Efficacy and safety of TCM combined with chemotherapy for SCLC: a systematic review and meta-analysis

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REVIEW – CLINICAL ONCOLOGY

Efficacy and safety of TCM combined with chemotherapy for SCLC: a systematic review and meta‑analysis Shuntai Chen1,2 · Yanju Bao3 · Jing Xu4 · Xiwen Zhang1 · Shulin He5 · Zhenhua Zhang1 · Runzhi Qi1 · Juling Jiang1 · Rui Liu1 · Qiujun Guo1 · Xing Zhang1 · Yupeng Xi6 · Honggang Zheng1 · Baojin Hua1  Received: 29 April 2020 / Accepted: 5 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract Background  Chemotherapy is the standard treatment for small cell lung cancer (SCLC), but chemotherapy resistance and adverse reactions remain major problems. Although Traditional Chinese Medicine (TCM) is wildly applied for patients with SCLC in China, the evidence of TCM in the treatment for SCLC is limited. Purpose  To evaluate the efficacy and safety of TCM combined with chemotherapy for patients with SCLC. Method  We conducted a systematic search of PubMed, EMBASE, the Chinese National Knowledge Infrastructure, the VIP Information Database, and the Wanfang Database for randomized-controlled trials (RCTs) that are relevant. The included studies were reviewed by two investigators, with relevant data extracted independently. The effect estimate of interest was the relative risk (RR) or mean difference with 95% confidence intervals (95% CIs). Results  22 RCTs involving 1887 patients were included in this study. Compared with patients treated with chemotherapy© alone, those with Chinese herbal medicine and chemotherapy (TCM-C) had better therapeutic effects (RR = 1.295, 95% CI 1.205–1.391, P  0.05)

Comparable (p > 0.05)

Comparable (p > 0.05)

Comparable (p > 0.05)

Control Etoposide, 100 mg/m2, ivgtt, day 1–5, 21 days*4 courses Cisplatin, 20 mg/m2, ivgtt, day 1–5, 21 days*4 courses Etoposide, 100 mg/m2, ivgtt, day 1–5, 21 days*4 courses Cisplatin, 20 mg/m2, ivgtt, day 1–5, 21 days*4 courses 1st cycle (21 days): Carboplatin, 300 mg/m2, ivgtt, day 1, Etoposide, 100 mg/m2, ivgtt, day 2–6 2nd cycle (21 days): Cyclophosphamide 1000 mg/m2, ivgtt, day 1, 8 Doxorubicin 40 mg/m2, ivgtt, day1 Cisplatin, 50 mg/m2, ivgtt, day 3–5 Etoposide, 100 mg/m2, ivgtt, day 1–5, 28 days*4 courses Cisplatin, 35 mg/m2, ivgtt, day 1–5, 28 days*4 courses Etoposide, 100 mg/m2, ivgtt, day 1–3, 21 days*4 courses Cisplatin, 60 mg/m2, ivgtt, day1, 21 days*4 courses Etoposide, 120 mg/m2, ivgtt, day 1–3, 21 days*4 courses Cisplatin, 60 mg/m2, ivgtt, day 1, 21 days*4 courses

Etoposide, 120 mg/m2, ivgtt, day 1–3, 21 days* 6–8 courses Cisplatin, 75 mg/m2, ivgtt, day 1, 21 days* 6–8 courses

Journal of Cancer Research and Clinical Oncology

26/38

84/82

42/46

37/37

92/48

64/62

Sun et al. (2008)

Xu et al. (2010)

Wo et al. (2013)

Shao et al. (1999)

Zhao et al. (2004)

Interventions

TCM patent medicine, 10 ml, po, TID, week TCM-C: limited disease: 20, extensive 1–2, 3 weeks* 3–5 courses disease: 6; C: limited disease: 27, extensive disease: 11; Etoposide, 100 mg/m2, ivgtt, day 1–5, 21 days* 3–5 courses Cisplatin 20 mg/m2, ivgtt, day 1–5, 21 days* 3–5 courses – TCM pill, 2 g, TID, 9 weeks Cyclophospha

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