背景:含人参的传统药物制剂(G-TMPs)与基于氟嘧啶的化疗(FBC)联合使用是晚期胃癌(AGC)的众所周知的治疗方法,具有优于单独FBC的疗效。然而,关于其疗效的证据仍然有限。这项荟萃分析的目的是评估G-TMPs联合FBC治疗AGC的有效性和安全性。
方法:在八个电子数据库中搜索使用G-TMPs和FBC治疗AGC的随机对照试验(RCT)。主要结果包括肿瘤反应,次要结局包括生活质量(QoL),外周血淋巴细胞的比例,药物不良反应(ADR),和癌症生物标志物的水平。使用GRADE分析器评估每个结果的证据质量。
结果:共有1,960名参与者参与了纳入的26项RCT。与单独使用FBC治疗的患者相比,使用FBC加G-TMPs治疗的患者具有更好的客观反应(风险比[RR]=1.23,95%置信区间[CI]:1.13至1.35,p<0.00001)和疾病控制率(RR=1.13,95%CI:1.08至1.19,p<0.00001)。此外,组合组有更好的QoL,CD3+T细胞的比例更高,CD4+T细胞,和自然杀伤细胞,以及更高的CD4+/CD8+T细胞比率。此外,在联合治疗组中证实了较低水平的CA19-9,CA72-4和CEA.此外,G-TMPs可降低化疗期间不良反应的发生率。
结论:与FBC结合使用,G-TMPs可以潜在地增强疗效,减少ADR,改善AGC患者的预后。然而,高质量的随机研究仍有必要.
背景:PROSPERO编号:CRD42021264938。
Ginseng-containing traditional medicine preparations (G-TMPs) in combination with fluoropyrimidine-based chemotherapy (FBC) are well-known treatments for advanced gastric cancer (AGC), with a superior efficacy to FBC alone. However, evidence regarding their efficacy remains limited. The purpose of this meta-analysis is to evaluate the efficacy and safety of G-TMPs in combination with FBC for the treatment of AGC.
Eight electronic databases were searched for randomized controlled trials (RCTs) using G-TMPs with FBC for the treatment of AGC. The primary outcome included the tumor response, while the secondary outcomes included the quality of life (QoL), proportions of peripheral blood lymphocytes, adverse drug reactions (ADRs), and levels of cancer biomarkers. The quality of evidence for each outcome was assessed using GRADE profilers.
A total of 1,960 participants were involved in the 26 RCTs included. Patients treated with FBC plus G-TMPs had better objective response (risk ratio [RR] = 1.23, 95% confidence interval [CI]: 1.13 to 1.35, p < 0.00001) and disease control (RR = 1.13, 95% CI: 1.08 to 1.19, p < 0.00001) rates than those treated with FBC alone. Additionally, the combination group had a better QoL, higher proportions of CD3+ T cells, CD4+ T cells, and natural killer cells, as well as a higher CD4+/CD8+ T-cell ratio. Furthermore, lower levels of CA19-9, CA72-4, and CEA were confirmed in the combination treatment group. In addition, G-TMPs reduced the incidence of ADRs during chemotherapy.
In combination with FBC, G-TMPs can potentially enhance efficacy, reduce ADRs, and improve prognosis for patients with AGC. However, high-quality randomized studies remain warranted.
PROSPERO Number: CRD42021264938.