Abstract
Introduction: As non-small cell lung cancer (NSCLC) seriously threatens human health, several clinical studies have reported that Chinese herbal injections (CHIs) in combination with and gemcitabine plus cisplatin (GP) are beneficial. This multidimensional network meta-analysis aimed to compare the clinical efficacy and safety of different CHIs in combination with GP against NSCLC.Methods: Randomized controlled trials (RCTs) for the treatment of NSCLC were retrieved from seven electronic databases from inception to April 30, 2020. Study selection and data extraction were based on a priori criteria. Data analysis was performed using Stata 13.0, WinBUGS 14.0 software. Multidimensional cluster analysis was performed using the “scatterplot3d” package in R 3.6.1 software.Results: This network meta-analysis included 71 eligible RCTs and 10 Chinese herbal injections. Delisheng injection and Kangai injection had the highest probability in terms of clinical effectiveness rate (94.60%) and gastrointestinal reactions (82.62%) when combined with GP compared with the other interventions. Compound Kushen injection combined with GP ranked ahead of the other interventions in terms of performance status (73.36%) and abnormal liver function (87.17%). Shenmai injection combined with GP had the highest probability in terms of leukopenia (94.59%) and thrombocytopenia (99.18%).Conclusion: The current evidence revealed that CHIs combined with GP have a better impact on patients with NSCLC than GP alone. Aidi injection, Compound kushen injection, and Kanglaite injection deserve more attention of clinicians when combined with GP in patients with NSCLC. Additionally, due to the limitations of this network meta-analysis, further well-designed, large-sample, multicenter RCTs are required to support our findings adequately.
Highlights
As non-small cell lung cancer (NSCLC) seriously threatens human health, several clinical studies have reported that Chinese herbal injections (CHIs) in combination with and gemcitabine plus cisplatin (GP) are beneficial
The results suggested that 8 types of CHIs: Aidi injection, Compound kushen injection, Delisheng injection, Javanica oil emulsion injection, Kangai injection, Kanglaite injection, Shenmai injection, and Shenqifuzheng injection, combined with GP were significantly more effective than GP alone
The results suggested that 6 types of CHIs: Aidi injection, Compound kushen injection, Javanica oil emulsion injection, Kanglaite injection, Shenmai injection, and Shenqifuzheng injection, combined with GP were significantly more effective than GP alone
Summary
As non-small cell lung cancer (NSCLC) seriously threatens human health, several clinical studies have reported that Chinese herbal injections (CHIs) in combination with and gemcitabine plus cisplatin (GP) are beneficial. This multidimensional network meta-analysis aimed to compare the clinical efficacy and safety of different CHIs in combination with GP against NSCLC. According to the International Agency for Research on Cancer (Sung et al, 2021), lung cancer is the second most commonly diagnosed cancer It is the leading cause of cancer death, accounting for 11.4 and 18.0% of new cases and deaths of all cancers worldwide. This treatment is associated with a highly toxic physiological environment and adverse events that may even lead to treatment discontinuation (Lischalk et al, 2016; Osarogiagbon et al, 2016)
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