Lung Cancer: Targets and Therapy
Open access peer-reviewed scientific and medical journals.
Dove Medical Press is now a member of the Open Access Initiative
An Author's Guide
A guide to help authors get their paper published.
Support Open Access and Dove Press
Promotional Article Monitoring - further details
Favored Author Program
Real benefits for authors, including fast-track processing of papers.
Astragalus-containing Chinese herbal combinations for advanced non-small-cell lung cancer: a meta-analysis of 65 clinical trials enrolling 4751 patients
(3841) Total Article Views
Authors: Jean Jacques Dugoua, Ping Wu, Dugald Seely, et al
Published Date July 2010
Volume 2010:1(Default) Pages 85 - 100
Jean Jacques Dugoua1, Ping Wu2, Dugald Seely3, Oghenowede Eyawo4, Edward Mills4,5
1Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada; 2Shanghai Hospital #4, Shanghai, China; 3Department of Clinical Epidemiology, Canadian College of Naturopathic Medicine; 4Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada; 5Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
Background: Non-small-cell lung cancer (NSCLC) is a leading cause of death. Interventions to reduce mortality in patients with NSCLC represent a patient-important field of research. Little is known about interventions used outside the Western world for NSCLC. One intervention widely used in Asia is astragalus-based herbal preparations.
Methods: We conducted a comprehensive systematic review of all published randomized clinical trials (RCTs) evaluating astragalus-based herbal preparations in NSCLC patients. We searched independently, in duplicate, 6 English language electronic databases and 2 Chinese-language databases. We abstracted data independently, in duplicate on studies reporting of methods, survival outcomes, tumor responses, and performance score responses. We applied a random-effects meta-analysis and report outcomes as relative risks (RR) with 95% confidence intervals (CIs).
Results: We included 65 RCTs enrolling 4751 patients. All trials included the herbal preparations plus platinum-based chemotherapy versus chemotherapy alone. We pooled 7 studies (n = 529) reporting on survival at 6 months and found a pooled RR of 0.54 (95% CI, 0.45 to 0.65, P ≤ 0.0001). We included 20 trials in (n = 1520) for survival at 12 months and found a pooled RR of 0.65 (95% CI, 0.54 to 0.79, P ≤ 0.0001). This effect was consistent at 24 and 36 months. When we applied a composite endpoint of any tumor treatment response we pooled data from 57 trials and found a pooled RR of 1.35 in favor of herbal treatment (95% CI, 1.26 to 1.44, P ≤ 0.0001). Statistical heterogeneity was low across trials.
Limitations: The quality of reporting the RCTs was generally poor. There is also reason to believe that studies reported as randomized may not be.
Conclusions: We found a large treatment effect of adding astragalus-based herbal treatment to standard chemotherapy regimens. There is a pressing need for validation of these findings in well-conducted RCTs in a Western setting.
Keywords: astralagus, non-small-cell lung cancer, herbal preparations
Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter
Other articles by Dr Edward Mills
Readers of this article also read:
- American Thoracic Society Conference
Dove Press will exhibit at the American Thoracic Society National Conference in Philadelphia on May 17 - 22. We invite you to come and meet Dr. Richard E Russell, our Founding Editor, at Dove Medical Press Booth 1437 on May 20th at 2:00 PM.
- ASCO 2013 Meet the Editor
We invite you to meet Prof Dr Hans-Joachim Schmoll at the Dove Medical Press booth 22102 on June 1st at 11am. Prof Dr Schmoll is the Editor-in-Chief of the journal OncoTargets and Therapy (IF 1.26).
- Epigenomics in cancer management
- The bradykinin B2 receptor induces multiple cellular responses leading to the proliferation of human renal carcinoma cell lines
- Intercellular cancer collisions generate an ejected crystal comet tail effect with fractal interface embryoid body reassembly transformation
- Integrative systems of genomic risk markers for cancer and other diseases: future of predictive medicine