A Meta-analysis About Aidi Injection As An Adjuvant Medicine In The Treatment Of Esophageal Cancer

Objective:The topic of this study is using the EBM’s methods to assess the efficacy and safety,for Aidi injection as an adjuvant medicine in the treatment of esophageal cancer.To provide the EBM’s evidence for Aidi injection as an adjuvant medicine in the treatment of esophageal cancer.Methods:Chinese and English databases were searched by computer,including CNKI,Wan fang,VIP,and Chinese Biomedical Literature Databases,PubMed,Embase,and Cochrane Library.The retrieval period was from the establishment of the database to June 1,2020.The literature we searched were the randomized controlled trials(RCTs)which were published in public about Aidi injection as an adjuvant medicine in the treatment of esophageal cancer and at least one outcome indicator.Repeatedly cited articles were eliminated by Endnote software,preliminary screening and re-screening were performed in combination with the inclusion criteria and exclusion criteria,using the CONSORT statement to evaluate the quality of the articles,The risk of bias was estimated by deviation risk evaluation form of Cochrane Handbook5.1.0,and use the software of RevMan 5.3 to Meta-analysis.Results:The clinical effective rate of Aidi injection combined with chemotherapy groups higher than that of chemotherapy group(RR=1.28,95%CI:1.08,1.50),Aidi injection combined with radiotherapy group is higher than that of radiotherapy group(RR=1.13,95%CI:1.05,1.21),Aidi injection combined with radiotherapy and chemotherapy group is higher than that of radiotherapy combined with chemotherapy group(RR=1.21,95%CI:1.11,1.31).The KPS scores of Aidi injection combined with Western medicine group are higher than that group which only western medicine(RR=1.83,95%CI:1.48,2.26).For the rate of 1-year survival,comparing with the Western medicine alone,Aidi injection combined with Western medicine treatment is higher.(RR=2.70,95%CI:1.87,3.88).For the incidence of radiation esophagitis,comparing with the radiotherapy alone,Aidi injection combined with radiotherapy group is lower.(RR=0.67,95%CI:0.49,0.92),the Aidi injection combined with chemotherapy and radiotherapy group is lower than the group which only radiotherapy and chemotherapy(RR=0.61,95%CI:0.53,0.71).The bone marrow toxicity(leukocyte decline rate)of the Aidi injection combined with chemotherapy group is lower than chemotherapy group(RR=0.52,95%CI:0.43,0,64),in the Aidi injection combined with radiotherapy group has serious statistical heterogeneity,Aidi injection combined with radiotherapy and chemotherapy group is lower than the group which only radiotherapy and chemotherapy(RR=0.52,95%CI:0.43,0,63).The gastrointestinal reaction of the Aidi injection combined with chemotherapy group is lower than chemotherapy group(RR=0.68,95%CI:0.57,0.82),Aidi injection combined with radiotherapy has serious statistical heterogeneity;Aidi injection combined with radiotherapy and chemotherapy group is lower than the group which only radiotherapy and chemotherapy(RR=0.55,95%CI:0.47,0.64).The CD3+T cell of Aidi injection combined with Western medicine group is higher than the group of Western medicine(MD=8.88,95%CI:7.46,10.30).For the CD4+T cell,comparing with the Western medicine alone,Aidi injection combined with western medicine group is higher.(MD=7.40,95%CI:6.35,8.45).For the CD8+T cell,comparing with the Western medicine alone,Aidi injection combined with western medicine is higher.(MD=-3.74,95%CI:-5.01,-2.47).The CD4/CD8+T cell of Aidi injection combined with western medicine group is higher than the group of Western medicine(MD=0.23,95%CI:0.17,0.29).Conclusion:Aidi injection combined with chemotherapy,radiotherapy or concurrent radiotherapy and chemotherapy can improve the clinical effectiveness of primary esophageal cancer,increase KPS scores,raise the 1-year survival rate,and increase the level of CD3+,CD4+,CD8+,CD4+/CD8+T cells.Enhance immunity,reduce the incidence of radiation esophagitis,Aidi injection combined with chemotherapy or combined with concurrent radiotherapy can alleviate bone marrow toxicity(leukocyte decline rate),gastrointestinal reaction rate.For the bone marrow toxicity and gastrointestinal reaction rate,there are serious statistical heterogeneity in Aidi injection combined with radiotherapy group.