Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis
BackgroundIn China, Atractylodes-containing Chinese medicines are widely used as adjuvant therapy to neoadjuvant chemotherapy (NAC) in individuals diagnosed with advanced gastric cancer (AGC). Nevertheless, the findings concerning its effectiveness are still restricted. The aim from this research wa...
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Frontiers Media S.A.
2024-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1431381/full |
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| author | Xiaotao Niu Xiaotao Niu Haoqing Gu Haoqing Gu Jingzhan Li Jingzhan Li Jiaqian Zuo Jiaqian Zuo Wenqin Ren Wenqin Ren Yujie Huang Yujie Huang Xinyan Shu Xinyan Shu Chao Jiang Chao Jiang Peng Shu Peng Shu |
| author_facet | Xiaotao Niu Xiaotao Niu Haoqing Gu Haoqing Gu Jingzhan Li Jingzhan Li Jiaqian Zuo Jiaqian Zuo Wenqin Ren Wenqin Ren Yujie Huang Yujie Huang Xinyan Shu Xinyan Shu Chao Jiang Chao Jiang Peng Shu Peng Shu |
| author_sort | Xiaotao Niu |
| collection | DOAJ |
| description | BackgroundIn China, Atractylodes-containing Chinese medicines are widely used as adjuvant therapy to neoadjuvant chemotherapy (NAC) in individuals diagnosed with advanced gastric cancer (AGC). Nevertheless, the findings concerning its effectiveness are still restricted. The aim from this research was to examine the efficiency and security Atractylodes macrocephala-containing traditional Chinese medicine together with NAC in the management of AGC.MethodsLiterature was systematically searched across 8 electronic databases until September 20, 2023. Two researchers conducted a thorough review of the selected studies. The primary outcome measures included the objective response rate (ORR), disease control rate (DCR), quality of life (QOL), adverse drug reactions (ADRs), and levels of peripheral blood lymphocytes. The relevant effect estimates are as follows as risk ratios (RR) or mean differences (MD) with corresponding 95% confidence intervals (CI). Credibility of information was evaluated using the GRADE analyzer.ResultsThe results showed that solely on the basis of the accessible literature examined in NAC patients, individuals who received the therapeutic regimen containing Atractylodis Macrocephalae Chinese herbal preparations demonstrated a superior overall response rate (Relative Risk: 1.41, 95% confidence interval: 1.27-1.57, P < 0.001); DCR (RR: 1.20, 95% confidence interval: 1.13-1.27, P < 0.001), as compared to QOL (RR: 1.43, 95% confidence interval: 1.30-1.57, P < 0.001, MD: 8.47, 95% confidence interval: 7.16 - 9.77, P < 0.001); the proportions of CD3+ T-cells, CD4+ T-cells, CD8+ T-cells, CD4+CD8+ T-cells were increased; and the incidence of adverse reactions was decreased. Subgroup analyses showed that oral administration of all the traditional Chinese medicines containing Atractylodes macrocephala could improve tumor efficacy. Regardless of the duration of therapy of ≥8 weeks or <8 weeks, Atractylodes macrocephala-containing traditional Chinese medicine increased the tumor response in AGC patients. Combination of Atractylodes macrocephala-containing TCM with neoadjuvant chemotherapy increased ORR and DCR; when used in conjunction with cisplatin, only ORR was increased.ConclusionThe combination of Atractylodes macrocephala-containing herbs with NAC in the treatment of AGC improves efficacy, improves prognosis, and reduces adverse effects. Nevertheless, additional high-quality randomized trials are required.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023461079. |
| format | Article |
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| institution | OA Journals |
| issn | 2234-943X |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-3fcc16b50edf4cfcb26d7074c7b275272025-08-20T01:47:33ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-10-011410.3389/fonc.2024.14313811431381Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysisXiaotao Niu0Xiaotao Niu1Haoqing Gu2Haoqing Gu3Jingzhan Li4Jingzhan Li5Jiaqian Zuo6Jiaqian Zuo7Wenqin Ren8Wenqin Ren9Yujie Huang10Yujie Huang11Xinyan Shu12Xinyan Shu13Chao Jiang14Chao Jiang15Peng Shu16Peng Shu17Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaAffiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaAffiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaAffiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaAffiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaAffiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaAffiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaAffiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaAffiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, ChinaSchool of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, ChinaBackgroundIn China, Atractylodes-containing Chinese medicines are widely used as adjuvant therapy to neoadjuvant chemotherapy (NAC) in individuals diagnosed with advanced gastric cancer (AGC). Nevertheless, the findings concerning its effectiveness are still restricted. The aim from this research was to examine the efficiency and security Atractylodes macrocephala-containing traditional Chinese medicine together with NAC in the management of AGC.MethodsLiterature was systematically searched across 8 electronic databases until September 20, 2023. Two researchers conducted a thorough review of the selected studies. The primary outcome measures included the objective response rate (ORR), disease control rate (DCR), quality of life (QOL), adverse drug reactions (ADRs), and levels of peripheral blood lymphocytes. The relevant effect estimates are as follows as risk ratios (RR) or mean differences (MD) with corresponding 95% confidence intervals (CI). Credibility of information was evaluated using the GRADE analyzer.ResultsThe results showed that solely on the basis of the accessible literature examined in NAC patients, individuals who received the therapeutic regimen containing Atractylodis Macrocephalae Chinese herbal preparations demonstrated a superior overall response rate (Relative Risk: 1.41, 95% confidence interval: 1.27-1.57, P < 0.001); DCR (RR: 1.20, 95% confidence interval: 1.13-1.27, P < 0.001), as compared to QOL (RR: 1.43, 95% confidence interval: 1.30-1.57, P < 0.001, MD: 8.47, 95% confidence interval: 7.16 - 9.77, P < 0.001); the proportions of CD3+ T-cells, CD4+ T-cells, CD8+ T-cells, CD4+CD8+ T-cells were increased; and the incidence of adverse reactions was decreased. Subgroup analyses showed that oral administration of all the traditional Chinese medicines containing Atractylodes macrocephala could improve tumor efficacy. Regardless of the duration of therapy of ≥8 weeks or <8 weeks, Atractylodes macrocephala-containing traditional Chinese medicine increased the tumor response in AGC patients. Combination of Atractylodes macrocephala-containing TCM with neoadjuvant chemotherapy increased ORR and DCR; when used in conjunction with cisplatin, only ORR was increased.ConclusionThe combination of Atractylodes macrocephala-containing herbs with NAC in the treatment of AGC improves efficacy, improves prognosis, and reduces adverse effects. Nevertheless, additional high-quality randomized trials are required.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023461079.https://www.frontiersin.org/articles/10.3389/fonc.2024.1431381/fullAtractylodes macrocephalaneoadjuvant chemotherapyprogressive gastric cancertraditional Chinese medicinemeta-analysis |
| spellingShingle | Xiaotao Niu Xiaotao Niu Haoqing Gu Haoqing Gu Jingzhan Li Jingzhan Li Jiaqian Zuo Jiaqian Zuo Wenqin Ren Wenqin Ren Yujie Huang Yujie Huang Xinyan Shu Xinyan Shu Chao Jiang Chao Jiang Peng Shu Peng Shu Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis Frontiers in Oncology Atractylodes macrocephala neoadjuvant chemotherapy progressive gastric cancer traditional Chinese medicine meta-analysis |
| title | Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis |
| title_full | Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis |
| title_fullStr | Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis |
| title_full_unstemmed | Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis |
| title_short | Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis |
| title_sort | efficacy and safety of atractylodes macrocephala containing traditional chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer a systematic evaluation and meta analysis |
| topic | Atractylodes macrocephala neoadjuvant chemotherapy progressive gastric cancer traditional Chinese medicine meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1431381/full |
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