Efficacy and Safety of Chinese Herbal Medicine on Ovarian Cancer After Reduction Surgery and Adjuvant Chemotherapy: A Systematic Review and Meta-Analysis

Abstract

Background: Ovarian cancer (OvC) is a malignant tumor which invades ovarian epithelium and interstitium. Reduction surgery combined with adjuvant chemotherapy is standard treatment for OvC patients, but the adverse effects due to chemotherapy still remains a major problem. While Chinese herbal medicine (CHM) therapy has a unique therapeutic effect to reduce side effects of chemotherapy by boosting immune system, the evidence of CHM in the treatment of OvC patients are limited. Objective: We conducted a systematic review to evaluate the efficacy and safety of CHM in the treatment of OvC after reduction surgery and adjuvant chemotherapy. Method: Chinese National Knowledge Infrastructure (CNKI) and PubMed up to Dec 31st 2018 were searched to identify relevant studies. Only randomized controlled trials (RCTs) were included, and there was no limitation on language of the publication. Data were extracted from all included studies and meta-analysis was performed with Review Manager 5.3. Study quality was assessed and pooled risk ratios (RR) or mean difference (MD) with 95% CIs were used to evaluate the efficacy and safety of CHM. Results: A total of 18 RCTs involving 975 participants were included. There was no placebo, no treatment and CHM alone. Compared with Western Medicine (WM) alone, Chinese herbal Medicine combined with WM (CHM-WM) significantly improved TCM syndromes and symptoms, KPS scores, CD4 counts, CA125 levels, and 3-years survival rate ( P < 0.05). Incidences of gastrointestinal reactions, marrow depression, urinary system symptoms were significantly lower in CHM-WM group than in WM group ( P < 0.01). There was no significant difference in CD3 counts, CD8 counts, quality of life, liver function, and peripheral neuropathy between the two groups ( P > 0.05). Conclusion: The systematic review indicated that CHM combined with WM is effective and safe as a treatment for OvC patients after reduction surgery and adjuvant chemotherapy. However, more high-quality and large-scale RCTs are needed to confirm the efficacy and safety of CHM intervention.

Effect of traditional Chinese medicine (TCM) on survival, quality of life, and immune function in patients with ovarian carcinoma

“…Several studies have recognized that TCM have a unique advantage in the treatment of malignant tumors by inhibiting the growth of cancer cells, enhancing immunity of human body, decreasing cancer relapses and metastases, and mitigating the progress of the disease. [ 17 – 21 , 32 – 38 ] Piao et al [ 21 ] found that complementary treatment with mistletoe extracts can beneficially reduce the side effects of chemotherapy and thus improve QoL of patients with breast, ovarian and nonsmall cell lung cancer. Research by Chan et al [ 18 ] indicated that TCM did not improve QoL of cancer patients but did have some effects in terms of maintaining immune function.…”

“…Research by Chan et al [ 18 ] indicated that TCM did not improve QoL of cancer patients but did have some effects in terms of maintaining immune function. The results of study by Wang et al [ 32 ] showed that the clinical application of Chinese herbal medicine not only significantly enhanced the curative effects of conventional treatment but also effectively improved QoL and clinical symptoms in patients with OC. Tao et al [ 33 ] found that the compound fuling granule (CFG, a traditional Chinese drug) can significantly suppresses OC cell proliferation by cell cycle arrest, apoptosis, and senescence.…”

Identification of the Active Constituents and Significant Pathways of Cangfu Daotan Decoction for the Treatment of PCOS Based on Network Pharmacology

“…TCM plays a crucial role in the pharmaceutical industry, alternative medicine, and many other fields [48][49][50]. However, due to the complex chemical composition and unclear pharmacological mechanism of action of TCMs, it faces great obstacles in pharmacological research, quality control and supervision, modernization, and internationalization [51].…”

Chinese Herbal Medicine and Its Application for Female Cancer

“…Reduction surgery combined with adjuvant chemotherapy is the standard treatment for OvC patients, but the adverse effects due to chemotherapy still remain a major problem. While CHM therapy has a unique therapeutic effect to reduce side effects of chemotherapy by boosting the immune system, the evidence of CHM in the treatment of OvC patients is limited [13].…”