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Review
. 2020 Oct 28:2020:1824536.
doi: 10.1155/2020/1824536. eCollection 2020.

Comparative Efficacy of Chinese Herbal Injections Combined with Paclitaxel Plus Cisplatin for Non-Small-Cell Lung Cancer: A Multidimensional Bayesian Network Meta-Analysis

Mengwei Ni  1 , Haojia Wang  1 , Miaomiao Wang  1 , Wei Zhou  1 , Jiarui Wu  1 , Bin Sun  2 , Qianqian Zhang  2 , Xiaotian Fan  1 , Dan Zhang  1 , Zhiwei Jing  3 , Jingyuan Zhang  1 , Xinkui Liu  1 , Shuyu Liu  1 , Ziqi Meng  1 , Siyu Guo  1 , Shanshan Jia  1 , Xiaomeng Zhang  1 , Xiaoguang Sheng  1
Affiliations
Review

Comparative Efficacy of Chinese Herbal Injections Combined with Paclitaxel Plus Cisplatin for Non-Small-Cell Lung Cancer: A Multidimensional Bayesian Network Meta-Analysis

Mengwei Ni et al. Evid Based Complement Alternat Med. .

Abstract

Introduction: Considering the limitations of pure paclitaxel plus cisplatin chemotherapy in the treatment of non-small-cell lung cancer and the extensive exploration of Chinese herbal injections, this study performed a multidimensional network meta-analysis to systematically evaluate the clinical efficacy and safety of 12 Chinese herbal injections in the treatment of non-small-cell lung cancer.

Methods: Randomized controlled trials were obtained from several databases according to the eligibility criteria, and the study quality was assessed by the Cochrane risk of bias tool. Data analysis was performed by Stata 13.1 software and WinBUGS 14.0 software. Multidimensional cluster analysis was performed with the "scatterplot3d" package in R 3.6.1 software (PROSPERO ID: CRD42020163503).

Results: A total of 58 eligible randomized controlled trials involving 4578 patients and 12 Chinese herbal injections were included. Combined with paclitaxel plus cisplatin chemotherapy, Xiaoaiping injection exhibited a better impact on the clinical effective rate than paclitaxel plus cisplatin alone. Shenqifuzheng injection was associated with a preferable response in performance status and reduced leukopenia and gastrointestinal reactions. Kangai injection was dominant in the comprehensive results of the cluster analysis.

Conclusions: Chinese herbal injections combined with paclitaxel plus cisplatin chemotherapy have a certain adjuvant effect in treating non-small-cell lung cancer, but the results of this study need to be verified by more well-designed, large-sample, multicenter randomized controlled trials.

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Conflict of interest statement

The authors Bin Sun and Qianqian Zhang were employed by the company Jiangsu Jiuxu Pharmaceutical Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram. (n, number of articles; CNKI, China National Knowledge Infrastructure Database; Wan-Fang, the Wan-Fang Database; VIP, the Chinese Scientific Journals Full-Text Database; and CBM, the Chinese Biomedical Literature Database).
Figure 2
Figure 2
Network graph for different outcomes. (a) Clinical effective rate; (b) performance status; (c) leukopenia; and (d) gastrointestinal reactions. TP, paclitaxel plus cisplatin; XAPI, Xiaoaiping injection; ADI, Aidi injection; AI, Huangqi injection; CKSI, compound Kushen injection; DLSI, Delisheng injection; HCSI, Huachansu injection; JOEI, Yadanziyouru injection; KAI, Kangai injection; KLTI, Kanglaite injection; SMI, Shenmai injection; SQFZI, Shenqifuzheng injection; and SFI, Shenfu injection.
Figure 3
Figure 3
Assessment of the risk of bias.
Figure 4
Figure 4
Surface under the cumulative ranking curves for all treatments. (a) Clinical effective rate; (b) performance status; (c) leukopenia; (d) gastrointestinal reactions. TP, paclitaxel plus cisplatin; XAPI, Xiaoaiping injection; ADI, Aidi injection; AI, Huangqi injection; CKSI, compound Kushen injection; DLSI, Delisheng injection; HCSI, Huachansu injection; JOEI, Yadanziyouru injection; KAI, Kangai injection; KLTI, Kanglaite injection; SMI, Shenmai injection; SQFZI, Shenqifuzheng injection; and SFI, Shenfu injection.
Figure 5
Figure 5
Surface under the cumulative ranking curve (SUCRA) probability results. TP, paclitaxel plus cisplatin; XAPI, Xiaoaiping injection; ADI, Aidi injection; AI, Huangqi injection; CKSI, compound Kushen injection; DLSI, Delisheng injection; HCSI, Huachansu injection; JOEI, Yadanziyouru injection; KAI, Kangai injection; KLTI, Kanglaite injection; SMI, Shenmai injection; SQFZI, Shenqifuzheng injection; and SFI, Shenfu injection.
Figure 6
Figure 6
Cluster analysis plots. (a) Clinical effective rate and leukopenia; (b) performance status and leukopenia; (c) clinical effective rate, performance status, and leukopenia; (d) clinical effective rate, performance status, and gastrointestinal reactions; (e) clinical effective rate, leukopenia, and gastrointestinal reactions; and (f) performance status, leukopenia, and gastrointestinal reactions. TP, paclitaxel plus cisplatin; XAPI, Xiaoaiping injection; ADI, Aidi injection; AI, Huangqi injection; CKSI, compound Kushen injection; DLSI, Delisheng injection; HCSI, Huachansu injection; JOEI, Yadanziyouru injection; KAI, Kangai injection; KLTI, Kanglaite injection; SMI, Shenmai injection; SQFZI, Shenqifuzheng injection; and SFI, Shenfu injection.
Figure 7
Figure 7
Funnel plots of publication bias. (a) Clinical effective rate; (b) performance status. TP, paclitaxel plus cisplatin; XAPI, Xiaoaiping injection; ADI, Aidi injection; AI, Huangqi injection; CKSI, compound Kushen injection; DLSI, Delisheng injection; HCSI, Huachansu injection; JOEI, Yadanziyouru injection; KAI, Kangai injection; KLTI, Kanglaite injection; SMI, Shenmai injection; and SQFZI, Shenqifuzheng injection.
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