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

Zongguo Yang,Bozong Tang,Xiaorong Chen,Yunfei Lu,Xian Liao,Qingnian Xu,Yongchun Yu

doi:10.1155/2017/3428253

Abstract

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.

Highlights

Primary liver cancer is the sixth most common cancer and the third most common cause of cancer-related deaths. 70%∼90% primary liver cancers occurring worldwide are hepatocellular carcinoma (HCC), which is the fastest growing cause of cancer-related death globally [1, 2]
Most newly diagnosed HCC cases are at an intermediate advanced stage, and the therapeutic options are limited to palliative approaches using TACE or chemotherapeutic agents [5, 40]
traditional Chinese medicine (TCM) has been used to treat HCC extensively and it can be used throughout the whole course of HCC [42]

Summary

Introduction

Primary liver cancer is the sixth most common cancer and the third most common cause of cancer-related deaths. 70%∼90% primary liver cancers occurring worldwide are hepatocellular carcinoma (HCC), which is the fastest growing cause of cancer-related death globally [1, 2]. 70%∼90% primary liver cancers occurring worldwide are hepatocellular carcinoma (HCC), which is the fastest growing cause of cancer-related death globally [1, 2]. Many clinical articles have reported that TCM or TCM plus chemotherapy can significantly alleviate symptoms, stabilize tumor size, reinforce the constitution, enhance therapy tolerance and immunological function, obviously reduce the incidence rate of adverse events, and prolong patients’ survival duration for unresectable HCC [8,9,10,11]. 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). Add-on therapy with TCM could improve overall survival, increase clinical tumor responses, lead to better QOL, and reduce adverse events in hepatocellular carcinoma

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