Traditional Chinese medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysisReportar como inadecuado




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Journal of Experimental and Clinical Cancer Research

, 28:112

First Online: 12 August 2009Received: 06 July 2009Accepted: 12 August 2009

Abstract

BackgroundLiver 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.

MethodsWe 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.

ResultsWe 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 = 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 = 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 = 7%, P = 0.36, 24 months 15 trials, 1.72, 95% CI, 1.40–2.03, P = < 0.0001, I = 0%, P = 0.75; and, at 36 months 8 trials, RR 2.40, 95% CI, 1.65–3.49, P = < 0.0001, I = 0%, P = 0.62.

LimitationsAll included trials were conducted in China where emerging evidence suggests many RCTs are not, in fact, randomized. Publication bias may exist, favouring positive reports.

ConclusionOur meta-analysis displays compelling evidence of effectiveness for hepatocellular cancers that should be evaluated in high-quality and transparent clinical trials.

Electronic supplementary materialThe online version of this article doi:10.1186-1756-9966-28-112 contains supplementary material, which is available to authorized users.

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Autor: Ping Wu - Jean Jacques Dugoua - Oghenowede Eyawo - Edward J Mills

Fuente: https://link.springer.com/



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