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The prophylactic use of Chinese herbal medicine for chemotherapy-induced leucopenia in oncology patients: a systematic review and meta-analysis of randomized clinical trials
Objective We performed a systematic review and meta-analysis to explore the clinical application of Chinese herbal medicine (CHM) for chemotherapy-induced leucopenia and to evaluate its effectiveness and safety. Methods We included randomized clinical trials (RCTs) with no limitation of publication...
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| Published in: | Supportive care in cancer 2015-02, Vol.23 (2), p.561-579 |
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| container_title | Supportive care in cancer |
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| creator | Ma, L. X. Ai, P. Li, H. Vardy, J. |
| description | Objective
We performed a systematic review and meta-analysis to explore the clinical application of Chinese herbal medicine (CHM) for chemotherapy-induced leucopenia and to evaluate its effectiveness and safety.
Methods
We included randomized clinical trials (RCTs) with no limitation of publication type or language. Participants were cancer patients undergoing chemotherapy. Trial designs included comparisons of CHM with granulocyte colony-stimulating factor, supportive treatments for leucopenia, and/or placebo. Main outcomes were white blood cell count and incidence of leucopenia. Screening, data extraction, and analysis were conducted according to the PRISMA guidelines.
Results
Eighty-three RCTs (
n
= 8,012) met the inclusion criteria. Fifteen Chinese patent medicines and 47 different modified formulas were used as prophylaxis for chemotherapy-induced leucopenia. Compared with no treatment, CHMs were shown to decrease the incidence of leucopenia (odds ratio (OR) −0.23 [−0.20, −0.27]),
P
|
| doi_str_mv | 10.1007/s00520-014-2469-8 |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_journals_1644087291</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A406992371</galeid><sourcerecordid>A406992371</sourcerecordid><originalsourceid>FETCH-LOGICAL-c509t-3351c5685ba5c0368ed7f8ce572fc38a376d48bcce1100cd4b1bfc1e7adc58823</originalsourceid><addsrcrecordid>eNp1UcuO1DAQtBCIHRY-gAuyxDmLHdtxwm014iWtxGU5W06nM_EqsYOdgMI_8Y84muUlgXxoq7uq-lGEPOfsijOmXyXGVMkKxmVRyqop6gfkwKUQhRaieUgOrJG8kEKpC_IkpTvGuNaqfEwuSpUBFW8O5PvtgHSOYR620cLigK4JaejpcXAe83fA2NqRTtg5yBnah0hhwCksuWLnrXC-WwE7OuIKYUbvLHWeBg9hDKeNznZx6Jf0mlqatrTgZPcuEb84_Eqt77L0Ygvr7bgll_bWMWfD5L5lURidd5D7L9HZMT0lj_oc8Nl9vCSf3r65Pb4vbj6--3C8vilAsWYphFAcVFWr1ipgoqqx030NqHTZg6it0FUn6xYAeb4jdLLlbQ8cte1A1XUpLsnLs26-zOcV02LuwhrziMnwSkpW67Lhv1EnO6Jxvg9LtDC5BOZasqppSqF31NU_UPl1ODkIHnuX838R-JkAMaQUsTdzdJONm-HM7L6bs-8m-252302dOS_uB17bbNUvxk-jM6A8A1Iu-RPGPzb6r-oPse-7PQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1644087291</pqid></control><display><type>article</type><title>The prophylactic use of Chinese herbal medicine for chemotherapy-induced leucopenia in oncology patients: a systematic review and meta-analysis of randomized clinical trials</title><source>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</source><source>Sociology Collection</source><source>Springer Link</source><creator>Ma, L. X. ; Ai, P. ; Li, H. ; Vardy, J.</creator><creatorcontrib>Ma, L. X. ; Ai, P. ; Li, H. ; Vardy, J.</creatorcontrib><description>Objective
We performed a systematic review and meta-analysis to explore the clinical application of Chinese herbal medicine (CHM) for chemotherapy-induced leucopenia and to evaluate its effectiveness and safety.
Methods
We included randomized clinical trials (RCTs) with no limitation of publication type or language. Participants were cancer patients undergoing chemotherapy. Trial designs included comparisons of CHM with granulocyte colony-stimulating factor, supportive treatments for leucopenia, and/or placebo. Main outcomes were white blood cell count and incidence of leucopenia. Screening, data extraction, and analysis were conducted according to the PRISMA guidelines.
Results
Eighty-three RCTs (
n
= 8,012) met the inclusion criteria. Fifteen Chinese patent medicines and 47 different modified formulas were used as prophylaxis for chemotherapy-induced leucopenia. Compared with no treatment, CHMs were shown to decrease the incidence of leucopenia (odds ratio (OR) −0.23 [−0.20, −0.27]),
P
< 0.00001), with the number needed to treat (NNT) −3.45 [−3.13, −3.85]. Subgroup analysis suggested a prophylactic benefit for white blood cell counts with
Fufang E-jiao Jiang
,
Diyu Shengbai Pian
, combination
Huangqi
and
Shengmai Zhusheye
, and
Fuzhong Shengbai Fang
for patients undergoing chemotherapy. No serious adverse events were reported. Only three articles (3/83, 4 %) were rated as having adequate methodological quality with a low level of bias. Funnel plots were asymmetrical.
Conclusions
Some CHMs may be efficacious in the treatment of chemotherapy-induced leucopenia, but the majority of reviewed studies were of poor quality. Results need to be confirmed in rigorously conducted high-quality trials, including pharmacokinetic studies to ensure that there are no interactions between the CHM agent and chemotherapy.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-014-2469-8</identifier><identifier>PMID: 25339619</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Antineoplastic Agents - adverse effects ; Antineoplastic Agents - therapeutic use ; Asian Continental Ancestry Group ; Birth control ; Blood cell count ; Cancer ; Cancer patients ; Chemotherapy ; Chemotherapy-Induced Febrile Neutropenia - prevention & control ; Clinical trials ; Drugs ; Drugs, Chinese Herbal - adverse effects ; Drugs, Chinese Herbal - therapeutic use ; Granulocyte colony-stimulating factor ; Granulocyte Colony-Stimulating Factor - therapeutic use ; Health Services Needs and Demand ; Herbal medicine ; Humans ; Leukocyte Count ; Medicine ; Medicine & Public Health ; Medicine, Botanic ; Medicine, Chinese ; Medicine, Herbal ; Meta-analysis ; Neoplasms - drug therapy ; Nursing ; Nursing Research ; Oncology ; Pain Medicine ; Product development ; Randomized Controlled Trials as Topic ; Rehabilitation Medicine ; Review Article</subject><ispartof>Supportive care in cancer, 2015-02, Vol.23 (2), p.561-579</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><rights>COPYRIGHT 2015 Springer</rights><rights>Springer-Verlag Berlin Heidelberg 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-3351c5685ba5c0368ed7f8ce572fc38a376d48bcce1100cd4b1bfc1e7adc58823</citedby><cites>FETCH-LOGICAL-c509t-3351c5685ba5c0368ed7f8ce572fc38a376d48bcce1100cd4b1bfc1e7adc58823</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1644087291/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1644087291?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21394,21395,27924,27925,33611,34530,43733,44115,74221,74639</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25339619$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ma, L. X.</creatorcontrib><creatorcontrib>Ai, P.</creatorcontrib><creatorcontrib>Li, H.</creatorcontrib><creatorcontrib>Vardy, J.</creatorcontrib><title>The prophylactic use of Chinese herbal medicine for chemotherapy-induced leucopenia in oncology patients: a systematic review and meta-analysis of randomized clinical trials</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Objective
We performed a systematic review and meta-analysis to explore the clinical application of Chinese herbal medicine (CHM) for chemotherapy-induced leucopenia and to evaluate its effectiveness and safety.
Methods
We included randomized clinical trials (RCTs) with no limitation of publication type or language. Participants were cancer patients undergoing chemotherapy. Trial designs included comparisons of CHM with granulocyte colony-stimulating factor, supportive treatments for leucopenia, and/or placebo. Main outcomes were white blood cell count and incidence of leucopenia. Screening, data extraction, and analysis were conducted according to the PRISMA guidelines.
Results
Eighty-three RCTs (
n
= 8,012) met the inclusion criteria. Fifteen Chinese patent medicines and 47 different modified formulas were used as prophylaxis for chemotherapy-induced leucopenia. Compared with no treatment, CHMs were shown to decrease the incidence of leucopenia (odds ratio (OR) −0.23 [−0.20, −0.27]),
P
< 0.00001), with the number needed to treat (NNT) −3.45 [−3.13, −3.85]. Subgroup analysis suggested a prophylactic benefit for white blood cell counts with
Fufang E-jiao Jiang
,
Diyu Shengbai Pian
, combination
Huangqi
and
Shengmai Zhusheye
, and
Fuzhong Shengbai Fang
for patients undergoing chemotherapy. No serious adverse events were reported. Only three articles (3/83, 4 %) were rated as having adequate methodological quality with a low level of bias. Funnel plots were asymmetrical.
Conclusions
Some CHMs may be efficacious in the treatment of chemotherapy-induced leucopenia, but the majority of reviewed studies were of poor quality. Results need to be confirmed in rigorously conducted high-quality trials, including pharmacokinetic studies to ensure that there are no interactions between the CHM agent and chemotherapy.</description><subject>Antineoplastic Agents - adverse effects</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Asian Continental Ancestry Group</subject><subject>Birth control</subject><subject>Blood cell count</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Chemotherapy</subject><subject>Chemotherapy-Induced Febrile Neutropenia - prevention & control</subject><subject>Clinical trials</subject><subject>Drugs</subject><subject>Drugs, Chinese Herbal - adverse effects</subject><subject>Drugs, Chinese Herbal - therapeutic use</subject><subject>Granulocyte colony-stimulating factor</subject><subject>Granulocyte Colony-Stimulating Factor - therapeutic use</subject><subject>Health Services Needs and Demand</subject><subject>Herbal medicine</subject><subject>Humans</subject><subject>Leukocyte Count</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Botanic</subject><subject>Medicine, Chinese</subject><subject>Medicine, Herbal</subject><subject>Meta-analysis</subject><subject>Neoplasms - drug therapy</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Pain Medicine</subject><subject>Product development</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Rehabilitation Medicine</subject><subject>Review Article</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>HEHIP</sourceid><sourceid>M2R</sourceid><sourceid>M2S</sourceid><recordid>eNp1UcuO1DAQtBCIHRY-gAuyxDmLHdtxwm014iWtxGU5W06nM_EqsYOdgMI_8Y84muUlgXxoq7uq-lGEPOfsijOmXyXGVMkKxmVRyqop6gfkwKUQhRaieUgOrJG8kEKpC_IkpTvGuNaqfEwuSpUBFW8O5PvtgHSOYR620cLigK4JaejpcXAe83fA2NqRTtg5yBnah0hhwCksuWLnrXC-WwE7OuIKYUbvLHWeBg9hDKeNznZx6Jf0mlqatrTgZPcuEb84_Eqt77L0Ygvr7bgll_bWMWfD5L5lURidd5D7L9HZMT0lj_oc8Nl9vCSf3r65Pb4vbj6--3C8vilAsWYphFAcVFWr1ipgoqqx030NqHTZg6it0FUn6xYAeb4jdLLlbQ8cte1A1XUpLsnLs26-zOcV02LuwhrziMnwSkpW67Lhv1EnO6Jxvg9LtDC5BOZasqppSqF31NU_UPl1ODkIHnuX838R-JkAMaQUsTdzdJONm-HM7L6bs-8m-252302dOS_uB17bbNUvxk-jM6A8A1Iu-RPGPzb6r-oPse-7PQ</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Ma, L. X.</creator><creator>Ai, P.</creator><creator>Li, H.</creator><creator>Vardy, J.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>20150201</creationdate><title>The prophylactic use of Chinese herbal medicine for chemotherapy-induced leucopenia in oncology patients: a systematic review and meta-analysis of randomized clinical trials</title><author>Ma, L. X. ; Ai, P. ; Li, H. ; Vardy, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-3351c5685ba5c0368ed7f8ce572fc38a376d48bcce1100cd4b1bfc1e7adc58823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Antineoplastic Agents - adverse effects</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Asian Continental Ancestry Group</topic><topic>Birth control</topic><topic>Blood cell count</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Chemotherapy</topic><topic>Chemotherapy-Induced Febrile Neutropenia - prevention & control</topic><topic>Clinical trials</topic><topic>Drugs</topic><topic>Drugs, Chinese Herbal - adverse effects</topic><topic>Drugs, Chinese Herbal - therapeutic use</topic><topic>Granulocyte colony-stimulating factor</topic><topic>Granulocyte Colony-Stimulating Factor - therapeutic use</topic><topic>Health Services Needs and Demand</topic><topic>Herbal medicine</topic><topic>Humans</topic><topic>Leukocyte Count</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Botanic</topic><topic>Medicine, Chinese</topic><topic>Medicine, Herbal</topic><topic>Meta-analysis</topic><topic>Neoplasms - drug therapy</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Pain Medicine</topic><topic>Product development</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Rehabilitation Medicine</topic><topic>Review Article</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ma, L. X.</creatorcontrib><creatorcontrib>Ai, P.</creatorcontrib><creatorcontrib>Li, H.</creatorcontrib><creatorcontrib>Vardy, J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection【Remote access available】</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ma, L. X.</au><au>Ai, P.</au><au>Li, H.</au><au>Vardy, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prophylactic use of Chinese herbal medicine for chemotherapy-induced leucopenia in oncology patients: a systematic review and meta-analysis of randomized clinical trials</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>23</volume><issue>2</issue><spage>561</spage><epage>579</epage><pages>561-579</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Objective
We performed a systematic review and meta-analysis to explore the clinical application of Chinese herbal medicine (CHM) for chemotherapy-induced leucopenia and to evaluate its effectiveness and safety.
Methods
We included randomized clinical trials (RCTs) with no limitation of publication type or language. Participants were cancer patients undergoing chemotherapy. Trial designs included comparisons of CHM with granulocyte colony-stimulating factor, supportive treatments for leucopenia, and/or placebo. Main outcomes were white blood cell count and incidence of leucopenia. Screening, data extraction, and analysis were conducted according to the PRISMA guidelines.
Results
Eighty-three RCTs (
n
= 8,012) met the inclusion criteria. Fifteen Chinese patent medicines and 47 different modified formulas were used as prophylaxis for chemotherapy-induced leucopenia. Compared with no treatment, CHMs were shown to decrease the incidence of leucopenia (odds ratio (OR) −0.23 [−0.20, −0.27]),
P
< 0.00001), with the number needed to treat (NNT) −3.45 [−3.13, −3.85]. Subgroup analysis suggested a prophylactic benefit for white blood cell counts with
Fufang E-jiao Jiang
,
Diyu Shengbai Pian
, combination
Huangqi
and
Shengmai Zhusheye
, and
Fuzhong Shengbai Fang
for patients undergoing chemotherapy. No serious adverse events were reported. Only three articles (3/83, 4 %) were rated as having adequate methodological quality with a low level of bias. Funnel plots were asymmetrical.
Conclusions
Some CHMs may be efficacious in the treatment of chemotherapy-induced leucopenia, but the majority of reviewed studies were of poor quality. Results need to be confirmed in rigorously conducted high-quality trials, including pharmacokinetic studies to ensure that there are no interactions between the CHM agent and chemotherapy.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25339619</pmid><doi>10.1007/s00520-014-2469-8</doi><tpages>19</tpages></addata></record> |
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| language | eng |
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| subjects | Antineoplastic Agents - adverse effects Antineoplastic Agents - therapeutic use Asian Continental Ancestry Group Birth control Blood cell count Cancer Cancer patients Chemotherapy Chemotherapy-Induced Febrile Neutropenia - prevention & control Clinical trials Drugs Drugs, Chinese Herbal - adverse effects Drugs, Chinese Herbal - therapeutic use Granulocyte colony-stimulating factor Granulocyte Colony-Stimulating Factor - therapeutic use Health Services Needs and Demand Herbal medicine Humans Leukocyte Count Medicine Medicine & Public Health Medicine, Botanic Medicine, Chinese Medicine, Herbal Meta-analysis Neoplasms - drug therapy Nursing Nursing Research Oncology Pain Medicine Product development Randomized Controlled Trials as Topic Rehabilitation Medicine Review Article |
| title | The prophylactic use of Chinese herbal medicine for chemotherapy-induced leucopenia in oncology patients: a systematic review and meta-analysis of randomized clinical trials |
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