| Background:Lung cancer (also known as lung cancer), the vast majority originated in bronchial epithelial cells, is the most common primary lung cancer in the world. Nearly50years, the incidence and mortality of lung cancer rise sharply,and lung cancer takes the first place on the cause of cancer deaths in the current global. The age of onset of lung cancer is over40years of age, and the peak age of onset is between60to79years. It is more common in male patients and male to female ratio is approximately2.3:1,considering its long-term smoking-related incidence. However, lung cancer incidence and mortality of women showed an increasing trend. Since1950, lung cancer mortality ra-te of women has increased by6times. There is more and more younger patients with lung cancer as the main reason is that smoking, drinking and other unhealthy lifestyle.In recent years, it provides a new way for many clinicians that application of traditional Chinese medicine combined with chemotherapy for malignant tumors to reduce the side effects of chemotherapy and improve tumor treatment. The cantharidinate is the first discovered Chinese medicine in China with anti-tumor effect. The anti-tumor mechanism is mainly related to that cantharidinate can inhibite the synthesis of cancer cell protein and reduce tumor hormone levels and affect the metabo lism tumor cell nucleic acid.Many clinical studies have shown that cantharidinate combined with chemotherapy in the treatment of malignant tumors with Synergy and Attenuation:to raise shortterm effect of chemotherapy, reduce the chemotherapy leukopenia and gastrointestinal reac tions, and improve patients’ quality of life. But now, the quality of clinical research literature, as well as of cantharides efficiency Attenuation of evidence based medicine is good enough or not? Currently,there is no systematic analysis and evaluation.Aims:By consolidating a number of domestic clinical research results, we gice an analysis of cantharidin sodium injection’s efficiency in clinical lung cancer patients, the Karnofsky score of the quality of life, common adverse reactions, leukopenia and gastrointestinal reactionsimpact by Meta-analysis method, and then hope that a comprehensive and objective assessment of cantharidin sodium injection Synergy and attenuation of lung cancer adjuvant chemotherapy. And we hope we can provide help to Clinical practice.Data Sources:By electronic retrieval method,we retrieve the foreignal database(PubMed database) and national database, including full-text database of Chinese journals network (CNKI), Chinese Biomedical Database (CBM), China Medical Information Resources System Outstanding Dissertation full-text database selfpost library until2011.12, and references in the papers or review of clinical trial reports to track the relevant literature. We retrieve the study with"cantharidinate"and "lung cancer"。We performed a metaanalysis of the results by the Review Manager5.0.Methods and Results:A total of14studies are included in the study Including941patients。We get a conclusion as below:1.Cantharidinate sodium injection combined with chemotherapy in the treatment group term efficacy response rate (CR+PR) was higher than the conventional chemotherapy group, P=0.0003, the RR=1.32,95%CI (1.14,1.54)2.Cantharidin sodium injection combined with chemotherapy in the treatment group on the rate of improvement in the quality of life than the conventional chemotherapy group, P<0.00001, the RR=1.86,95%CI (1.55,2.23)3.Cantharidin to sodium injection combined with chemotherapy in the treatment group a significant heterogeneity in comparison with the conventional chemotherapy group, the various studies on the leukocyte inhibition (Ph<0.00001; I2=94%). Performed a subgroup analysis, the comparison of observation the cantharides sodium combined with vinorelbine+platinum class (NP group) and paclitaxel plus platinum (TP Group) program and its control group in the leukocyte inhibition, found the disodium cantharidinate+TP group in reducing leukocyte inhibition than the control group, P <0.0001; RR=0.57,95%CI:(0.44,0.74); cantharides sodium+NP group in reducing leukocyte inhibition on the superior than the control group no significant difference, I2=97%, P=0.008; RR=0.77,95%CI:(0.64,0.93). The observed the difference between cantharis sodium injection combined with chemotherapy in the treatment group in comparison with the conventional chemotherapy group Ⅲ, Ⅳ neutropenia inhibition. The cantharides sodium injection combined with chemotherapy in the treatment group in Ⅲ, Ⅳ neutropenia inhibition is lower than the conventional chemotherapy group, P <0.0001, RR=0.50,95%CI:(0.35,0.70)。It is no statistical significance in the gastrointestinal tract response between the cantharides sodium injection in the treatment group and the conventional chemotherapy group (P<0.00001; I2=89%).Subgroup analysis about observing the cantharidin sodium combined with vinorelbine+platinum (NP group) and paclitaxel plus platinum (TP group) program between its control group comparison on the response of the gastrointestinal tract and found that cantharidin sodium+NP group, thereis no significant difference in the reduction of gastrointestinal side effects with the control group, P=0.40, cantharides sodium+TP group to reduce gastrointestinal side effects with the control group shows no significant difference, P=0.41. The occurrence of adverse reactions according to the WHO anti-cancer drugs, grading standards, the response of the gastrointestinal tract bilirubin, alanine aminotransferase, alkaline phosphatase, and laboratory data changes and oral erythema, ulcers, and nausea and vomiting, diarrhea, etc., the original data is difficult to obtain, and therefore we can not continue to other sub-group analysis.Conclusion:By our meta-analysis we found that the cantharides sodium injection combined with chemotherapy in the treatment group is higher than the conventional chemotherapy group in the near future efficacy response rate (CR+PR) to improve the quality of life;and is lower than the conventional chemotherapy group in neutropenia inhibition and Ⅲ, Ⅳ neutropenia inhibition. The cantharides sodium injection in the treatment group is significantly attenuated in reducing gastrointestinal side effects than conventional chemotherapy group. |
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