Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy
BackgroundBreast cancer, a malignant disorder, occurs in epithelial tissue of the breast glands and ducts. Endocrine therapy is commonly applied as an important adjuvant treatment for breast cancer, but it usually induces a variety of side effects. Chinese Medicines (CM) has therapeutic effect on re...
| Main Authors: | , , , , , , , , , , |
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| Language: | English |
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Frontiers Media S.A.
2021-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.661925/full |
| _version_ | 1818669205988311040 |
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| author | Lu Li Lu Li Lu Li Lu Li Rongyun Wang Aolin Zhang Aolin Zhang Ling Wang Qianwen Ge Yuan Liu Tianhui Chen Chi Chiu Wang Chi Chiu Wang Ping Chung Leung Qiuhua Sun Xiaohui Fan Xiaohui Fan |
| author_facet | Lu Li Lu Li Lu Li Lu Li Rongyun Wang Aolin Zhang Aolin Zhang Ling Wang Qianwen Ge Yuan Liu Tianhui Chen Chi Chiu Wang Chi Chiu Wang Ping Chung Leung Qiuhua Sun Xiaohui Fan Xiaohui Fan |
| author_sort | Lu Li |
| collection | DOAJ |
| description | BackgroundBreast cancer, a malignant disorder, occurs in epithelial tissue of the breast glands and ducts. Endocrine therapy is commonly applied as an important adjuvant treatment for breast cancer, but it usually induces a variety of side effects. Chinese Medicines (CM) has therapeutic effect on reducing adverse effects of the endocrine therapy in many clinical studies. But strong evidence is still limited on the efficacy and safety of CM combined western medicines (CM-WM) for breast cancer.ObjectiveTo study the efficacy and safety of CM-WM as an adjuvant treatment for reducing side effects induced by endocrine therapy in breast cancer patients.MethodWe searched relevant clinical studies in PubMed and the Chinese National Knowledge Infrastructure (CNKI) databases up to February 28, 2021 and only Randomized Controlled Trials (RCTs) were included. There were no limitations on the languages. We extracted data from the included RCTs, assessed study quality, conducted meta-analyses by RevMan 5.4 and compared the pooled Risk Ratios (RR) or Mean Difference (MD) with 95% CIs.ResultsIn total 28 trials involving 1,926 participants were included. Six RCTs compared CM-WM with CM placebo-WM, while 22 RCTs compared CM-WM with WM alone. No study compared CM-WM with no treatment. Meta-analysis showed that CM-WM treatment significantly improved quality of life (MD = 0.73, 95% CI = 0.11–1.35, P = 0.02) when compared with CM placebo-WM treatment. When compared with WM treatment alone, CM-WM treatment significantly improved bone mineral density (MD = 0.24, 95% CI = 0.13–0.35, P <0.0001), TCM syndrome score (MD = −5.39, 95% CI = −8.81 to −1.97, P = 0.0002), Kupperman Scale (MD = 0.24, 95% CI = −2.76 to −1.94, P <0.0001), Karnofsky Performance Scale (MD = 3.76, 95% CI = 1.64–5.88, P = 0.0005), quality of life (MD = 3.01, 95% CI = 1.00–5.02, P = 0.003), and pain relief (MD = 2.10, 95% CI = 0.72–3.48, P <0.0001). Compared with WM, CM-WM significantly decreased incidence of TCM symptoms (nausea, vomiting, fatigue, etc.) (RR = 1.60, 95% CI = 1.40–1.84, P <0.0001). For safety, serum calcium, estradiol, ALP, and blood CD3, CD4 and CD8 counts were not significantly difference between two treatments (P >0.05). Serious side effects or reactions were not reported in all included studies.ConclusionThe adjunctive use of CM reduced the endocrine therapy associated adverse events, including bone mineral density loss, perimenopausal symptoms, poor quality of life, pain and impaired immune function. But large-scale and high quality RCTs are needed to support the application of CM-WM therapy. |
| first_indexed | 2024-12-17T06:48:31Z |
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| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-17T06:48:31Z |
| publishDate | 2021-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-2045603fa76e488593564fc75688b6f52022-12-21T21:59:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-06-011110.3389/fonc.2021.661925661925Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine TherapyLu Li0Lu Li1Lu Li2Lu Li3Rongyun Wang4Aolin Zhang5Aolin Zhang6Ling Wang7Qianwen Ge8Yuan Liu9Tianhui Chen10Chi Chiu Wang11Chi Chiu Wang12Ping Chung Leung13Qiuhua Sun14Xiaohui Fan15Xiaohui Fan16College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, ChinaInnovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, ChinaDepartment of Obstetrics & Gyneacology, The Chinese University of Hong Kong, Hong Kong, Hong KongInstitute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, Hong KongSchool of Nursing, Zhejiang Chinese Medical University, Hangzhou, ChinaCollege of Pharmaceutical Sciences, Zhejiang University, Hangzhou, ChinaInnovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, ChinaThe First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, ChinaThe First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, ChinaThe First College of Clinical Medicine, Lanzhou University, Lanzhou, ChinaDepartment of Cancer Prevention/Experimental Research Center, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, ChinaDepartment of Obstetrics & Gyneacology, The Chinese University of Hong Kong, Hong Kong, Hong KongSchool of Nursing, Zhejiang Chinese Medical University, Hangzhou, ChinaInstitute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, Hong KongSchool of Nursing, Zhejiang Chinese Medical University, Hangzhou, ChinaCollege of Pharmaceutical Sciences, Zhejiang University, Hangzhou, ChinaInnovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, ChinaBackgroundBreast cancer, a malignant disorder, occurs in epithelial tissue of the breast glands and ducts. Endocrine therapy is commonly applied as an important adjuvant treatment for breast cancer, but it usually induces a variety of side effects. Chinese Medicines (CM) has therapeutic effect on reducing adverse effects of the endocrine therapy in many clinical studies. But strong evidence is still limited on the efficacy and safety of CM combined western medicines (CM-WM) for breast cancer.ObjectiveTo study the efficacy and safety of CM-WM as an adjuvant treatment for reducing side effects induced by endocrine therapy in breast cancer patients.MethodWe searched relevant clinical studies in PubMed and the Chinese National Knowledge Infrastructure (CNKI) databases up to February 28, 2021 and only Randomized Controlled Trials (RCTs) were included. There were no limitations on the languages. We extracted data from the included RCTs, assessed study quality, conducted meta-analyses by RevMan 5.4 and compared the pooled Risk Ratios (RR) or Mean Difference (MD) with 95% CIs.ResultsIn total 28 trials involving 1,926 participants were included. Six RCTs compared CM-WM with CM placebo-WM, while 22 RCTs compared CM-WM with WM alone. No study compared CM-WM with no treatment. Meta-analysis showed that CM-WM treatment significantly improved quality of life (MD = 0.73, 95% CI = 0.11–1.35, P = 0.02) when compared with CM placebo-WM treatment. When compared with WM treatment alone, CM-WM treatment significantly improved bone mineral density (MD = 0.24, 95% CI = 0.13–0.35, P <0.0001), TCM syndrome score (MD = −5.39, 95% CI = −8.81 to −1.97, P = 0.0002), Kupperman Scale (MD = 0.24, 95% CI = −2.76 to −1.94, P <0.0001), Karnofsky Performance Scale (MD = 3.76, 95% CI = 1.64–5.88, P = 0.0005), quality of life (MD = 3.01, 95% CI = 1.00–5.02, P = 0.003), and pain relief (MD = 2.10, 95% CI = 0.72–3.48, P <0.0001). Compared with WM, CM-WM significantly decreased incidence of TCM symptoms (nausea, vomiting, fatigue, etc.) (RR = 1.60, 95% CI = 1.40–1.84, P <0.0001). For safety, serum calcium, estradiol, ALP, and blood CD3, CD4 and CD8 counts were not significantly difference between two treatments (P >0.05). Serious side effects or reactions were not reported in all included studies.ConclusionThe adjunctive use of CM reduced the endocrine therapy associated adverse events, including bone mineral density loss, perimenopausal symptoms, poor quality of life, pain and impaired immune function. But large-scale and high quality RCTs are needed to support the application of CM-WM therapy.https://www.frontiersin.org/articles/10.3389/fonc.2021.661925/fullbreast cancerChinese medicines combined western medicinesefficacyendocrine therapysafety |
| spellingShingle | Lu Li Lu Li Lu Li Lu Li Rongyun Wang Aolin Zhang Aolin Zhang Ling Wang Qianwen Ge Yuan Liu Tianhui Chen Chi Chiu Wang Chi Chiu Wang Ping Chung Leung Qiuhua Sun Xiaohui Fan Xiaohui Fan Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy Frontiers in Oncology breast cancer Chinese medicines combined western medicines efficacy endocrine therapy safety |
| title | Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy |
| title_full | Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy |
| title_fullStr | Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy |
| title_full_unstemmed | Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy |
| title_short | Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy |
| title_sort | evidence on efficacy and safety of chinese medicines combined western medicines treatment for breast cancer with endocrine therapy |
| topic | breast cancer Chinese medicines combined western medicines efficacy endocrine therapy safety |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.661925/full |
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