PMID- 32176081
OWN - NLM
STAT- MEDLINE
DCOM- 20200324
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 11
DP  - 2020 Mar
TI  - Efficacy and safety of elemene combined with chemotherapy in advanced gastric 
      cancer: A Meta-analysis.
PG  - e19481
LID - 10.1097/MD.0000000000019481 [doi]
LID - e19481
AB  - BACKGROUND: Elemene is a natural compound extracted from Zingiberaceae plants, 
      and is used in various cancer. However, the efficacy and safety elemene combined 
      with chemotherapy in advanced gastric cancer (GC) are lack of systematic 
      assessment. METHODS: we searched the PubMed, EMBASE, Web of Science, Cochrane 
      Library, China Academic Journals (CNKI), Chinese Science and Technology Journals 
      (CQVIP) and Chinese Biomedical Literature databases. Randomized controlled trials 
      (RCTs) comparing elemene plus chemotherapy with chemotherapy alone in 
      participants with advanced GC and reporting at least one of the following 
      outcomes were selected and assessed for inclusion. JADAD scale was used to assess 
      the quality. Data was screened and extracted by two independent investigators. 
      The primary clinical outcome was overall response rate (ORR); the secondary 
      outcomes were quality of life (QOL) and adverse events (AEs). Analysis was 
      performed using Review Manager 5.3. RESULTS: Sixteen RCTs matched the selection 
      criteria, which reported on 969 subjects. Risk ratios (RR) and corresponding 95% 
      confidence intervals (CIs) were pooled for ORR, life quality based on KPS, and 
      risk of AEs. Compared to chemotherapy alone, elemene combined with chemotherapy 
      in the treatment of GC may increase the efficiency of ORR(RR: 1.41; 95% CI: 
      1.23-1.60; P < .0001), improve their life quality based on KPS (RR: 1.84; 95% CI: 
      1.45-2.34; P < .00001), and reduce the adverse reactions, including 
      leukopenia(RR: 0.73; 95% CI: 0.62-0.85; P < .00001), neutropenia (RR: 0.75; 95% 
      CI: 0.60-0.95; P = .02), anemia (RR: 0.76; 95% CI: 0.60-0.95; P = .02), 
      thrombocytopenia (RR: 0.56; 95% CI: 0.43-0.73; P < .00001). Nausea and vomiting 
      (RR: 0.84; 95% CI: 0.84-1.07; P = .39), diarrhea (RR: 0.69; 95% CI: 0.41-1.15; 
      P = .15), neurotoxicity (RR: 0.77; 95% CI: 0.59-1.00; P = .05) and hepatic 
      dysfunction (RR: 0.95; 95% CI: 0.58-1.54; P = .83) were similar between two 
      groups. CONCLUSIONS: Elemene may have the potential to improve the efficacy and 
      reduce the AEs of chemotherapy for gastric cancer. However, the long-term, 
      high-quality researches with a large sample size in different populations are 
      required.
FAU - Liu, Ying
AU  - Liu Y
AD  - Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, 
      Zhejiang University.
FAU - Chen, Liuxi
AU  - Chen L
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
FAU - Zhang, Ruonan
AU  - Zhang R
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Chen, Bi
AU  - Chen B
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Xiang, Yu
AU  - Xiang Y
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Zhang, Mingming
AU  - Zhang M
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Huang, Xingxing
AU  - Huang X
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Zhang, Wenzheng
AU  - Zhang W
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Chen, Xiaying
AU  - Chen X
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Pan, Ting
AU  - Pan T
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Yan, Lili
AU  - Yan L
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Jin, Ting
AU  - Jin T
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Liu, Shuiping
AU  - Liu S
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Feng, Jiao
AU  - Feng J
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Duan, Ting
AU  - Duan T
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Xie, Tian
AU  - Xie T
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
FAU - Lin, Shuang
AU  - Lin S
AD  - Department of Lung Transplantation, Department of Thoracic Surgery, the First 
      Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 
      Zhejiang, China.
FAU - Sui, Xinbing
AU  - Sui X
AD  - Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, 
      Zhejiang University.
AD  - Department of Medical Oncology, Holistic Integrative Oncology Institutes and 
      Holistic Integrative Cancer Center of Traditional Chinese and Western Medicine, 
      the Affiliated Hospital of Hangzhou Normal University.
AD  - Department of Cancer Pharmacology, Holistic Integrative Pharmacy Institutes, 
      College of Medicine.
AD  - Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province 
      and Engineering Laboratory of Development and Application of Traditional Chinese 
      Medicine from Zhejiang Province, Hangzhou Normal University.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Drugs, Chinese Herbal)
RN  - 0 (Sesquiterpenes)
RN  - 11029-06-4 (elemene)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Drugs, Chinese Herbal/*therapeutic use
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Sesquiterpenes/*therapeutic use
MH  - Stomach Neoplasms/*drug therapy
PMC - PMC7220410
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2020/03/17 06:00
MHDA- 2020/03/25 06:00
PMCR- 2020/03/13
CRDT- 2020/03/17 06:00
PHST- 2020/03/17 06:00 [entrez]
PHST- 2020/03/17 06:00 [pubmed]
PHST- 2020/03/25 06:00 [medline]
PHST- 2020/03/13 00:00 [pmc-release]
AID - 00005792-202003130-00058 [pii]
AID - MD-D-19-09009 [pii]
AID - 10.1097/MD.0000000000019481 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 Mar;99(11):e19481. doi: 10.1097/MD.0000000000019481.