Effectiveness and Safety of Kanglaite Combined with Gemcitabine for Advanced Non-small Cell Lung Cancer: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 ZENGLin-miao ¹ , ZHENGHai-lun ¹ , PENGJin-yun ¹ , XIAOJian-hong ¹ , PANWei-piao ² , WUDong-mei ¹

1. Mindong Hospital Affiliated to Fujian Medical University, Fu'an 355000, China;
2. Fujian Medical University, Fuzhou 350108, China;

Corresponding?author：

Keywords：

Kanglaite; Gemcitabine; Non-small-cell lung cancer; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140138

Video：

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Objective To systematically review the effectiveness and safety of Kanglaite combined with gemcitabine in treating patients with advanced non-small cell lung cancer (NSCLC). Methods The randomized controlled trials (RCTs) about Kanglaite ombined with gemcitabine treating advanced NSCLC was retrieved in PubMed, EMbase, The Cochrane Library (Issue 9, 2013), CBM, CNKI, VIP, and WanFang Data from the dates of their establishment to September 2013. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment were completed by two reviewers independently. Meta-analysis was then conducted using RevMan 5.2 software. Results A total of seven RCTs involving 506 patients were finally included. The results of meta-analysis indicated that:a) Kanglaite injection combined with gemcitabine chemotherapy increased short-term effectiveness (OR=1.85, 95%CI 1.29 to 2.65, P=0.000 8), patients' quality of life (OR=3.02, 95%CI 1.90 to 4.78, P < 0.000 1), and immune function (MD=0.64, 95%CI 0.31 to 0.97, P=0.000 1); and reduced the incidences of leukopenia decrease (OR=0.30, 95%CI 0.19 to 0.47, P < 0.000 01), nausea and vomiting (OR=0.49, 95%CI 0.34 to 0.73, P=0.000 3), bone marrow suppression (OR=0.27, 95%CI 0.16 to 0.45, P < 0.000 01), and liver and renal impairments (OR=0.43, 95%CI 0.28 to 0.68, P=0.000 3), all with significant differences. b) Both groups were alike in reducing thrombocytopenia (OR=0.67, 95%CI 0.40 to 1.14, P=0.14) without significant differences. Conclusion Applying Kanglaite injection combined with gemcitabine in treating patients with advanced NSCLC could increase short-term effectiveness, improve patients' quality of life and immune function; and reduce the incidences of adverse reaction caused by chemotherapy. However, it has no obvious advantage in reducing thrombocytopenia. Due to the limited quantity and quality of the included studies, more larger sample size, multicenter, high quality RCT are needed to verify the above conclusion.

Citation： ZENGLin-miao, ZHENGHai-lun, PENGJin-yun, XIAOJian-hong, PANWei-piao, WUDong-mei. Effectiveness and Safety of Kanglaite Combined with Gemcitabine for Advanced Non-small Cell Lung Cancer: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(7): 827-834. doi: 10.7507/1672-2531.20140138 Copy

1.	王道英, 李征, 楊克虎, 等.放療聯合熱療治療局部晚期非小細胞肺癌療效與安全性的系統評價.中國循證醫學雜志, 2012, 12(10):1203-1208.
2.	過為, 李健華, 王峰, 等.奈達鉑聯合化療治療晚期非小細胞肺癌療效和安全性的Meta分析.中國循證醫學雜志, 2013, 13(1):47-54.
3.	徐少華, 王偉, 柳相珍, 等.國產吉西他濱聯合卡鉑治療老年晚期非小細胞肺癌的臨床觀察.中國腫瘤臨床, 2006, 33(1):35-37.
4.	Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin, 2009, 59(4):225-249.
5.	錢桂生, 余時滄.肺癌流行病學最新資料與啟示.中華結核和呼吸雜志, 2012, 35(2):86-89.
6.	王廷賢.澤菲治療非小細胞肺癌的臨床療效觀察.中國社區醫師(醫學專業), 2012, 14(9):45-46.
7.	劉睿, 郭姍, 閔婕, 等.高溫聯合順鉑及多西他賽對肺腺癌A549細胞體外作用的研究.現代腫瘤醫學, 2010, 18(5):857-861.
8.	朱小生, 胡曉文, 操樂杰, 等.化療聯合恩度治療非小細胞肺癌臨床觀察.臨床肺科雜志, 2009, 14(2):194-195.
9.	Zhan YP, Huang XE, Cao J, et al. Clinical safety and efficacy of Kanglaite^? (Coix Seed Oil) injection combined with chemotherapy in treating patients with gastric cancer. Asian Pac J Cancer Prev, 2012, 13(10):5319-5321.
10.	Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0).[cited 2012 Jan 5]. Available at:http://www.cochrane-handbook.org.
11.	車曙華, 羅超, 劉瑛, 等.康萊特注射液聯合GP方案治療晚期非小細胞肺癌的臨床觀察.腫瘤藥學, 2012, 2(4):286-289.
12.	管燕, 郭其森, 宋潔, 等.康萊特聯合GP方案治療老年晚期非小細胞肺癌臨床觀察.中國老年保健醫學, 2010, 8(1):5-7.
13.	劉軍強, 尚立群, 李學昌, 等.康萊特聯合GP方案治療晚期非小細胞肺癌的療效觀察.現代腫瘤醫學, 2011, 19(10):1974-1976.
14.	黃振步, 朱春雅, 吳式琇.康萊特聯合化療治療晚期非小細胞肺癌的療效觀察.中國藥房, 2010, 21(20):1860-1861.
15.	練祖平, 陸運鑫, 侯恩存, 等.康萊特聯合化療治療中晚期非小細胞肺癌.中國肺癌雜志, 2006, 9(1):74-77.
16.	佟倩.康萊特聯合吉西他濱治療老年晚期非小細胞肺癌的臨床研究.中國醫藥指南, 2012, 10(8):31-33.
17.	鄧曙光, 文石兵, 陳安麗, 等.康萊特聯合健擇、卡鉑治療中晚期非小細胞肺癌的臨床觀察.浙江實用醫學, 2006, 11(4):234-236.
18.	張特, 劉大海, 王斌, 等.恩度聯合吉西他濱和順鉑二線方案治療晚期非小細胞肺癌的近期療效及安全性.中國全科醫學, 2009, 12(11):969-971.
19.	Rosell R, Cobo M, Isla D, et al. Pharnkacogenomics and gemcitabine. Ann Oncol, 2006, 17 (Suppl 5):v13-16.
20.	高慶, 王福元, 余宏, 等.吉西他濱聯合卡鉑或紫杉醇與紫杉醇聯合卡鉑治療晚期非小細胞肺癌的隨機對照研究.中華腫瘤雜志, 2011, 33(11):874-876.
21.	Cho KH, Song YB, Choi IS, et al, A phase II study of single agent gemcitabine as a second-1ine treatment in advanced non-small cell lung cancer. JPN J Clin Oncol, 2006, 36:50-54.
22.	Genestreti G, Giovannini N, Frizziero M, et al. Carboplatin and gemcitabine in first-1ine treatment of elderly patients with advanced non-small cell 1ung cancer:data from a retrospective study. J Chemother, 201l, 23:232-237.
23.	施勛, 余新民, 張沂平, 等.培美曲塞或吉西他濱聯合卡鉑一線治療老年晚期非小細胞肺癌的療效和安全性.中華腫瘤雜志, 2013, 35(3):221-224.
24.	趙文英, 陳冬云.伊立替康聯合順鉑與吉西他濱聯合順鉑一線治療晚期非小細胞肺癌的隨機對照研究.中華腫瘤雜志, 2012, 34(10):775-779.
25.	陳建強.香菇多糖聯合化療對非小細胞肺癌的療效觀察.蘇州大學學報(醫學版), 2008, 28(2):306-307.
26.	張明, 謝可, 陳淋, 等.康萊特注射液改善晚期腫瘤患者食欲和生存質量的臨床觀察.腫瘤防治雜志, 2003, 10(12):1298-1298, 1304.
27.	包三裕, 張洪.康萊特注射液作用機理及臨床應用研究.長春中醫藥大學學報, 2011, 27(1):139-140.
28.	李大鵬.康萊特注射液抗癌作用機理研究進展.中藥新藥與臨床藥理, 2001, 12(2):122-124.
29.	吳巖, 潘沛, 王彧杰, 等.康萊特注射液對Lewis肺癌小鼠免疫功能的影響.上海交通大學學報(醫學版), 2009, 29(12):1455-1458.
30.	譚煌英, 李園, 于莉莉, 等.康萊特對大鼠的鎮痛作用及其對促炎細胞因子的影響.中國中西醫結合外科雜志, 2007, 13(2):152-155.

1. 王道英, 李征, 楊克虎, 等.放療聯合熱療治療局部晚期非小細胞肺癌療效與安全性的系統評價.中國循證醫學雜志, 2012, 12(10):1203-1208.
2. 過為, 李健華, 王峰, 等.奈達鉑聯合化療治療晚期非小細胞肺癌療效和安全性的Meta分析.中國循證醫學雜志, 2013, 13(1):47-54.
3. 徐少華, 王偉, 柳相珍, 等.國產吉西他濱聯合卡鉑治療老年晚期非小細胞肺癌的臨床觀察.中國腫瘤臨床, 2006, 33(1):35-37.
4. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin, 2009, 59(4):225-249.
5. 錢桂生, 余時滄.肺癌流行病學最新資料與啟示.中華結核和呼吸雜志, 2012, 35(2):86-89.
6. 王廷賢.澤菲治療非小細胞肺癌的臨床療效觀察.中國社區醫師(醫學專業), 2012, 14(9):45-46.
7. 劉睿, 郭姍, 閔婕, 等.高溫聯合順鉑及多西他賽對肺腺癌A549細胞體外作用的研究.現代腫瘤醫學, 2010, 18(5):857-861.
8. 朱小生, 胡曉文, 操樂杰, 等.化療聯合恩度治療非小細胞肺癌臨床觀察.臨床肺科雜志, 2009, 14(2):194-195.
9. Zhan YP, Huang XE, Cao J, et al. Clinical safety and efficacy of Kanglaite^? (Coix Seed Oil) injection combined with chemotherapy in treating patients with gastric cancer. Asian Pac J Cancer Prev, 2012, 13(10):5319-5321.
10. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0).[cited 2012 Jan 5]. Available at:http://www.cochrane-handbook.org.
11. 車曙華, 羅超, 劉瑛, 等.康萊特注射液聯合GP方案治療晚期非小細胞肺癌的臨床觀察.腫瘤藥學, 2012, 2(4):286-289.
12. 管燕, 郭其森, 宋潔, 等.康萊特聯合GP方案治療老年晚期非小細胞肺癌臨床觀察.中國老年保健醫學, 2010, 8(1):5-7.
13. 劉軍強, 尚立群, 李學昌, 等.康萊特聯合GP方案治療晚期非小細胞肺癌的療效觀察.現代腫瘤醫學, 2011, 19(10):1974-1976.
14. 黃振步, 朱春雅, 吳式琇.康萊特聯合化療治療晚期非小細胞肺癌的療效觀察.中國藥房, 2010, 21(20):1860-1861.
15. 練祖平, 陸運鑫, 侯恩存, 等.康萊特聯合化療治療中晚期非小細胞肺癌.中國肺癌雜志, 2006, 9(1):74-77.
16. 佟倩.康萊特聯合吉西他濱治療老年晚期非小細胞肺癌的臨床研究.中國醫藥指南, 2012, 10(8):31-33.
17. 鄧曙光, 文石兵, 陳安麗, 等.康萊特聯合健擇、卡鉑治療中晚期非小細胞肺癌的臨床觀察.浙江實用醫學, 2006, 11(4):234-236.
18. 張特, 劉大海, 王斌, 等.恩度聯合吉西他濱和順鉑二線方案治療晚期非小細胞肺癌的近期療效及安全性.中國全科醫學, 2009, 12(11):969-971.
19. Rosell R, Cobo M, Isla D, et al. Pharnkacogenomics and gemcitabine. Ann Oncol, 2006, 17 (Suppl 5):v13-16.
20. 高慶, 王福元, 余宏, 等.吉西他濱聯合卡鉑或紫杉醇與紫杉醇聯合卡鉑治療晚期非小細胞肺癌的隨機對照研究.中華腫瘤雜志, 2011, 33(11):874-876.
21. Cho KH, Song YB, Choi IS, et al, A phase II study of single agent gemcitabine as a second-1ine treatment in advanced non-small cell lung cancer. JPN J Clin Oncol, 2006, 36:50-54.
22. Genestreti G, Giovannini N, Frizziero M, et al. Carboplatin and gemcitabine in first-1ine treatment of elderly patients with advanced non-small cell 1ung cancer:data from a retrospective study. J Chemother, 201l, 23:232-237.
23. 施勛, 余新民, 張沂平, 等.培美曲塞或吉西他濱聯合卡鉑一線治療老年晚期非小細胞肺癌的療效和安全性.中華腫瘤雜志, 2013, 35(3):221-224.
24. 趙文英, 陳冬云.伊立替康聯合順鉑與吉西他濱聯合順鉑一線治療晚期非小細胞肺癌的隨機對照研究.中華腫瘤雜志, 2012, 34(10):775-779.
25. 陳建強.香菇多糖聯合化療對非小細胞肺癌的療效觀察.蘇州大學學報(醫學版), 2008, 28(2):306-307.
26. 張明, 謝可, 陳淋, 等.康萊特注射液改善晚期腫瘤患者食欲和生存質量的臨床觀察.腫瘤防治雜志, 2003, 10(12):1298-1298, 1304.
27. 包三裕, 張洪.康萊特注射液作用機理及臨床應用研究.長春中醫藥大學學報, 2011, 27(1):139-140.
28. 李大鵬.康萊特注射液抗癌作用機理研究進展.中藥新藥與臨床藥理, 2001, 12(2):122-124.
29. 吳巖, 潘沛, 王彧杰, 等.康萊特注射液對Lewis肺癌小鼠免疫功能的影響.上海交通大學學報(醫學版), 2009, 29(12):1455-1458.
30. 譚煌英, 李園, 于莉莉, 等.康萊特對大鼠的鎮痛作用及其對促炎細胞因子的影響.中國中西醫結合外科雜志, 2007, 13(2):152-155.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Kanglaite Combined with Gemcitabine for Advanced Non-small Cell Lung Cancer: A Meta-Analysis

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