Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis
<p>Abstract</p> <p>Background</p> <p>Liver cancer is a common malignancy with a high mortality rate. Given the poor prognosis associated with this cancer, many patients seek additional therapies that may improve quality of life or survival. Several Traditional Chinese M...
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| Format: | Article |
| Language: | English |
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BMC
2009-08-01
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| Series: | Journal of Experimental & Clinical Cancer Research |
| Online Access: | http://www.jeccr.com/content/28/1/112 |
| _version_ | 1811251442297602048 |
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| author | Eyawo Oghenowede Dugoua Jean Wu Ping Mills Edward J |
| author_facet | Eyawo Oghenowede Dugoua Jean Wu Ping Mills Edward J |
| author_sort | Eyawo Oghenowede |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Liver cancer is a common malignancy with a high mortality rate. Given the poor prognosis associated with this cancer, many patients seek additional therapies that may improve quality of life or survival. Several Traditional Chinese Medicines (TCM) have been evaluated in clinical trials, but little is known about them outside of China.</p> <p>Methods</p> <p>We searched independently and in duplicate 8 electronic databases, including 2 Chinese language databases, until February 2009. We included any randomized clinical trials (RCT) evaluating a TCM oral preparation for the treatment of hepatocellular cancers. We abstracted data on survival, tumor response, and performance scores. We conducted a random-effects meta-analysis and applied a meta-regression analysis.</p> <p>Results</p> <p>We included 45 RCTs (n = 3,236). All studies employed an active control group. In general, the reporting of methodological issues was poor. We analyzed data from 37 trials reporting on complete response effects score (Relative Risk [RR] of 1.26 (95 CI, 1.04–1.52, P = 0.01, I<sup>2 </sup>= 0%, P = 0.99). Products containing ginseng, astragalus and mylabris had a larger treatment effect (OR 1.34, 95% CI, 1.04–1.71, P = 0.01) than the pooled broad estimate, also the case for astragalus-based treatments (OR 1.35, 95% CI, 1.001–1.80. P = 0.048). We examined survival rates and pooled 15 studies reporting on 6 month outcomes (RR 1.10, 95% CI, 1.04–1.15, P = < 0.0001, I<sup>2 </sup>= 0%, P = 0.60). This effect was consistent at other prospective dates, including 12 months (22 trials, RR 1.26, 95% CI, 1.17–1.36, P = < 0.0001, I<sup>2 </sup>= 7%, P = 0.36), 24 months (15 trials, 1.72, 95% CI, 1.40–2.03, P = < 0.0001, I<sup>2 </sup>= 0%, P = 0.75); and, at 36 months (8 trials, RR 2.40, 95% CI, 1.65–3.49, P = < 0.0001, I<sup>2 </sup>= 0%, P = 0.62).</p> <p>Limitations</p> <p>All included trials were conducted in China where emerging evidence suggests many RCTs are not, in fact, randomized. Publication bias may exist, favouring positive reports.</p> <p>Conclusion</p> <p>Our meta-analysis displays compelling evidence of effectiveness for hepatocellular cancers that should be evaluated in high-quality and transparent clinical trials.</p> |
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| id | doaj.art-f70b368e39ae451bb3610900e652e006 |
| institution | Directory Open Access Journal |
| issn | 1756-9966 |
| language | English |
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| publishDate | 2009-08-01 |
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| series | Journal of Experimental & Clinical Cancer Research |
| spelling | doaj.art-f70b368e39ae451bb3610900e652e0062022-12-22T03:25:35ZengBMCJournal of Experimental & Clinical Cancer Research1756-99662009-08-0128111210.1186/1756-9966-28-112Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysisEyawo OghenowedeDugoua JeanWu PingMills Edward J<p>Abstract</p> <p>Background</p> <p>Liver cancer is a common malignancy with a high mortality rate. Given the poor prognosis associated with this cancer, many patients seek additional therapies that may improve quality of life or survival. Several Traditional Chinese Medicines (TCM) have been evaluated in clinical trials, but little is known about them outside of China.</p> <p>Methods</p> <p>We searched independently and in duplicate 8 electronic databases, including 2 Chinese language databases, until February 2009. We included any randomized clinical trials (RCT) evaluating a TCM oral preparation for the treatment of hepatocellular cancers. We abstracted data on survival, tumor response, and performance scores. We conducted a random-effects meta-analysis and applied a meta-regression analysis.</p> <p>Results</p> <p>We included 45 RCTs (n = 3,236). All studies employed an active control group. In general, the reporting of methodological issues was poor. We analyzed data from 37 trials reporting on complete response effects score (Relative Risk [RR] of 1.26 (95 CI, 1.04–1.52, P = 0.01, I<sup>2 </sup>= 0%, P = 0.99). Products containing ginseng, astragalus and mylabris had a larger treatment effect (OR 1.34, 95% CI, 1.04–1.71, P = 0.01) than the pooled broad estimate, also the case for astragalus-based treatments (OR 1.35, 95% CI, 1.001–1.80. P = 0.048). We examined survival rates and pooled 15 studies reporting on 6 month outcomes (RR 1.10, 95% CI, 1.04–1.15, P = < 0.0001, I<sup>2 </sup>= 0%, P = 0.60). This effect was consistent at other prospective dates, including 12 months (22 trials, RR 1.26, 95% CI, 1.17–1.36, P = < 0.0001, I<sup>2 </sup>= 7%, P = 0.36), 24 months (15 trials, 1.72, 95% CI, 1.40–2.03, P = < 0.0001, I<sup>2 </sup>= 0%, P = 0.75); and, at 36 months (8 trials, RR 2.40, 95% CI, 1.65–3.49, P = < 0.0001, I<sup>2 </sup>= 0%, P = 0.62).</p> <p>Limitations</p> <p>All included trials were conducted in China where emerging evidence suggests many RCTs are not, in fact, randomized. Publication bias may exist, favouring positive reports.</p> <p>Conclusion</p> <p>Our meta-analysis displays compelling evidence of effectiveness for hepatocellular cancers that should be evaluated in high-quality and transparent clinical trials.</p>http://www.jeccr.com/content/28/1/112 |
| spellingShingle | Eyawo Oghenowede Dugoua Jean Wu Ping Mills Edward J Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis Journal of Experimental & Clinical Cancer Research |
| title | Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis |
| title_full | Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis |
| title_fullStr | Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis |
| title_full_unstemmed | Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis |
| title_short | Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis |
| title_sort | traditional chinese medicines in the treatment of hepatocellular cancers a systematic review and meta analysis |
| url | http://www.jeccr.com/content/28/1/112 |
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