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Network meta‐analysis of Chinese herb injections combined with FOLFOX chemotherapy in the treatment of advanced colorectal cancer
Author(s) -
Ge L.,
Wang Yf.,
Tian Jh.,
Mao L.,
Zhang J.,
Zhang Jh.,
Shen Xp.,
Yang Kh.
Publication year - 2016
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12410
Subject(s) - folfox , medicine , oxaliplatin , colorectal cancer , meta analysis , oncology , randomized controlled trial , cancer
Summary What is known and Objective Research has indicated that some Chinese herb injections ( CHI s) might be beneficial in combination with chemotherapy, including remedies that might be used as effective chemosensitizers and radiosensitizers, or as palliative therapy. Here, we carried out a network meta‐analysis to assess the clinical efficacy and safety of CHI s combined with oxaliplatin, 5‐fluorouracil and leucovorin ( FOLFOX ) for advanced colorectal cancer ( CRC ). Methods PubMed, EMBASE .com, the Cochrane Central Register of Controlled Trials ( CENTRAL ), Chinese Biomedical Literature Database ( CBM ), Wanfang Database and Chinese Journal Full‐text Database were searched from inception to 31 December 2014, to identify relevant randomized controlled trails ( RCT s). The risk of bias in included RCT s was evaluated according to the Cochrane Handbook version 5.1.0. Standard pairwise meta‐analysis and Bayesian network meta‐analysis were performed to compare the efficacy and safety of different CHI s combined with FOLFOX . Data were analysed using STATA 12.0 and Win BUGS 1.4 software. Results and discussion We identified 63 eligible studies (with 4837 patients in total), involving 9 CHI s. Pairwise meta‐analysis showed that compared with FOLFOX alone, combinations with Aidi injection and compound matrine injection could significantly improve the overall response rate and quality of life and reduce the incidence of nausea and vomiting ( III ‐ IV ), diarrhoea ( III – IV ), thrombocytopenia ( III – IV ), leukopenia ( III – IV ) and peripheral neurotoxicity ( III – IV ). According to results of indirect comparison, there were no statistically significant differences for most of comparison groups. Aidi+ FOLFOX , shenqifuzheng+ FOLFOX and compound matrine+ FOLFOX had the greatest probability of being the best treatment in clinical efficacy and safety, considering the small sample size. What is new and Conclusions Most of the included studies were of low quality, and there was a scarcity of eligible trials and numbers of participants. Based on currently limited evidence, aidi, shenqifuzheng and compound matrine were superior to other CHI s in patients receiving FOLFOX chemotherapy for advanced CRC . More studies are required to confirm the efficacy of CHI s in combination with FOLFOX for advanced CRC .