Effect of full-endoscopic cervical laminectomy and decompression versus anterior cervical decompression with fusion in the treatment of patients with cervical spondylotic myelopathy: A protocol for systematic review and meta-analysis

Review question / Objective: This systematic review aims to comprehensively assess the efficacy and safety of full-endoscopic cervical laminectomy and decompression versus anterior cervical decompression with fusion in treating cervical spondylotic myelopathy (CSM) patients. Condition being studied: Cervical spondylotic myelopathy (CSM) is a degenerative disease associated with cervical cord compression, which has increased significant health-related social costs and derived disabilities. Anterior cervical discectomy and fusion (ACDF) is the "gold standard" for the treatment of CSM. However, the application of ACDF may cause some complications. Recently, full-endoscopic cervical laminectomy and decompression have shown potential therapeutic effects for CSM. However, no systematic review or meta-analysis has focused on the effects of full-endoscopic cervical laminectomy and decompression in the treatment of CSM. This systematic review aims to comprehensively assess the efficacy and safety of full-endoscopic cervical laminectomy and decompression versus anterior cervical decompression with fusion in treating CSM patients.

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Efficacy and Safety of Brucea javanica Oil Emulsion Injection in the Treatment of Gastric Cancer: A Systematic Review and Meta-Analysis

Frontiers in Nutrition ◽

10.3389/fnut.2021.784164 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xinmiao Wang ◽

Heping Wang ◽

Luchang Cao ◽

Jingyuan Wu ◽

Taicheng Lu ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Conventional Therapy ◽

Meta Analysis ◽

Performance Status ◽

Biomedical Literature ◽

Therapeutic Effects ◽

Efficacy And Safety ◽

Oil Emulsion ◽

Brucea Javanica

Background: Gastric cancer (GC) is one of the most common digestive tract cancers and ranks fifth in the incidence of malignant tumors worldwide. Brucea javanica oil emulsion injection (BJOEI), a Chinese patent medicine extracted from Brucea javanica (Yadanzi in Chinese Pinyin), is widely used as an adjuvant treatment for GC in China. This systematic review and meta-analysis aimed to evaluate the available data on the efficacy and safety of BJOEI in the treatment of GC and assess the quality of the synthesized evidence.Methods: A comprehensive search was performed on PubMed, EMBASE, CENTRAL, Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database and Chinese Scientific Journals Database (VIP database), and other potential resources, such as the Chinese Clinical Trial Registry (ChiCTR) and ClinicalTrials.gov from their inception to July 31, 2021. Randomized controlled trials (RCTs) comparing the therapeutic effects of BJOEI combined with conventional therapy to those of conventional therapy alone were included. We used RevMan 5.3 for data analysis and quality evaluation of the included studies and assessed the evidence quality based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.Results: Eighteen RCTs involving 1,210 patients were included, and the meta-analysis results demonstrated that compared with the control group (conventional therapy), the experimental group (BJOEI combined with conventional therapy) showed a significantly improved overall response rate (ORR) (risk ratio [RR] = 1.52, 95% CI: 1.36–1.69, P < 0.00001), clinical benefit rate (CBR) (RR = 1.17, 95% CI: 1.11–1.23, P < 0.00001), performance status (RR = 1.72, 95% CI: 1.46–2.01, P < 0.00001), and reduced incidence of the following adverse drug reactions (ADRs): neutropenia, leukopenia, nausea and vomiting, diarrhea, liver damage, hand-foot syndrome, and peripheral sensory nerve toxicity. Subgroup analysis showed that the BJOEI intervention could significantly improve the ORR and CBR in patients with GC when combined with FOLFOX4, XELOX, and other chemotherapeutics.Conclusion: The evidence presented in this study supports the fact that BJOEI combined with conventional chemotherapy provides a statistically significant and clinically important effect in the improvement of ORR, CBR, performance status, and ADR reduction in patients with GC. To further support this conclusion, more rigorously designed, large-scale, and multicenter RCTs are needed in the future.

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