis

Corresponding Author(s): Hanmin Li

Just Accepted Date: 21 February 2017 Online First Date: 27 March 2017 Issue Date: 01 June 2017

Cite this article:

Li Ma,Bin Wang,Yuanxiong Long, et al. Effect of traditional Chinese medicine combined with Western therapy on primary hepatic carcinoma: a systematic review with meta-analysis[J]. Front. Med., 2017, 11(2): 191-202.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0512-0
https://academic.hep.com.cn/fmd/EN/Y2017/V11/I2/191

Fig.1 Flow diagram of study inclusion and exclusion.

Studies	Treatment measures	Sample size	Outcomes	Average age	Clinical stages	Treatment duration
Studies	Experimental group	Control group	Outcomes	(E/C)	Clinical stages	Treatment duration	(E/C)
Wang et al., 2009 []	Chemotherapy plus CHM formula	Chemotherapy	40/37	C, D	51.67/52.4	Mid-late	4-6 weeks
Yan et al., 2007 []	Oral medication plus CHM formula	Oral medication	87/42	B	52.3/51.5	Mid-late	1 month
Cui, 2013 []	Chemotherapy plus CHM formula	Chemotherapy	39/39	A, D	51.2/53.1	Mid	8 weeks
Hanet al., 2009 []	Oral medication plus CHM formula	Oral medication	24/24	A, B	-	Mid-late	3-4 months
Tian et al., 2009 []	Oral medication plus Aidi injection and CHM formula	Oral medication	30/30	C, D	60.4/61.2	Late	3 months
Lin, 2012 []	Chemotherapy plus CHM formula	Chemotherapy	80/80	A, C	-	Late	2 months
Liu et al., 2005 []	Chemotherapy plus CHM formula	Chemotherapy	33/33	A, B, D	58.15/57.61	Mid-late	1 month
Chen et al., 2009 []	Chemotherapy plus Xiaoaiping injection	Chemotherapy	56/43	A, D	-	Mid-late	2-3 weeks
Zhou, 2010 []	Oral medication plus Cinobufotalin injection	Oral medication	29/29	A, C	-	Mid-late	20 days
Bai et al., 2012 []	Radiotherapy plus Kangai injection	Radiotherapy	25/25	A, D	-	Mid-late	6 months
Lin et al., 2009 []	Radiotherapy plus Kangai injection	Radiotherapy	42/40	A, D	50.6/49.3	Mid-late	4 weeks
Deng et al., 2004 []	Radiotherapy plus CHM formula	Radiotherapy	56/39	C	-	Mid-late	1 month
Pang et al., 2012 []	Radiotherapy plus CHM formula	Radiotherapy	48/52	A, C, D	-	Mid-late	2?3 months
Xiang, 2009 []	Surgery plus CHM formula	Surgery	40/40	A	59.38/50.56	Mid-late	3 month
Chen et al., 2005 []	Surgery plus CHM formula	Surgery	30/30	C	48/49	Mid-late	1 month
Chen et al., 2012 []	Surgery plus Cinobufotalin injection	Surgery	127/82	C	51.35/47.98	Early-mid	3-6 months
Chen et al., 2005 []	Surgery plus CHM formula	Surgery	42/30	C	-	Mid-late	2 years
Lin et al., 2005 []	TACE plus CHM formula	TACE	25/25	C	-	Mid-late	2 months
Zheng et al., 2010 []	TACE plus CHM formula	TACE	30/31	A	46.2/45.2	Mid-late	1 month
Gu, 2011 []	TACE plus CHM formula	TACE	32/32	A, C	46.8/47.4	Mid-late	2 months
Lin, 2008 []	TACE plus CHM formula	TACE	58/58	A, B	56.5/57.6	Mid-late	2 months
Zhang et al., 2012 []	TACE plus CHM formula	TACE	43/40	A, C, D	46.9/45.8	Mid-late	2 courses
Zeng et al., 2011 []	TACE plus CHM formula	TACE	37/30	A, B, D	53.6/54.5	Mid-late	2 months
Di et al., 2010 []	TACE plus CHM formula	TACE	32/30	A, B, C, D	54.6/56.1	Mid-late	4 months
Lu et al., 2011 []	TACE plus CHM formula	TACE	34/32	B	55/56	Mid-late	3 months
Chi et al., 2010 []	TACE plus CHM formula	TACE	60/60	A, B, C	-	Mid-late	2 months
Li et al., 2011 []	TACE plus CHM formula	TACE	38/36	A, B, C	54.1/52.7	Mid-late	2 months
Zhang et al., 2008 []	TACE plus CHM formula	TACE	31/30	A, C	51.3/49.1	Mid-late	2 months
Yang et al., 2011 []	TACE plus Aidi injection	TACE	30/30	B, C	49.8/49	Mid-late	1 month
Yang, 2008 []	TACE plus Aidi injection	TACE	20/20	A, B	-	Late	2-3months
Zhang et al., 2009 []	TACE plus CHM formula	TACE	52/51	C	48/46	Mid-late	4 weeks
Ling, 2010 []	TACE plus CHM formula	TACE	64/64	A, B	-	Mid-late	2-3 months
Rong et al., 2013 []	TACE plus CHM formula	TACE	30/30	A	-	Mid-late	1-2 months
Jiang et al., 2012 []	TACE plus CHM formula	TACE	43/40	A, C	46.9/45.8	Mid-late	2 months
Tang et al., 2014 []	Oral medication plus CHM formula	Oral medication	31/30	A, C	49.21/48.64	Mid-late	2 months
Zhang, 2014 []	Radiotherapy plus CHM formula	Radiotherapy	32/31	A, C, D	55.3/54.8	Mid-late	3 months
Tan, 2014 []	TACE plus CHM formula	TACE	34/34	A	52.9/51.29	Mid-late	3 months
Shang et al., 2014 []	TACE plus CHM formula	TACE	30/29	A	-	Mid-late	1 month
Qiao et al., 2014 []	TACE plus CHM formula	TACE	40/38	A	50.32/50.28	Mid-late	6 weeks
Li, 2014 []	TACE plus CHM formula	TACE	39/39	B	56.3/54.8	Mid-late	-
Qin, 2014 []	TACE plus CHM formula	TACE	40/40	A	63.5/61.5	Mid-late	-
Tang, 2014 []	Oral medication plus CHM formula	Oral medication	30/30	A	59.1/61.3	Mid-late	4 weeks
Wang, 2014 []	Oral medication plus CHM formula	Oral medication	30/30	B	46.9/47.1	Mid-late	3 months
Wang et al., 2014 []	TACE plus CHM formula	TACE	38/22	B	53.5/52.1	Mid-late	4?6 weeks

Tab.1 Characteristics of included studies

Fig.2 Forest plot with a combined result of meta-analysis for odds ratio (OR) of short-term clinical efficacy.

Fig.3 Forest plot with a combined result of meta-analysis for odds ratio (OR) of the quality of life.

Fig.4 Forest plot with a combined result of meta-analysis for odds ratio (OR) of adverse effect.

Fig.5 Funnel plot of short-term clinical efficacy.

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