PMID- 36203451
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221009
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - Chinese herbal injections versus intrapleural cisplatin for lung cancer patients 
      with malignant pleural effusion: A Bayesian network meta-analysis of randomized 
      controlled trials.
PG  - 942941
LID - 10.3389/fonc.2022.942941 [doi]
LID - 942941
AB  - BACKGROUND: Malignant pleural effusion (MPE) is a common complication in patients 
      with advanced lung cancer that can severely compromise the quality of life and 
      limit life expectancy. Randomized controlled trials (RCTs) have shown that 
      Chinese herbal injections (CHIs) may be beneficial in improving quality of life. 
      This network meta-analysis (NMA) aims to explore several CHIs used for lung 
      cancer patients with MPE. METHODS: Seven databases were systematically searched 
      for eligible RCTs from inception to November 2021. The primary outcome was the 
      clinical effective rate. Secondary outcomes were the improvement rate of 
      Karnofsky performance status (KPS) score and incidence of adverse events (AEs). 
      The Cochrane risk of bias 2 tool was used to assess the quality of included 
      studies. Data analysis was performed using STATA 16.0 and R software 4.1.0. Both 
      pairwise meta-analysis and Bayesian NMA were conducted. Competing interventions 
      were ranked using the surface under the cumulative ranking (SUCRA) probabilities. 
      Evidence grading was evaluated using the Confidence in Network Meta-Analysis 
      online software (https://cinema.ispm.unibe.ch/). RESULTS: A total of 44 studies 
      involving 2,573 patients were included. The combined Huachansu injection (HCS) 
      with intrapleural cisplatin (cis-diamminedichloro-platinum, DDP) had the highest 
      probability of improving the clinical effective rate (SUCRA, 84.33%). The Kangai 
      injection (KA) combined with DDP had the most improvement rate of KPS score 
      (SUCRA, 80.82%), while the Fufangkushen injection (FFKS) alone was more likely to 
      reduce AEs including gastrointestinal reactions (SUCRA, 89.92%), leukopenia 
      (SUCRA, 91.85%), and chest pain (SUCRA, 98.17%). FFKS combined with DDP ranked 
      the best in reducing the incidence of fever (SUCRA, 75.45%). CONCLUSIONS: Our NMA 
      showed that CHIs alone or combined with DDP could improve clinical effectiveness 
      and quality of life and reduce AEs, compared to DDP alone. HSC and KA, combined 
      with DDP, may be the most effective considering clinical effective rate and 
      improvement of KPS score, respectively. FFKS, either used alone or in combination 
      therapy with DDP, may be the best in reducing AEs. However, high-quality RCTs 
      with larger sample sizes are needed to further support the evidence. SYSTEMATIC 
      REVIEW REGISTRATION: PROSPERO https://www.crd.york.ac.uk/prospero/, identifier 
      CRD42021285275.
CI  - Copyright (c) 2022 Xu, Chen, Bu, Huang, Sun, Li, Sellick, Liu, Qin and Liu.
FAU - Xu, Yi-Fang
AU  - Xu YF
AD  - Department of Oncology, Hubei Provincial Hospital of Traditional Chinese 
      Medicine, Wuhan, China.
AD  - Centre for Evidence-based Chinese Medicine, School of Traditional Chinese 
      Medicine, Beijing University of Chinese Medicine, Beijing, China.
FAU - Chen, Yun-Ru
AU  - Chen YR
AD  - Centre for Evidence-based Chinese Medicine, School of Traditional Chinese 
      Medicine, Beijing University of Chinese Medicine, Beijing, China.
FAU - Bu, Fan-Long
AU  - Bu FL
AD  - Beijing Children's Hospital, Capital Medical University, National Center for 
      Children's Health, Beijing, China.
FAU - Huang, Yu-Bei
AU  - Huang YB
AD  - Department of Epidemiology and Biostatistics, National Clinical Research Center 
      of Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin 
      Medical University Cancer Institute and Hospital, Tianjin, China.
FAU - Sun, Yu-Xin
AU  - Sun YX
AD  - Centre for Evidence-based Chinese Medicine, School of Traditional Chinese 
      Medicine, Beijing University of Chinese Medicine, Beijing, China.
FAU - Li, Cheng-Yin
AU  - Li CY
AD  - Department of Oncology, Hubei Provincial Hospital of Traditional Chinese 
      Medicine, Wuhan, China.
FAU - Sellick, Jodi
AU  - Sellick J
AD  - Chinese Medicine Centre, Western Sydney University, Campbelltown, NSW, Australia.
FAU - Liu, Jian-Ping
AU  - Liu JP
AD  - Centre for Evidence-based Chinese Medicine, School of Traditional Chinese 
      Medicine, Beijing University of Chinese Medicine, Beijing, China.
FAU - Qin, Dan-Mei
AU  - Qin DM
AD  - Department of Oncology, Hubei Provincial Hospital of Traditional Chinese 
      Medicine, Wuhan, China.
FAU - Liu, Zhao-Lan
AU  - Liu ZL
AD  - Centre for Evidence-based Chinese Medicine, School of Traditional Chinese 
      Medicine, Beijing University of Chinese Medicine, Beijing, China.
LA  - eng
PT  - Systematic Review
DEP - 20220920
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9531116
OTO - NOTNLM
OT  - Chinese herbal injections
OT  - cisplatin
OT  - lung cancer
OT  - malignant pleural effusion (MPE)
OT  - network meta-analysis
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/10/08 06:00
MHDA- 2022/10/08 06:01
PMCR- 2022/01/01
CRDT- 2022/10/07 02:34
PHST- 2022/05/13 00:00 [received]
PHST- 2022/08/24 00:00 [accepted]
PHST- 2022/10/07 02:34 [entrez]
PHST- 2022/10/08 06:00 [pubmed]
PHST- 2022/10/08 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.942941 [doi]
PST - epublish
SO  - Front Oncol. 2022 Sep 20;12:942941. doi: 10.3389/fonc.2022.942941. eCollection 
      2022.