J Cancer 2024; 15(4):889-907. doi:10.7150/jca.91301 This issue Cite

Research Paper

Effectiveness and Safety of Chinese Herbal Injections Combined with SOX Chemotherapy Regimens for Advanced Gastric Cancer: a Bayesian Network Meta-Analysis

Zhi-jun Bu1, Shu-run Wan2, Peter Steinmann3,4, Ze-tao Yin5, Jin-ping Tan6, Wen-xin Li7, Zhen-yan Tang8, Shuo Jiang8, Meng-meng Ye9, Jin-yang Xu1, You-you Zheng1, Xue-hui Wang1, Jian-ping Liu1, Zhao-lan Liu1,✉

1. Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
2. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing Key Laboratory, Beijing, China.
3. Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
4. University of Basel, Basel, Switzerland.
5. Critical Respiratory Medicine, China-Japan Friendship Hospital, Beijing University of Chinese Medicine, Beijing, China.
6. School of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China.
7. The First Affiliated Hospital of Nanchang University, Nanchang, China.
8. School of the First Clinical College, Hubei University of Chinese Medicine, Wuhan, China.
9. School of Basic Medicine, Hubei University of Chinese Medicine, Wuhan, China.

Citation:
Bu Zj, Wan Sr, Steinmann P, Yin Zt, Tan Jp, Li Wx, Tang Zy, Jiang S, Ye Mm, Xu Jy, Zheng Yy, Wang Xh, Liu Jp, Liu Zl. Effectiveness and Safety of Chinese Herbal Injections Combined with SOX Chemotherapy Regimens for Advanced Gastric Cancer: a Bayesian Network Meta-Analysis. J Cancer 2024; 15(4):889-907. doi:10.7150/jca.91301. https://www.jcancer.org/v15p0889.htm
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Abstract

Graphic abstract

Background: Randomized controlled trials (RCTs) have demonstrated that combining Chinese herbal injections (CHIs) with oxaliplatin plus tegafur (SOX) chemotherapy regimens improves clinical effectiveness and reduces adverse reactions in patients with advanced gastric cancer (AGC). These RCTs highlight the potential applications of CHIs and their impact on AGC patient prognosis. However, there is insufficient comparative evidence on the clinical effectiveness and safety of different CHIs when combined with SOX. Therefore, we performed a network meta-analysis to rank the clinical effectiveness and safety of different CHIs when combined with SOX chemotherapy regimens. This study aimed to provide evidence for selecting appropriate CHIs in the treatment of patients with AGC.

Methods: We searched eight databases from their inception until March 2023. Surface Under the Cumulative Ranking Curve (SUCRA) probability values were used to rank the treatment measures, and the Confidence in Network Meta-Analysis (CINeMA) software assessed the grading of evidence.

Results: A total of 51 RCTs involving 3,703 AGC patients were identified. Huachansu injections + SOX demonstrated the highest clinical effectiveness (SUCRA: 78.17%), significantly reducing the incidence of leukopenia (93.35%), thrombocytopenia (80.19%), and nausea and vomiting (95.15%). Shenfu injections + SOX improved Karnofsky's Performance Status (75.59%) and showed a significant reduction in peripheral neurotoxicity incidence (88.26%). Aidi injections + SOX were most effective in reducing the incidence of liver function damage (75.16%). According to CINeMA, most confidence rating results were classified as “low”.

Conclusion: The combination of CHIs and SOX shows promising effects in the treatment of AGC compared to SOX alone. Huachansu and Shenfu injections offer the greatest overall advantage among the CHIs, while Aidi injections are optimal for reducing the incidence of liver damage. However, further rigorous RCTs with larger sample sizes and additional pharmacological studies are necessary to reinforce these findings.

Keywords: Chinese herbal injections, SOX chemotherapy, Advanced gastric cancer, Bayesian network meta-analysis


Citation styles

APA
Bu, Z.j., Wan, S.r., Steinmann, P., Yin, Z.t., Tan, J.p., Li, W.x., Tang, Z.y., Jiang, S., Ye, M.m., Xu, J.y., Zheng, Y.y., Wang, X.h., Liu, J.p., Liu, Z.l. (2024). Effectiveness and Safety of Chinese Herbal Injections Combined with SOX Chemotherapy Regimens for Advanced Gastric Cancer: a Bayesian Network Meta-Analysis. Journal of Cancer, 15(4), 889-907. https://doi.org/10.7150/jca.91301.

ACS
Bu, Z.j.; Wan, S.r.; Steinmann, P.; Yin, Z.t.; Tan, J.p.; Li, W.x.; Tang, Z.y.; Jiang, S.; Ye, M.m.; Xu, J.y.; Zheng, Y.y.; Wang, X.h.; Liu, J.p.; Liu, Z.l. Effectiveness and Safety of Chinese Herbal Injections Combined with SOX Chemotherapy Regimens for Advanced Gastric Cancer: a Bayesian Network Meta-Analysis. J. Cancer 2024, 15 (4), 889-907. DOI: 10.7150/jca.91301.

NLM
Bu Zj, Wan Sr, Steinmann P, Yin Zt, Tan Jp, Li Wx, Tang Zy, Jiang S, Ye Mm, Xu Jy, Zheng Yy, Wang Xh, Liu Jp, Liu Zl. Effectiveness and Safety of Chinese Herbal Injections Combined with SOX Chemotherapy Regimens for Advanced Gastric Cancer: a Bayesian Network Meta-Analysis. J Cancer 2024; 15(4):889-907. doi:10.7150/jca.91301. https://www.jcancer.org/v15p0889.htm

CSE
Bu Zj, Wan Sr, Steinmann P, Yin Zt, Tan Jp, Li Wx, Tang Zy, Jiang S, Ye Mm, Xu Jy, Zheng Yy, Wang Xh, Liu Jp, Liu Zl. 2024. Effectiveness and Safety of Chinese Herbal Injections Combined with SOX Chemotherapy Regimens for Advanced Gastric Cancer: a Bayesian Network Meta-Analysis. J Cancer. 15(4):889-907.

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