Therapeutic efficacy and safety of Compound Kushen Injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma: An update systematic review and meta-analysis
Background: Compound Kushen Injection (CKI) is a Chinese patent medicine approved by the Chinese State Food and Drug Administration for the treatment of various types of solid tumors. CKI, combined with transarterial chemoembolization (TACE), is believed to increase the therapeutic efficacy of unres...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-03-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fphar.2016.00070/full |
| _version_ | 1818238637474578432 |
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| author | Xiao eMa Xiao eMa Ruisheng eLi Jian eWang Yinqiu eHuang Yinqiu eHuang Pengyan eLi Ji eWang Haibin eSu Ruilin eWang Yaming eZhang Honghong eLiu Congen eZhang Congen eZhang Zhijie eMa Jiabo eWang Yanling eZhao Xiaohe eXiao |
| author_facet | Xiao eMa Xiao eMa Ruisheng eLi Jian eWang Yinqiu eHuang Yinqiu eHuang Pengyan eLi Ji eWang Haibin eSu Ruilin eWang Yaming eZhang Honghong eLiu Congen eZhang Congen eZhang Zhijie eMa Jiabo eWang Yanling eZhao Xiaohe eXiao |
| author_sort | Xiao eMa |
| collection | DOAJ |
| description | Background: Compound Kushen Injection (CKI) is a Chinese patent medicine approved by the Chinese State Food and Drug Administration for the treatment of various types of solid tumors. CKI, combined with transarterial chemoembolization (TACE), is believed to increase the therapeutic efficacy of unresectable hepatocellular carcinoma (HCC). We report an updated and extended meta-analysis with detailed outcomes of both the efficacy and adverse events of CKI combined with TACE therapy.Materials and methods: Electronic databases, including PubMed, Embase, the Cochrane Library, the Chinese Biomedical Database (CBM), Wanfang, the VIP medicine information system (VMIS) and the China National Knowledge Infrastructure (CNKI), were examined for relevant articles before November 13, 2015. An odds ratio (OR) was used to estimate tumor response, Karnofsky Performance Scale (KPS) improvement, Child-Pugh improvement, survival rate and adverse events. A publication bias and a subgroup analysis were also assessed.Results: Eighteen studies, with a total of 1,338 HCC patients who met the criteria for the meta-analysis, were included. Tumor response, KPS improvement and Child-Pugh improvement were significantly enhanced for the combination therapy compared to TACE alone (OR=1.84, 95% CI: [1.46, 2.33], P<0.00001; OR=2.37, 95% CI: [1.76, 3.18], P<0.00001; OR=1.81, 95% CI: [1.08, 3.03], P=0.02, respectively). The combination therapy was associated with an improvement in one-year and two-year survival rates but not an improved three-year survival rate (OR=2.40; 95% CI: [1.59, 3.62], P<0.0001; OR=2.49, 95% CI: [1.24, 5.00], P=0.01; OR=2.49, 95% CI: [0.94, 6.61], P=0.07, respectively). A safety analysis indicated that adverse events (including nausea/vomiting, fever, hepatalgia, increased transaminase, increased bilirubin and leukopenia) were reduced for the combination treatment compared to TACE alone.Conclusion: The combination treatment of TACE and CKI was associated with improved tumor response, KPS and Child-Pugh improvement and improved one- and two-year survival rates in patients with unresectable HCC. The three-year survival rate was not improved. The combination therapy resulted in a reduction in adverse events. The findings of this study should be interpreted with caution because of the small sample size and study limitations. |
| first_indexed | 2024-12-12T12:44:49Z |
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| id | doaj.art-8568104126264ad79b0ad4d1bb5cbe5e |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-12T12:44:49Z |
| publishDate | 2016-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-8568104126264ad79b0ad4d1bb5cbe5e2022-12-22T00:24:09ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122016-03-01710.3389/fphar.2016.00070185198Therapeutic efficacy and safety of Compound Kushen Injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma: An update systematic review and meta-analysisXiao eMa0Xiao eMa1Ruisheng eLi2Jian eWang3Yinqiu eHuang4Yinqiu eHuang5Pengyan eLi6Ji eWang7Haibin eSu8Ruilin eWang9Yaming eZhang10Honghong eLiu11Congen eZhang12Congen eZhang13Zhijie eMa14Jiabo eWang15Yanling eZhao16Xiaohe eXiao17302 Military Hospital of People’s Liberation ArmyChengdu University of Traditional Chinese Medicine302 Military Hospital of People’s Liberation ArmyChengdu University of Traditional Chinese Medicine302 Military Hospital of People’s Liberation ArmyChengdu University of Traditional Chinese Medicine302 Military Hospital of People’s Liberation ArmySichuan University302 Military Hospital of People’s Liberation Army302 Military Hospital of People’s Liberation Army302 Military Hospital of People’s Liberation Army302 Military Hospital of People’s Liberation ArmyChengdu University of Traditional Chinese Medicine302 Military Hospital of People’s Liberation ArmyCapital Medical University302 Military Hospital of People’s Liberation Army302 Military Hospital of People’s Liberation Army302 Military Hospital of People’s Liberation ArmyBackground: Compound Kushen Injection (CKI) is a Chinese patent medicine approved by the Chinese State Food and Drug Administration for the treatment of various types of solid tumors. CKI, combined with transarterial chemoembolization (TACE), is believed to increase the therapeutic efficacy of unresectable hepatocellular carcinoma (HCC). We report an updated and extended meta-analysis with detailed outcomes of both the efficacy and adverse events of CKI combined with TACE therapy.Materials and methods: Electronic databases, including PubMed, Embase, the Cochrane Library, the Chinese Biomedical Database (CBM), Wanfang, the VIP medicine information system (VMIS) and the China National Knowledge Infrastructure (CNKI), were examined for relevant articles before November 13, 2015. An odds ratio (OR) was used to estimate tumor response, Karnofsky Performance Scale (KPS) improvement, Child-Pugh improvement, survival rate and adverse events. A publication bias and a subgroup analysis were also assessed.Results: Eighteen studies, with a total of 1,338 HCC patients who met the criteria for the meta-analysis, were included. Tumor response, KPS improvement and Child-Pugh improvement were significantly enhanced for the combination therapy compared to TACE alone (OR=1.84, 95% CI: [1.46, 2.33], P<0.00001; OR=2.37, 95% CI: [1.76, 3.18], P<0.00001; OR=1.81, 95% CI: [1.08, 3.03], P=0.02, respectively). The combination therapy was associated with an improvement in one-year and two-year survival rates but not an improved three-year survival rate (OR=2.40; 95% CI: [1.59, 3.62], P<0.0001; OR=2.49, 95% CI: [1.24, 5.00], P=0.01; OR=2.49, 95% CI: [0.94, 6.61], P=0.07, respectively). A safety analysis indicated that adverse events (including nausea/vomiting, fever, hepatalgia, increased transaminase, increased bilirubin and leukopenia) were reduced for the combination treatment compared to TACE alone.Conclusion: The combination treatment of TACE and CKI was associated with improved tumor response, KPS and Child-Pugh improvement and improved one- and two-year survival rates in patients with unresectable HCC. The three-year survival rate was not improved. The combination therapy resulted in a reduction in adverse events. The findings of this study should be interpreted with caution because of the small sample size and study limitations.http://journal.frontiersin.org/Journal/10.3389/fphar.2016.00070/fullMeta-analysisSystematic reviewTransarterial chemoembolizationCompound kushen injectionUnresectable hepatocellular carcinoma |
| spellingShingle | Xiao eMa Xiao eMa Ruisheng eLi Jian eWang Yinqiu eHuang Yinqiu eHuang Pengyan eLi Ji eWang Haibin eSu Ruilin eWang Yaming eZhang Honghong eLiu Congen eZhang Congen eZhang Zhijie eMa Jiabo eWang Yanling eZhao Xiaohe eXiao Therapeutic efficacy and safety of Compound Kushen Injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma: An update systematic review and meta-analysis Frontiers in Pharmacology Meta-analysis Systematic review Transarterial chemoembolization Compound kushen injection Unresectable hepatocellular carcinoma |
| title | Therapeutic efficacy and safety of Compound Kushen Injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma: An update systematic review and meta-analysis |
| title_full | Therapeutic efficacy and safety of Compound Kushen Injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma: An update systematic review and meta-analysis |
| title_fullStr | Therapeutic efficacy and safety of Compound Kushen Injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma: An update systematic review and meta-analysis |
| title_full_unstemmed | Therapeutic efficacy and safety of Compound Kushen Injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma: An update systematic review and meta-analysis |
| title_short | Therapeutic efficacy and safety of Compound Kushen Injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma: An update systematic review and meta-analysis |
| title_sort | therapeutic efficacy and safety of compound kushen injection combined with transarterial chemoembolization in unresectable hepatocellular carcinoma an update systematic review and meta analysis |
| topic | Meta-analysis Systematic review Transarterial chemoembolization Compound kushen injection Unresectable hepatocellular carcinoma |
| url | http://journal.frontiersin.org/Journal/10.3389/fphar.2016.00070/full |
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