The clinical efficacy and safety of kanglaite adjuvant therapy in the treatment of advanced hepatocellular carcinoma: A PRISMA-compliant meta-analysis

Jingjing Liu,Chao Xu,Jing Ma,Xueni Liu,Ke Li

doi:10.1042/bsr20193319

Jingjing Liu, Chao Xu + Show 3 more

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https://doi.org/10.1042/bsr20193319

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Journal: Bioscience reports	Publication Date: Nov 26, 2019
Citations: 17	License type: CC BY 4.0

Affiliation: Liaocheng People's Hospital

Abstract

Kanglaite, a type of Chinese medicine preparation, is considered a promising complementary therapy option for advanced hepatocellular carcinoma (HCC). Although an analysis of the published literature has been performed, the exact effects and safety are yet to be systematically investigated. Therefore, we conducted a wide-ranging online search of electronic databases to provide systematic conclusions; data from 31 trials with 2315 HCC patients were included. The results indicated that compared with conventional treatment (CT) alone, the combination of kanglaite with CT markedly prolonged patients’ 6-month overall survival (OS, P=0.003), 12-month OS (P<0.0001), 18-month OS (P=0.003), 24-month OS (P=0.03) and 36-month OS (P=0.0006) and significantly improved the overall response rate (odds ratio (OR) = 2.57, 95% confidence interval (CI) = 2.10–3.16, P<0.00001) and disease control rate (OR = 3.10, 95% CI = 2.42–3.97, P<0.00001) of patients. The quality of life (QoL), clinical symptoms and immune function of patients were also obviously improved after combined treatment. The incidence rates of nausea and vomiting (P=0.04), hepatotoxicity (P=0.0002), leukopenia (P<0.00001), thrombocytopenia (P<0.0001), gastrointestinal side effects (P=0.01) and fever (P<0.0009) were lower in the group receiving CT and kanglaite than in the group receiving CT alone. In summary, the combination of kanglaite and CT is safe and more effective in treating HCC than is CT alone, and its application in the clinic is worth promoting.

Highlights

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths, and in 2018, 781631 deaths worldwide were attributed to HCC [1]
The results indicated that compared with conventional treatment (CT) alone, the combination of kanglaite with CT markedly prolonged patients’ 6-month overall survival (OS, P=0.003), 12-month OS (P
The inclusion criteria were as follows: (1) controlled trials with advanced HCC patients; (2) studies involving more than 30 HCC patients; (3) studies comparing the clinical outcomes of CT plus kanglaite adjuvant therapy with those of CT alone; and (4) the CT included transcatheter arterial chemoembolization (TACE), transhepatic arterial embolization (TAE), chemotherapy, stereotactic radiotherapy (SRT), support and symptomatic treatment (SST) and targeted therapy

Summary

Introduction

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths, and in 2018, 781631 deaths worldwide were attributed to HCC [1]. The incidence of HCC has significantly increased, with approximately 840000 new cases every year [1]. China is a high-risk region for HCC, with the deaths caused by HCC in this country accounting for approximately 50% of HCC-related deaths worldwide [2]. HCC progresses to an advanced stage, with a 5-year survival rate of less than 20% [3]. Surgery and liver transplantation are regarded as the optimal treatment options, but only a small proportion of HCC patients can undergo potentially curative resection [3,4]. The therapeutic effects of current conventional treatment (CT), such as radiotherapy and chemotherapy for advanced HCC, are still unsatisfactory [3–5].

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