Efficiency of Protective Interventions on Irinotecan-Induced Diarrhea: A Systematic Review and Meta-Analysis
Background: Irinotecan is widely used in the treatment of various solid tumors, but the adverse effects from it, especially diarrhea, limit its use. Several clinical trials of prophylactic treatment of irinotecan-induced diarrhea (IID) have been ongoing, and some of the data are controversial. This...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-04-01
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| Series: | Integrative Cancer Therapies |
| Online Access: | https://doi.org/10.1177/15347354241242110 |
| _version_ | 1797224513858961408 |
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| author | Yanxi He MB Lili Wu MM Xiaoyi Qi MD,PhD Xuan Wang MM Bing He BS Wei Zhang MM Wenjing Zhao MB Mingming Deng MB Xia Xiong MB Yu Wang MB Sicheng Liang PhD |
| author_facet | Yanxi He MB Lili Wu MM Xiaoyi Qi MD,PhD Xuan Wang MM Bing He BS Wei Zhang MM Wenjing Zhao MB Mingming Deng MB Xia Xiong MB Yu Wang MB Sicheng Liang PhD |
| author_sort | Yanxi He MB |
| collection | DOAJ |
| description | Background: Irinotecan is widely used in the treatment of various solid tumors, but the adverse effects from it, especially diarrhea, limit its use. Several clinical trials of prophylactic treatment of irinotecan-induced diarrhea (IID) have been ongoing, and some of the data are controversial. This encouraged us to conduct a meta-analysis of the effects of interventions on preventing IID. Method: This systematic review was conducted based on the PRISMA statement. We performed literature searches from PubMed, Web of Science, Embase, and Cochrane Library. The number registered in PROSPERO is CRD42022368633. After searching 1034 articles in the database and references, 8 studies were included in this meta-analysis. Result: The RR of high-grade diarrhea and all-grade diarrhea were 0.31 ( I 2 = 51%, 95% CI: 0.14-0.69; P = .004) and .76 ( I 2 = 65%, 95% CI: 0.62-0.93; P < .008) respectively, thus the use of intervention measures for preventing IID is effective, and the risk reduction of high-grade diarrhea was more significant. Subgroup analysis revealed that the monotherapy group (RR: 0.48, 95% CI: 0.21-1.13, I 2 = 0%) and combination therapy group (RR: 0.14, 95% CI: 0.06-0.32, I 2 = 0%) in the risk of high-grade diarrhea had no significant heterogeneity within the groups, and traditional herbal medicines (Kampo medicine Hangeshashin-to, PHY906 and hot ironing with Moxa Salt Packet on Tianshu and Shangjuxu) were effective preventive measures (RR:0.20, 95% CI: 0.07-0.60, I 2 = 0%). The Jadad scores for traditional herbal medicines studies were 3, and the follow-up duration was only 2 to 6 weeks. Conclusion: This systematic review and meta-analysis suggest that preventive treatments significantly reduced the risk of high-grade and all-grade diarrhea, confirming the efficacy in the incidence and severity of IID, among which traditional herbal medicines (baicalin-containing) provided a protective effect in reducing the severity of IID. However, the traditional herbal medicines studies were of low quality. Combined irinotecan therapy can obtain better preventive effects than monotherapy of IID. These would be helpful for the prevention of IID in clinical practice. |
| first_indexed | 2024-04-24T13:54:19Z |
| format | Article |
| id | doaj.art-0890d19bb02a467b91152579d92225a2 |
| institution | Directory Open Access Journal |
| issn | 1552-695X |
| language | English |
| last_indexed | 2024-04-24T13:54:19Z |
| publishDate | 2024-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Integrative Cancer Therapies |
| spelling | doaj.art-0890d19bb02a467b91152579d92225a22024-04-03T18:03:31ZengSAGE PublishingIntegrative Cancer Therapies1552-695X2024-04-012310.1177/15347354241242110Efficiency of Protective Interventions on Irinotecan-Induced Diarrhea: A Systematic Review and Meta-AnalysisYanxi He MB0Lili Wu MM1Xiaoyi Qi MD,PhD2Xuan Wang MM3Bing He BS4Wei Zhang MM5Wenjing Zhao MB6Mingming Deng MB7Xia Xiong MB8Yu Wang MB9Sicheng Liang PhD10The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaZunyi Medical University, Zunyi, ChinaThe Affiliated Hospital of Southwest Medical University, Luzhou, ChinaThe Affiliated Hospital of Southwest Medical University, Luzhou, ChinaSouthwest Medical University, Luzhou, ChinaThe Affiliated Hospital of Southwest Medical University, Luzhou, ChinaHuman Microecology and Precision Diagnosis and Treatment of Luzhou Key Laboratory, Luzhou, ChinaThe Affiliated Hospital of Southwest Medical University, Luzhou, ChinaThe Affiliated Hospital of Southwest Medical University, Luzhou, ChinaGulin County People’s Hospital, Luzhou, ChinaCardiovascular and Metabolic Diseases of Sichuan Key Laboratory, Luzhou, ChinaBackground: Irinotecan is widely used in the treatment of various solid tumors, but the adverse effects from it, especially diarrhea, limit its use. Several clinical trials of prophylactic treatment of irinotecan-induced diarrhea (IID) have been ongoing, and some of the data are controversial. This encouraged us to conduct a meta-analysis of the effects of interventions on preventing IID. Method: This systematic review was conducted based on the PRISMA statement. We performed literature searches from PubMed, Web of Science, Embase, and Cochrane Library. The number registered in PROSPERO is CRD42022368633. After searching 1034 articles in the database and references, 8 studies were included in this meta-analysis. Result: The RR of high-grade diarrhea and all-grade diarrhea were 0.31 ( I 2 = 51%, 95% CI: 0.14-0.69; P = .004) and .76 ( I 2 = 65%, 95% CI: 0.62-0.93; P < .008) respectively, thus the use of intervention measures for preventing IID is effective, and the risk reduction of high-grade diarrhea was more significant. Subgroup analysis revealed that the monotherapy group (RR: 0.48, 95% CI: 0.21-1.13, I 2 = 0%) and combination therapy group (RR: 0.14, 95% CI: 0.06-0.32, I 2 = 0%) in the risk of high-grade diarrhea had no significant heterogeneity within the groups, and traditional herbal medicines (Kampo medicine Hangeshashin-to, PHY906 and hot ironing with Moxa Salt Packet on Tianshu and Shangjuxu) were effective preventive measures (RR:0.20, 95% CI: 0.07-0.60, I 2 = 0%). The Jadad scores for traditional herbal medicines studies were 3, and the follow-up duration was only 2 to 6 weeks. Conclusion: This systematic review and meta-analysis suggest that preventive treatments significantly reduced the risk of high-grade and all-grade diarrhea, confirming the efficacy in the incidence and severity of IID, among which traditional herbal medicines (baicalin-containing) provided a protective effect in reducing the severity of IID. However, the traditional herbal medicines studies were of low quality. Combined irinotecan therapy can obtain better preventive effects than monotherapy of IID. These would be helpful for the prevention of IID in clinical practice.https://doi.org/10.1177/15347354241242110 |
| spellingShingle | Yanxi He MB Lili Wu MM Xiaoyi Qi MD,PhD Xuan Wang MM Bing He BS Wei Zhang MM Wenjing Zhao MB Mingming Deng MB Xia Xiong MB Yu Wang MB Sicheng Liang PhD Efficiency of Protective Interventions on Irinotecan-Induced Diarrhea: A Systematic Review and Meta-Analysis Integrative Cancer Therapies |
| title | Efficiency of Protective Interventions on Irinotecan-Induced Diarrhea: A Systematic Review and Meta-Analysis |
| title_full | Efficiency of Protective Interventions on Irinotecan-Induced Diarrhea: A Systematic Review and Meta-Analysis |
| title_fullStr | Efficiency of Protective Interventions on Irinotecan-Induced Diarrhea: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Efficiency of Protective Interventions on Irinotecan-Induced Diarrhea: A Systematic Review and Meta-Analysis |
| title_short | Efficiency of Protective Interventions on Irinotecan-Induced Diarrhea: A Systematic Review and Meta-Analysis |
| title_sort | efficiency of protective interventions on irinotecan induced diarrhea a systematic review and meta analysis |
| url | https://doi.org/10.1177/15347354241242110 |
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