scholarly journals Add-On Therapy with Traditional Chinese Medicine Improves Outcomes and Reduces Adverse Events in Hepatocellular Carcinoma: A Meta-Analysis of Randomized Controlled Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-13 ◽  
Author(s):  
Zongguo Yang ◽  
Xian Liao ◽  
Yunfei Lu ◽  
Qingnian Xu ◽  
Bozong Tang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Improvement Rate ◽  
Randomized Controlled

Background and Aims. Traditional Chinese medicine (TCM) therapy for hepatocellular carcinoma remains controversial. This study aimed to evaluate the efficacy and safety of TCM regimens in HCC treatment. Methods. Randomized controlled trials (RCTs) up to June 1, 2016, of the TCM treatment for hepatocellular carcinoma were systematically identified in PubMed, CNKI, Ovid, Embase, Web of Science, Wanfang, VIP, CBM, AMED, and Cochrane Library databases. Results. A total of 1010 and 931 patients in 20 RCTs were randomly treated with add-on TCM therapy and conventional therapy, respectively. The additional use of TCM significantly improved six-month, one-year, two-year, and three-year overall survival rates in HCC cases (RR = 1.3, P=0.01; RR = 1.38, P=0.0008; RR = 1.44, P<0.0001; RR = 1.31, P=0.02, resp.). Add-on TCM therapy significantly increased PR rate and total response rate (tRR) and reduced PD rate compared to those in control group (34.4% versus 26.3%, RR = 1.30, P=0.002; 41.6% versus 31.0%, RR = 1.30, P<0.0001; and 16.6% versus 26.5%, RR = 0.64, P<0.0001, resp.). Additionally, TCM combination therapy significantly increased the quality of life (QOL) improvement rate and reduced adverse events including leukopenia, thrombocytopenia, anemia or erythropenia, liver injury, and gastrointestinal discomfort in HCC patients (all P<0.05). Conclusion. Add-on therapy with TCM could improve overall survival, increase clinical tumor responses, lead to better QOL, and reduce adverse events in hepatocellular carcinoma.

scholarly journals Jianpi Bushen, a Traditional Chinese Medicine Therapy, Combined with Chemotherapy for Gastric Cancer Treatment: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Yunbo Chen ◽  
Guijuan Zhang ◽  
Xiaoping Chen ◽  
Xuefeng Jiang ◽  
Fengjie Bie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Cancer Treatment ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Gastric Cancer Treatment

Objective. To investigate the effects of Jianpi Bushen (JPBS), a traditional Chinese medicine that is used to invigorate the spleen and tonify the kidney, combined with chemotherapy for the treatment of gastric cancer. Methods. Literature retrieval was performed in PubMed, EMBASE, Cochrane Library, MEDLINE, CNKI, Wanfang Data Information Site, and VIP from inception to October 2017. Randomized controlled trials to evaluate the effects of JPBS combined with chemotherapy were identified. The primary reported outcomes were KPS (Karnofsky Performance Status), clinical curative efficiency, immune function, blood system, and nonhematologic system. Review Manager 5.3 (RevMan 5.3) was used for data analysis, and the quality of the studies was also appraised. Results. A total of 26 studies were included with 3098 individuals. The results of the meta-analysis indicated that treatment of gastric cancer with the combination of JPBS and chemotherapy resulted in better outcomes compared to chemotherapy alone. Conclusion. Evidence from the meta-analysis suggested that JPBS combined with chemotherapy has a positive effect on gastric cancer treatment. However, additional rigorously designed and large sample randomized controlled trials are required to confirm the efficacy and safety of this treatment.

scholarly journals The Therapeutic Effects of a Traditional Chinese Medicine Formula Wuzi Yanzong Pill for the Treatment of Oligoasthenozoospermia: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Ming Peng Zhao ◽  
Xiao Shi ◽  
Grace Wing Shan Kong ◽  
Chi Chiu Wang ◽  
Justin Che Yuen Wu ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Male Infertility ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Semen Parameters ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Therapeutic Effects ◽  
Randomized Controlled

Oligoasthenozoospermia is a crucial factor in male infertility. Wuzi Yanzong (WZYZ) pill is a popular traditional Chinese medicine (TCM) formula which has been used for male infertility treatment for years. However, its effects on semen quality remain controversial. We conducted a preregistered meta-analysis to assess the effect of WZYZ pill for the therapeutic effects on oligoasthenozoospermia. Five randomized controlled trials including 960 participants were selected from databases of domains in North-East Asian regions, PubMed, Embase, and Cochrane Library. WZYZ pill group yielded a greater mean increment on sperm concentration (5 trials: MD 5.99, 95% CI 2.12–9.85, P=0.002), sperm motility (5 trials: MD 4.57, 95% CI 0.47–8.68, P=0.03), sperm morphology (2 trials: MD −1.93, 95% CI −4.87–1.01, P=0.20), activity of acrosomal enzyme (2 trials: MD 28.27, 95% CI 12.41–44.14, P<0.01), volume of semen (2 trials: MD 0.56, 95% CI 0.21–0.91, P=0.002), and a decrement of sperm DNA fragmentation index (2 trials: MD −3.82, 95% CI −6.45–−1.19, P=0.004). However, qualities of selected studies were generally unsatisfactory, and there was inherent heterogeneity among some of the outcomes. Despite these limitations, the WZYZ pill improved sperm quality by improving several semen parameters and decreasing DNA damage in oligoasthenozoospermia patients.

scholarly journals Suhuang Zhike Capsules for the Treatment of Cough Variant Asthma: A Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Cheng Gu ◽  
Wenpan Peng ◽  
Zhichao Wang ◽  
Yong Xu ◽  
Di Han ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy Rate ◽  
Cough Variant Asthma ◽  
Randomized Controlled

Cough variant asthma (CVA) is a unique type of asthma characterized by cough as the only or primary clinical presentation. Inhaled glucocorticoid is the main treatment in clinical practice currently, but its efficacy remains relatively unsatisfactory. Traditional Chinese medicine has certain advantages in the treatment of CVA, and at present, the most commonly used traditional Chinese medicine is Suhuang Zhike Capsule (SZC). The aim of this study was to systematically evaluate the efficacy and safety of SZC in the treatment of CVA using a meta-analysis. A comprehensive search of papers published in the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature database (CBM), Wanfang Database, and VIP Information (VIP) from January 2018 to June 2019 was conducted. Review Manager 5.3 was used to carry out a meta-analysis of 10 studies that fulfilled the inclusion criteria. In a total of 10 randomized controlled trials, 896 CVA patients were included. The results showed the following: (1) compared with conventional Western medicine, SZC can effectively increase the efficacy rate of CVA (RR 1.25, 95% CI, 1.16–1.35, P < 0.00001 ) and (2) compared with other traditional Chinese medicines, SZC can effectively increase the efficacy rate of CVA (RR 1.44, 95% CI, 1.01–2.05, P = 0.05 ), In conclusion, our study builds on existing clinical evidence showing that SZC is safe and effective in treating CVA. However, larger randomized controlled trials are required for further validation.

scholarly journals Adjuvant Treatment with Xiaoqinglong Formula for Bronchial Asthma in Acute Attack: A Systematic Review of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Long Wang ◽  
Xianrong Feng ◽  
Baojia Wang ◽  
Yu Yang ◽  
Tianyao Zhang ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Randomized Controlled Trials ◽  
Bronchial Asthma ◽  
Adjuvant Treatment ◽  
Acute Attack ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Serum Ige ◽  
Randomized Controlled

Background. XQLF (Xiaoqinglong formula) is the most commonly used prescription of traditional Chinese medicine in the treatment of asthma. XQLF combined with western medicine has been used to treat bronchial asthma in more and more cases, and good results have been achieved. Therefore, this meta-analysis aimed to evaluate the adjuvant treatment of traditional Chinese medicine classic herbal formula XQLF with bronchial asthma in acute attack. Methods. The following electronic databases were systematically searched from inception to April 2019: PubMed, EMBASE database, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang, VIP Database for Chinese Technical Periodicals, and China Biology Medicine (CBM). Two reviewers searched these databases and independently evaluated all the eligible articles for inclusion. Stata 14.0 was used for data synthesis and analysis. Results. A total of 33 RCTs (randomized controlled trials) including 2176 patients were enrolled. All of the patients in these studies were in the acute attack stage of asthma. We conducted subgroup analysis according to the duration of treatment, which was 14 days, 10 days, and 7 days, respectively. The overall results show that adjuvant treatment with XQLF significantly improve CER (clinical efficacy rate) (RR = 1.17; 95% CI, 1.14 to 1.21; P<0.0001) and promote pulmonary function including FEV1 (WMD = 0.35; 95% CI, 0.27 to 0.43; P<0.0001), PEF (SMD = 1.02; 95% CI, 0.49 to 1.55; P<0.0001), and FVC (WMD = 0.51; 95% CI, 0.35 to 0.66; P<0.0001). The adjuvant treatment of XQLF can also reduce serum IgE concentration (SMD = −1.39; 95% CI, 1.92 to −0.85; P<0.0001) and serum EOS concentration at 14 days (WMD = −39.85; 95% CI, −56.20 to −23.49; P<0.0001). Conclusion. This study finally showed that XQLF has the auxiliary effect of improving the efficiency, promoting the lung function, and reducing the serum IgE in the treatment of acute attack asthma. This trial is registered with CRD42019133549.

Efficacy and Safety of Non-Steroidal Anti-Androgens in Patients with Metastatic Prostate Cancer: Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 15 (1) ◽  
pp. 34-47 ◽  
Author(s):  
Muhammed Rashid ◽  
Madhan Ramesh ◽  
K. Shamshavali ◽  
Amit Dang ◽  
Himanshu Patel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Quality Assessment ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference

Background: Prostate cancer (PCa) is the sixth primary cause of cancer death. However, conflicts are present about the efficacy and safety of Non-steroidal anti-androgens (NSAA) for its treatment. The aim of this study was to assess the efficacy and safety of NSAAs versus any comparator for the treatment of advanced or metastatic PCa (mPCa). Methodology: MEDLINE and the Cochrane Library were searched. References of included studies and clinicaltrials.gov were also searched for relevant studies. Only English language studies after 1990 were considered for review. Randomized controlled trials (RCTs) examining the efficacy and safety of NSAAs as compared with any other comparator including surgery or chemotherapy in mPCa patients were included. The outcomes include efficacy, safety and the tolerability of the treatment. The Cochrane Risk of Bias Assessment Tool was used for quality assessment. Two authors were independently involved in the selection, extraction and quality assessment of included studies and disagreements were resolved by discussion or by consulting a third reviewer. Results: Fifty-eight out of 1307 non-duplicate RCTs with 29154 patients were considered for the review. NSAA showed significantly better progression-free survival [PFS] (Hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.46-0.78; P=0.0001), time to distant metastasis or death [TTD] (HR, 0.80; 95% CI 0.73-0.91; p<0.0001), objective response (Odds ratio [OR], 1.64; 95% CI 1.06-2.54; P=0.03) and clinical benefits (OR, 1.33; 95% CI 1.08-1.63; P=0.006) as compared to the control group. There was no significant difference observed between the groups in terms of overall survival (HR, 0.95; 95%CI, 0.87-1.03; P=0.18) and time to progression (HR, 0.93; 95% CI 0.77-1.11; P=0.43). Treatment-related adverse events were more with the NSAA group, but the discontinuation due to lack of efficacy reason was 43% significantly lesser than the control group in patients with mPCa. Rest of the outcomes were appeared to be non-significant. Conclusion: Treatment with NSAA was appeared to be better efficacious with respect to PFS, TTD, and response rate with considerable adverse events when compared to the control group in patients with metastatic PCa.

scholarly journals Adjuvant Transarterial Chemoembolization Following Curative-Intent Hepatectomy Versus Hepatectomy Alone for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2984
Author(s):  
Stepan M. Esagian ◽  
Christos D. Kakos ◽  
Emmanouil Giorgakis ◽  
Lyle Burdine ◽  
J. Camilo Barreto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Curative Intent ◽  
Randomized Controlled

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.

Overall survival after perioperative chemotherapy in the management of pulmonary metastasis in osteosarcoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23508-e23508
Author(s):  
Zeba Siddiqui ◽  
Megan E Delisle ◽  
Amirrtha Srikanthan ◽  
Ying Wang
Keyword(s):  
Overall Survival ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Pulmonary Metastasectomy ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Perioperative Chemotherapy ◽  
Extrinsic Factors ◽  
Term Survival ◽  
Randomized Controlled

e23508 Background: Pulmonary metastasectomy is performed on a select cohort of patients with advanced osteosarcoma with the potential for long term survival. However, evidence on peri-operative chemotherapy at time of metastasectomy is not completely understood and difficult to summarize without a systematic examination of existing literature. The purpose of this project is to perform a meta-analysis of existing studies to determine overall survival (OS) and prognostic factors in adults and children with advanced and recurrent osteosarcoma receiving chemotherapy around time of metastasectomy. Methods: We reviewed survival studies conducted in children and adults with advanced and recurrent osteosarcoma who undergo pulmonary metastasectomy published in English with more than 5 patients. The primary outcome was overall survival. Literature searches were performed in multiple electronic databases including Ovid MEDLINE (1946 to present), Ovid EMBASE (1974 to present), Web of Science, and Cochrane Library. Two investigators independently screened all citations, abstracts, and full-text articles. Results: 24 out of 80 observational studies between 1977 to 2018 were included. 2146 patients were studied of which 987 underwent pulmonary metastasectomy for osteosarcoma. 822 patients received perioperative chemotherapy in this setting. No randomized controlled trials were identified. Studies included patients from Asia, Africa, Europe, and North America. The median OS ranged between 20 to 90 months. 5-year OS ranged between 15 to 63%. Factors associated with survival included: age, number of lesions, disease free interval, time of development of metastases, number of lesions and laterality of pulmonary disease. Conclusions: Overall survival in study has a significant range. Factors influencing survival included intrinsic factors such as patient age and disease characteristics, as well as extrinsic factors such as evolution of chemotherapy regimen over the past four decades. The main limitations are related to the inherently low-quality evidence as a result of lack of randomized controlled trials. More comprehensive data is needed to guide shared decision making in this area.

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