Which are the best Chinese herbal injections combined with XELOX regimen for gastric cancer?

Abstract

Background:The optimal Chinese herbal injections (CHIs) combined with XELOX regimen for patients with gastric cancer remains elusive. The aim of our network meta-analysis (NMA) is to explore the best options among different CHIs for gastric cancer.Methods:PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure Database (CNKI), Wan-fang Database, Cqvip Database (VIP), China Biology Medicine disc (CBMdisc) were searched to identify RCTs which focused on CHIs against gastric cancer. The quality assessment of included randomized controlled trials (RCTs) was conducted by the Cochrane risk of bias tool. Standard pair-wise and Bayesian NMAs were performed to compare the efficacy and safety of different CHIs combined with the XELOX regimen via Stata 13.0 and WinBUGS1.4 software.Results:A total of 2316 records were searched, the network of evidence included 26 eligible RCTs involving 13 types of CHIs and 2154 patients. The results suggested that Shenqifuzheng+ XELOX, Huachansu+ XELOX, Kangai+ XELOX, Javanica oil emulsion+ XELOX, Aidi injection+ XELOX might be the optimal treatment for gastric cancer in improving the performance status than using XELOX regimen single, with odds ratios (OR) and 95% confidence intervals (CIs) of 2.74 (1.24, 6.17), 8.27 (1.74, 42.43), 4.28 (1.80, 10.48), 5.14 (1.87, 16.28), 0.20 (0.090, 0.44). At the aspects of ADRs (adverse reactions), Compound Kushen+ XELOX, Lentinan+ XELOX, Xiaoaiping injection+ XELOX could obviously relieve leukopenia than only receiving XELOX regimen, and their ORs and 95% CIs were 5.62 (1.41, 36.24), 8.16 (2.25, 29.43), 5.69 (1.85, 15.77). Furthermore, Disodium cantharidinate and vitamin B6+ XELOX, Shenqifuzheng+ XELOX, Kangai+ XELOX, Lentinan+ XELOX could obviously relieve the nausea and vomiting than receiving the XELOX regimen alone, with ORs and 95% CIs of 5.29 (1.30, 23.96), 2.50 (1.16, 5.26), 2.42 (1.06, 5.63), 9.04 (3.24, 26.73). Nevertheless, CHIs combined with XELOX regimen did not confer higher better clinical effectiveness rate over receiving XELOX regimen alone, with nonstatistically significant between-group differences.Conclusions:As the available evidence suggested that CHIs combined with XELOX regimen could provide treatment benefits for patients with gastric cancer. Among 13 types of CHIs, Javanica oil emulsion and Compound Kushen injection is the optimal treatment in improving the clinical effectiveness rate and performance status, and Lentinan injection was superior in relieving ADRs.

Study on the mechanisms of compound Kushen injection for the treatment of gastric cancer based on network pharmacology

“…Previous studies have confirmed the effectiveness of CKI in the treatment of GC [20,21] but did not explore the molecular biology. To better analyze and predict the molecular mechanism of CKI in the treatment of GC, this study adopted the network pharmacology and molecular docking method.…”

A novel multi-scale bioinformatics strategy for identifying the molecular mechanism by insighting into ceRNA network integrating WGCNA and meta-analysis: compound kushen injection for treating gastric carcinoma as a proof

“…Besides, it has passed the standardized Good Manufacturing Process (GMP) certi cation and is often used clinically to treat gastric cancer [9]. After multiple systematic reviews and meta-analysis studies, it was found that CKI can not only improve the clinical e cacy of gastric cancer patients but also alleviate the adverse effects of radiotherapy and chemotherapy [48][49][50]. Cancer is a complex disease arising from changes in multiple biological networks [51].…”

Comparative efficacy of Chinese herbal injections combined with azithromycin for mycoplasma pneumonia in children: A Bayesian network meta‐analysis of randomized controlled trials

“…Chinese herbal injection (CHI) is a new formulation with rapid action and high bioavailability and made from components extracted from traditional Chinese herb using modern technology . It is widely used in the treatment of cardiovascular diseases, cancers and respiratory diseases . Although numerous traditional pairwise meta‐analytic reviews have reported on the efficacy of many CHIs that could be used to treat mycoplasma pneumonia in children, the effect of which kind of injection is the best remains unclear.…”

“…18 It is widely used in the treatment of cardiovascular diseases, cancers and respiratory diseases. [19][20][21][22][23][24] Although numerous traditional pairwise metaanalytic reviews have reported on the efficacy of many CHIs that could be used to treat mycoplasma pneumonia in children, [25][26][27][28] the effect of which kind of injection is the best remains unclear. This is because the traditional pairwise meta-analysis can only achieve direct comparison between the two interventions and cannot comprehensively evaluate the efficacy of various interventions.…”