Abstract
Objective To perform a systematic evaluation of the efficacy and safety of combined treatment of Shenmai injection and chemotherapy for lung cancer. Methods A literature search for randomized controlled trials (RCTs) describing the treatment of lung cancer by Shenmai injection and chemotherapy or chemotherapy alone was performed using the PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Value In Paper (VIP), China BioMed, and Wanfang databases. The databases were searched for entries published before September 1, 2019. Results Thirty-seven RCTs, comprising a total of 2808 cases, were included in the present meta-analysis. Of these, 1428 cases were treated by Shenmai injection plus chemotherapy, and 1380 cases were treated only by chemotherapy. The results of meta-analysis showed that the combined treatment (Shenmai injection plus chemotherapy) increased the short-term efficacy of treatment (relative risk [RR] = 1.183, 95% confidence interval [CI] = 1.043–1.343, P < 0.01) and improved patients' quality of life (RR = 1.514, 95%CI = 1.211–1.891, P < 0.01) compared with chemotherapy alone. With regard to the adverse effects, the combined treatment markedly reduced the incidence of white blood cell (WBC) reduction (RR = 0.846, 95%CI = 0.760–0.941, P < 0.01), platelet reduction (RR = 0.462, 95% CI = 0.330–0.649, P < 0.01), and hemoglobin reduction (RR = 0.462, 95% CI = 0.330–0.649, P < 0.01) and alleviated drug-induced liver injury (RR = 0.677, 95%CI = 0.463–0.990, P < 0.05). However, it did not offer a significant protective effect (RR = 0.725, 95%CI = 0.358–1.468, P < 0.05). The effect of the combined treatment on the occurrence of vomiting was considerable (RR = 0.889, 95%CI = 0.794–0.996, P < 0.05), and the combined treatment markedly increased the immunity of patients with lung cancer. Conclusion The combined treatment of Shenmai injection plus chemotherapy enhanced the short-term efficacy of chemotherapy, improved the patient quality of life, alleviated the adverse effects of chemotherapeutics, and increased the patient immunity. These results should be confirmed by large-scale, high-quality RCTs.
Highlights
Lung cancer is a malignant disease with the highest death rate and the second highest incidence worldwide [1]. ere are two types of lung cancer: small-cell lung cancer and nonsmall-cell lung cancer (NSCLC); NSCLC accounts for 85% of all lung cancers and has a death rate as high as 80%–90% [2]
Five studies documented the changes in CD3+ in patients receiving the combination treatment (Shenmai injection plus chemotherapy) and in patients receiving chemotherapy alone. e results of heterogeneity test suggested large heterogeneity (P < 0.1; I2 83.3%); a random effects model was used to analyze the data. e results of the meta-analysis showed that the combination treatment markedly increased the proportion of CD3+ compared with chemotherapy alone (SMD 1.044, 95% confidence interval (CI) 0.830–1.258, P < 0.05, Figure 11(a))
Chinese medicine can alleviate the toxic adverse effects associated with the current clinical treatments, extend the survival time of patients with cancer, increase patient quality of life, and enhance immune function; it may compensate for the shortage of available treatments for lung cancer in Western medicine and is emerging as an indispensable component of cancer treatment [50]
Summary
Lung cancer is a malignant disease with the highest death rate and the second highest incidence worldwide [1]. ere are two types of lung cancer: small-cell lung cancer and nonsmall-cell lung cancer (NSCLC); NSCLC accounts for 85% of all lung cancers and has a death rate as high as 80%–90% [2]. Lung cancer is a malignant disease with the highest death rate and the second highest incidence worldwide [1]. Ere are two types of lung cancer: small-cell lung cancer and nonsmall-cell lung cancer (NSCLC); NSCLC accounts for 85% of all lung cancers and has a death rate as high as 80%–90% [2]. Small-cell lung cancers are sensitive to chemotherapy; they are treated mainly by chemotherapy. Stage lung cancers can still be treated surgically. Approximately 70% of patients with a lung cancer are in an advanced stage upon diagnosis and are treated mainly by chemotherapy [3, 4]. Patients are forced to query their treatment, and the final efficacy is Evidence-Based Complementary and Alternative Medicine affected. Patients are forced to query their treatment, and the final efficacy is Evidence-Based Complementary and Alternative Medicine affected. erefore, one aim of research is to find drugs that enhance efficacy of chemotherapeutics and alleviate their toxicity
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