Oxaliplatin-based chemotherapy combined with traditional medicines for neutropenia in colorectal cancer: A meta-analysis of the contributions of specific plants

Abstract

This review assessed the effects on chemotherapy induced neutropenia (CIN) of combining oxaliplatin regimens with traditional plant-based medicines (TMs) in the management of colorectal cancer (CRC). 32 RCTs (2224 participants) were included. Meta-analysis showed reduced incidence of grade 3/4 CIN (RR 0.45[0.31, 0.65], I(2)=0%). No studies reported serious adverse events or reduction in tumour response rates associated with concurrent use of oxaliplatin and TM. Due to small sample sizes and risk of bias, these results should be interpreted with caution. Analyses of sub-groups of studies that used similar TM interventions assessed the relative contributions of individual plant-based ingredients to the results. Astragalus, Codonopsis, Atractylodes, Poria and Coix, in various combinations were consistently associated with reduced CIN incidence when administered orally. Experimental studies of these plants have reported reduced myelosuppression and/or enhanced immune response. Further studies of these plants may lead to the development of interventions to supplement conventional CIN treatment.

Dietary Supplements Commonly Used by Cancer Survivors: Are There Any Benefits?

“…Furthermore, prolonged survival was associated with use of Chinese herbal medicine, which often included astragalus, in patients with acute myeloid leukemia receiving standard treatment 156 . Last, in patients with colorectal cancer receiving oxaliplatin, astragalus was associated with reduced neutropenia 157 . Other benefits in this study included a reduction in cancer‐related fatigue and chemotherapy‐induced nausea and vomiting.…”

Herbal medicine for hand–foot syndrome induced by fluoropyrimidines: A systematic review and meta‐analysis

“…Further sensitivity analyses were performed for studies of multi‐ingredient herbal medicine in reducing incidence of HFS. The approach used to analyze studies containing the same herb(s) was based on a method described previously (Chen, May, Zhou Zhang, & Xue, ; Chen, May, Zhou, Xue, & Zhang, ). Briefly, the approach involved a multilevel procedure:…”

“…To select herbs for further research, the following selection criteria were used, as previously described (Chen, May, Zhou, Zhang, et al, ; Chen, May, Zhou, Xue, et al, ): The RR of studies containing the same herb(s) was significantly lower than that of the control. The RR of studies containing the same herb(s) was equal to or lower than that of the total pooled RR. There was no important heterogeneity ( I 2 < 30%). The RR results for the herb were significant at multiple levels of combination. …”

An update on Chinese herbal medicines as adjuvant treatment of anticancer therapeutics

“…A modern agent Shenqi Fuzheng Injection, prepared from Codonopsis Radix and Astragali Radix, commonly used as a supplementary therapy for cancers, could reprogram the immunosuppressive microenvironment in vivo to enhance the cytotoxicity of tumor-infiltrating immune cells in melanoma (38). Combining oxaliplatin regimens with some TCM decoctions containing Radix Codonopsis in the management of colorectal cancer (CRC) could effectively improve chemotherapy induced CIN, reduce myelosuppression and/or enhance immune response of patients (39). In addition, polysaccharides from Radix Codonopsis exhibited significant inhibitory effects on tumor cell growth, invasion, and migration of human epithelial ovarian cancer cells (40).…”