FOLFOX 4 Combined with Herbal Medicine for Advanced Colorectal Cancer: A Systematic Review

被引:50
作者
Chen, Menghua [1 ,2 ]
May, Brian H. [1 ,2 ]
Zhou, Iris W. [1 ,2 ]
Xue, Charlie C. L. [1 ,2 ,3 ,4 ]
Zhang, Anthony L. [1 ,2 ]
机构
[1] RMIT Univ, Sch Hlth Sci, Bundoora, Vic 3083, Australia
[2] RMIT Univ, Tradit & Complementary Med Res Program, Hlth Innovat Res Inst, Bundoora, Vic 3083, Australia
[3] Guangdong Prov Acad Chinese Med Sci, Guangzhou, Guangdong, Peoples R China
[4] Guangdong Prov Hosp Chinese Med, Guangzhou, Guangdong, Peoples R China
关键词
colorectal cancer; FOLFOX; herbal medicine; tumor response; quality of life; meta-analysis; FLUOROURACIL PLUS LEUCOVORIN; RANDOMIZED CONTROLLED-TRIAL; PRENEOPLASTIC LESIONS; ETHANOLIC EXTRACT; 1ST-LINE THERAPY; PALLIATIVE CARE; CHINESE HERBS; ADLAY BRAN; IN-VITRO; KAPPA-B;
D O I
10.1002/ptr.5092
中图分类号
R914 [药物化学];
学科分类号
100705 [微生物与生化药学];
摘要
This systematic review evaluates the clinical evidence for the addition of herbal medicines (HMs) to FOLFOX 4 for advanced colorectal cancer (ACRC) in terms of tumor response rate (tRR), survival, quality of life and reduction in adverse events (AEs). Seven electronic databases were searched for randomized controlled trials (RCTs) of FOLFOX4 combined with HMs compared to FOLFOX4 alone. Outcome data for 13 randomized controlled trials were analysed using Review Manager 5.1. Risk of bias for objective outcomes including tumor response and survival was judged as low. Publication bias was not evident. Meta-analyses found the addition of HMs improved tRR (RR 1.25, 95% CI 1.06-1.47, I-2 = 0%), one year survival (RR 1.51, 95% CI 1.19-1.90, I-2 = 0%) and quality of life in terms of Karnofsky Performance Status (KPS) gained (RR 1.84, 95% CI 1.54-2.19, I-2 = 0%); alleviated grade 3 and 4 chemotherapy-related AEs for neutropenia (RR 0.33, 95% CI 0.18-0.60, I-2 = 0%), nausea and vomiting (RR 0.34, 95% CI 0.17-0.67, I-2 = 0%) and neurotoxicity (RR 0.39, 95% CI 0.15-1.00, I-2 = 0%), compared to FOLFOX4 alone. The most frequently used herbs were Astragalus membranaceus, Panax ginseng, Atractylodes macrocephala, Poria cocos, Coix lachryma-jobi and Sophora flavescens. In experimental studies, each of these herbs has shown actions that could have contributed to improved tumor response. Copyright (C) 2013 John Wiley & Sons, Ltd.
引用
收藏
页码:976 / 991
页数:16
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