Network Meta-analyses Of Chinese Herb Injection Combined With Chemotherapy For Non-small Cell Lung Cancer

Objective To the assess the clinical effects and safety of Chinese herb injection(CHI) combined chemotherapy for Non-small Cell Lung Cancer(NSCLC).Methods The relative randomized controlled trials (RCTs) of CHI were searched from PubMed(1966-2011.12),EMB ASE.com(1974-2011.12),Cochrane Library(-2011.12),Web of Science (1980-2011.12), CancerLit(-2011.12),China National Knowledge Infrastructure (1994-2011.12),Chinese Scientific Journals Fulltext Database(1989-2011.12),Chinese Biomedical Literature Database(1978-2011.12),Wan-Fang Database(1997-2011.12) and Chinese Science Citation Database(1989-2011.12),the related references and website were also traced. The RCTs were screened according to the predefined inclusion and exclusion criteria, the related items were used to assess the quality of RCTs, data were analyzed by WinBugs,GRADEpro,Meta analyst softwares.Results①total of1859articles were found to be RCTs related and371RCTs including27370patients and twelve CHI were finally included.Only one(0.3%) RCT mentioned sample size calculation,120(32.3%) included RCTs reported the included criteria,14(3.8%) reported the excluded criteria,31(8.4%) reported the diagnostic criteria,335(90.3%) provided the criteria for assessing the effectiveness.317(85.4%) RCTs were not reported the details of their methods of randomization,41(11.1%) RCTs were deemed to have authentic randomization,4(1.1%) RCTs mentioned the blinding, but only one paper (0.3%) described that the participants were blind.54(14.6%) RCTs reported the details of baseline characteristics of the participants in a separate table,344(92.7%) provided the information about adverse events,4(1.1%) RCTs provided on the length of time for which participants were followed, no RCTS provided the information about drop-out rate,0.5%RCTs reported approval by an ethics committee and94.1%RCTs did not discuses informed consent.②The result of meta analysis showed that compared with the single chemotherapy,the ginseng polysacchride injection combined with chemotherapy could improved the quality of life and decrease the nausea and vomiting(Ⅲ-Ⅳ) and leukopenia(Ⅲ-Ⅳ), bufalin injection combined with chemotherapy could improve the efficacy and quality of life and decrease the nausea and vomiting(Ⅲ-Ⅳ) and leukopenia(Ⅲ-Ⅳ), astragalus polysaccharide injection combined with chemotherapy could improved the quality of life, xiaoaiping injection combined with chemotherapy could improve the quality of life, delisheng injection combined with chemotherapy could improve the efficacy and quality of life and decrease the nausea and vomiting(Ⅲ-Ⅳ) and leukopenia(Ⅲ-Ⅳ), bufonin injection combined with chemotherapy could improve the efficacy and quality of life and decrease the nausea and vomiting(Ⅲ-Ⅳ) and leukopenia(Ⅲ-Ⅳ), fructus bruceae oil emulsion injection combined with chemotherapy could improve the efficacy and quality of life and decrease the leukopenia(Ⅲ-Ⅳ), kangai injection combined with chemotherapy could improve the efficacy and quality of life and decrease the leukopenia(Ⅲ-Ⅳ), shenqi fuzheng injection combined with chemotherapy could improve the efficacy and quality of life and decrease the leukopenia(Ⅲ-Ⅳ), compound matrine injection combined with chemotherapy could improve the efficacy and quality of life and decrease the nausea and vomiting(Ⅲ-Ⅳ) and leukopenia(Ⅲ-Ⅳ), kanglaite injection combined with chemotherapy could improve the efficacy and quality of life and decrease the nausea and vomiting(Ⅲ-Ⅳ) and leukopenia(Ⅲ-Ⅳ), aidi injection combined with chemotherapy could improve the efficacy and quality of life and decrease the nausea and vomiting(Ⅲ-Ⅳ) and leukopenia(Ⅲ-Ⅳ).downgrade quality of evidence were risk of bias,indirectness and publication bias.③The result of network meta analysis showed that the common comparsion was gemcitabine combined with cisplatin/carboplatin(GP),compared with delisheng injection combined with GP, compound matrine injection combined with GP and aidi injection combined with GP could improve the efficacy and decrease the nausea and vomiting; the common comparison was navelbine combined with cisplatin/carboplatin(NP),compared with bufonin injection combined with NP and fructus bruceae oil emulsion injection combined with NP, delisheng injection combined with NP could improve the quality of life.compared with delisheng injection combined with NP and shenqi fuzheng njection combined with NP, fructus bruceae oil emulsion injection combined with NP could decrease the nausea and vomiting.the rate of nausea and vomiting in bufonin injection combined with NP, fructus bruceae oil emulsion injection combined with NP, kangai injection combined with NP was lower than compound matrine injection combined with NP,kanglaite injection combined with NP,aidi injection combined with NP,respectively. compared with bufonin injection combined with NP,frucrus bruceae oil emulsion injection combined with NP and kangai injection combined with NP could decrease the leucopenia; the common comparsion was taxotere combined with cisplatin/carboplatin(TP), compared with kangai injection combined with TP, shenqi fuzheng injection combined with TP and compound matrine injection combined with TP could improve the efficacy.Conclusion The data indicate that the quality of methodological reporting in RCTs on CHI for NSCLC has not improved over time, but still remains poor. Chinese authors and journals should adopt and keep up with the CONSORT statement to improve the reporting quality of RCTs in this field;Compared with chemotherapy,CHI combined with chemotherapy could improve the quality of life and decrease the nausea and vomiting and leukopenia; kangai injection,shenqi fuzheng injection and compound matrine injection was more than other nine CHI injections.