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Medicine Mar 2021A growing number of studies suggest that lentinan combined with cisplatin thoracic injection for the treatment of lung cancer is an effective combination of traditional...
BACKGROUND
A growing number of studies suggest that lentinan combined with cisplatin thoracic injection for the treatment of lung cancer is an effective combination of traditional Chinese and Western medicine, which has a continuous and beneficial effect on eliminating clinical symptoms and improving cachexia in lung cancer patients. However, whether this treatment is effective and safe for lung cancer patients or not, evidence supporting the effectiveness and safety of this treatment is still incomplete. Besides, there is lack of systematic review to assess the detailed situation (including risk of bias and methodology) of current related clinical studies.
OBJECTIVE
This study aimed to evaluate the effectiveness and safety of lentinan combined with cisplatin thoracic injection in the treatment of lung cancer.
METHODS
The major databases (Embase, PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database [VIP] Database, Chinese Biomedical Literature Service System [SinoMed], and Wanfang Database) were searched from inception to March 1, 2020. Randomized controlled trials (RCTs) of lentinan combined with cisplatin chest injection on patients with non-small cell lung cancer (NSCLC) were identified. Two assessors reviewed each trial independently. The methodological quality of the eligible studies was evaluated according to the Cochrane Collaboration's tool for assessing risk of bias. Both the data extraction and the literature quality screening evaluation were conducted independently by 2 researchers.
RESULTS
Totally 17 clinical RCTs were included in this study, involving 1390 patients. Meta-analysis results showed that the clinical efficacy (risk ratio [RR] = 1.34, 95% confidence interval [CI] 1.21-1.48), effective subgroup analysis (RR = 1.51, 95% CI 1.3-1.77), and quality of life (RR = 1.48, 95% CI 1.27-1.72), the differences are statistically significant. In terms of adverse reactions, mainly related to gastrointestinal reactions and bone marrow suppression, the incidence and degree of adverse reactions of lentinan combined with cisplatin thoracic injection group were lower than those of cisplatin thoracic injection group alone.
CONCLUSIONS
The current evidence prompted that Lentinan combined with cisplatin in thoracic injection might benefit patients with NSCLC on a certain extent; this systematic review revealed some definite conclusions about the application of Lentinan combined with cisplatin in thoracic injection for NSCLC. Due to the low methodological quality, high risk of bias, and inadequate reporting on clinical data, these results still require verification by a large number of well designed, heterogeneous RCT studies. More rigorous, multicenter, sufficient-sample, and double-blind RCTs are warranted.
Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Cisplatin; Drugs, Chinese Herbal; Humans; Lentinan; Lung Neoplasms; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 33761711
DOI: 10.1097/MD.0000000000025220 -
Indian Journal of Cancer Nov 2015To systematic review and analysis the clinical efficacy and toxicity of lentinan injection combined with chemotherapy in the treatment of nonsmall cell lung cancer... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematic review and analysis the clinical efficacy and toxicity of lentinan injection combined with chemotherapy in the treatment of nonsmall cell lung cancer (NSCLC).
MATERIALS AND METHODS
The databases of PubMed and CNKI were electronic searched with the free text word of lung cancer/NSCLC and lentinan. The prospective clinical study reporting the clinical efficacy and safety of lentinan injection combined with chemotherapy in the treatment of NSCLC were reviewed and included in this meta-analysis. The combined treatment efficacy and toxicity of lentinan injection combined with chemotherapy were pooled by Stata 11.0 software.
RESULTS
Twelve clinical studies of lentinan injection combined with chemotherapy in the treatment of NSCLC with 458 controls and 492 NSCLCs patients were finally included in this meta-analysis. The pooled results indicated that the objective response rate was significant improved in the lentinan injection combined chemotherapy group compared with chemotherapy group only (relative risk [RR] = 1.31, 95% confidence interval [CI]: 1.14-1.52). The chemotherapy-related toxicity of III/IV gastrointestinal reaction (RR = 0.54, 95% CI: 0.43-0.68) and III/IV granulocytopenia (RR = 0.65, 95% CI: 0.51-0.70) were significant decreased in the combined group.
CONCLUSION
Lentinan injection combined chemotherapy significant increase the objective response rate and decreased the chemotherapy-related toxicity.
Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Humans; Lentinan; Lung Neoplasms; Prospective Studies; Treatment Outcome
PubMed: 26548936
DOI: 10.4103/0019-509X.168953 -
Frontiers in Pharmacology 2018Esophageal cancer is one of the most common human cancers, and its incidence is highly endemic in China. The combination of Chinese herbal injections (CHIs) and...
Esophageal cancer is one of the most common human cancers, and its incidence is highly endemic in China. The combination of Chinese herbal injections (CHIs) and radiotherapy should be informed by the best available evidence. To update and expand on previous work in order to compare and rank the efficacy and safety of CHIs in combination with radiotherapy to treat esophageal cancer. We searched several electronic databases to identify randomized controlled trials (RCTs) regarding CHIs to treat esophageal cancer from their inception to March 15, 2017. In a network meta-analysis (NMA), the bias of the included trials was assessed by two individuals independently in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Outcomes such as the clinical effectiveness rate, performance status, adverse reactions (ADRs), and survival rate were evaluated. We performed a random-effects NMA to obtain estimates of efficacy and safety outcomes, and we present these estimates as odds ratios (ORs) and corresponding 95% confidence intervals (CIs) calculated via Stata 13.1 and WinBUGS 1.4 software. Furthermore, the surface under cumulative the ranking curve (SUCRA) was used to rank the efficacy and safety of different CHIs in relation to each outcome. Of 685 identified trials, 55 were eligible for inclusion in the study. These 55 trials included 12 CHIs and 4,114 participants. The cluster analysis results suggested that Compound kushen injection therapy is the optimal CHI treatment for patients with esophageal cancer in terms of improving the clinical effectiveness rate and performance status. Huachansu and Kangai injection are superior in improving 1-year and 2-year survival rates. Lentinan injection may be considered a favorable choice for reliving ADRs, and Compound kushen injection may provide treatment benefits by reducing both gastrointestinal reaction and radiation esophagitis. The current clinical evidence indicated that Compound kushen injection combined with radiotherapy is the most preferable and beneficial option for patients with esophageal cancer in terms of efficacy and safety. However, the results of our study should be interpreted with caution given the limitations of the sample size and the methodological quality of the included trials.
PubMed: 30662402
DOI: 10.3389/fphar.2018.01470