Cancer Research on Prevention and Treatment    2022, Vol. 49 Issue (09) : 913-922     DOI: 10.3971/j.issn.1000-8578.2022.22.0012
Traditional Chinese Medicine Combined with Chemotherapy in Prevention and Treatment of Recurrence and Metastasis of Locally Advanced Gastric Cancer After Radical Resection: A Meta-analysis
WANG Yue1, ZHAO Weizhe1, LI Xiaojie1, NAN Mengdie1, XIE Meiwen1, LI Peijin1, HOU Li2
1. Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China; 2. Hematology Oncology Department, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
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Abstract Objective To explore the efficacy and safety of traditional Chinese medicine(TCM) combined with chemotherapy in the prevention and treatment of postoperative recurrence and metastasis of locally advanced gastric cancer (LAGC) by meta-analysis. Moreover, we evaluated the efficacy of TCM on the quality of life, immune indexes, and toxic and side effects during adjuvant chemotherapy. Methods The CNKI, Wanfang, PubMed, and other databases were searched by computer. Randomized controlled trials (RCTs) were searched. After literature screening and data extraction, Review Manager 5.3 software provided by Cochrane was used for meta-analysis. Results A total of 18 RCTs were included. Compared with chemotherapy alone, TCM combined with chemotherapy could improve the KPS score and CD3+ and CD4+/CD8+ index levels. The incidence rates of postoperative leucopenia, hemoglobin reduction, thrombocytopenia, nausea and vomiting, diarrhea, and neurotoxicity were reduced. In terms of postoperative QLQ-C30 score, abnormal liver function, and abnormal renal function, the incidence of TCM combined chemotherapy was similar to that of chemotherapy alone, with no statistical difference. Compared with chemotherapy alone, TCM combined chemotherapy could reduce the 1-, 2-, 3-, and 5-year cumulative recurrence and metastasis rates and prolong the disease-free survival time. Conclusion Compared with chemotherapy alone in adjuvant chemotherapy, TCM combined chemotherapy could improve the immune level and KPS score of LACC patients after surgery, reduce the incidence of adverse reactions, as well as reduce the recurrence and metastasis rate of LAGC after surgery and DFS could be improved.
Keywords Locally advanced gastric cancer      Radical gastrectomy      Recurrence and metastasis      Traditional Chinese medicine      Meta-analysis     
ZTFLH:  R735.2  
Fund:Capital Health Development Scientific Research Project (No. 2020-2-4193); Beijing Municipal Science and Technology Project (No. D161100005116004)
Issue Date: 15 September 2022
 Cite this article:   
WANG Yue,ZHAO Weizhe,LI Xiaojie, et al. Traditional Chinese Medicine Combined with Chemotherapy in Prevention and Treatment of Recurrence and Metastasis of Locally Advanced Gastric Cancer After Radical Resection: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2022, 49(09): 913-922.
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ZHAO Weizhe
LI Xiaojie
NAN Mengdie
XIE Meiwen
LI Peijin
[1] 孙可欣, 郑荣寿, 张思维, 等. 2015年中国分地区恶性肿瘤发病<br /> 和死亡分析[J]. 中国肿瘤, 2019, 28(1): 1-11. [Sun KX, Zheng<br /> RS, Zhang SW, et al. Report of Cancer Incidence and Mortality<br /> in Different Areas of China, 2015[J]. Zhongguo Zhong Liu, 2019,<br /> 28(1): 1-11.]<br /> [2] 中华人民共和国国家卫生健康委员会. 胃癌诊疗规范(2018年<br /> 版)[J]. 中华消化病与影像杂志(电子版), 2019, 9(3): 118-144.<br /> [National Health Commission of the People’s Repuplic of China.<br /> Standard for diagnosis and treatment of gastric cancer (2018<br /> Edition)[J]. Zhonghua Xiao Hua Bing Yu Ying Xiang Za Zhi(Dian<br /> Zi Ban), 2019, 9(3): 118-144.]<br /> [3] 王殷东, 孙璐, 许雯, 等. 中药复方胃肠安对胃癌肝转移患者总<br /> 生存期的影响[J]. 中华中医药杂志, 2020, 35(12): 6285-6289.<br /> [Wang YD, Sun L, Xu W, et al. Effects of Chinaese herbal<br /> compound Weichang’an on overall survival of patients of gastric<br /> cancer with liver metastases[J]. Zhonghua Zhong Yi Yao Za Zhi,<br /> 2020, 35(12): 6285-6289.]<br /> [4] 刘靖, 蔡美. 蔡美自拟胃复方防治胃癌术后复发[J]. 中医药临床<br /> 杂志, 2020, 32(1): 41-44. [Liu J, Cai M. Experience of CAI Mei<br /> in Preventing and Treating Recurrence of Gastric Cancer with<br /> Self-made Recovering Stomach Decoction[J]. Zhong Yi Yao Lin<br /> Chuang Za Zhi, 2020, 32(1): 41-44.]<br /> [5] 罗兰.斯基尔. 癌症化疗手册[M]. 于世英, 等译. 北京: 科学出版<br /> 社, 2010. [Roland.Skill. Handbook of cancer chemotherapy[M].<br /> Yu SY, et al transl. Beijing: Science Press, 2010.]<br /> [6] Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted<br /> systematic reviews: a new edition of the Cochrane Handbook for<br /> Systematic Reviews of Interventions[J]. Cochrane Database Syst<br /> Rev, 2019, 10(10): ED000142.<br /> [7] 张雪娇. 中医综合疗法对进展期胃癌术后气虚血瘀证的临<br /> 床疗效观察[D]. 南京中医药大学, 2020. [Zhang XJ. Clinical<br /> observation of comprehensive therapy of traditional Chinese<br /> medicine on Qi deficiency and blood stasis syndrome after<br /> operation of advanced gastric cancer[D]. Nanjing University of<br /> traditional Chinese medicine, 2020.]<br /> [8] 俞国法, 蔡国英. 扶正抑癌汤联合腹腔镜辅助小切口根治手术<br /> 治疗胃癌临床研究[J]. 新中医, 2020, 52(4): 121-124. [Yu GF,<br /> Cai GY. Clinical study on Fuzheng Yiai Tang combined with<br /> laparoscopy assisted small Incision Radical Operation for Gastric<br /> Cancer[J]. Xin Zhong Yi, 2020, 52(4): 121-124.]<br /> [9] 许秀东.胃癌根治术后中医辨证治疗方案的临床效果观察<br /> [J]. 中国民康医学, 2019, 31(2): 110-112. [Xu XD. Clinical<br /> effect of TCM syndrome differentiation treatment after radical<br /> gastrectomy[J]. Zhongguo Min Kang Yi Xue, 2019, 31(2):<br /> 110-112.]<br /> [10] 胡抢. 和胃解毒汤在胃癌根治术后辅助化疗期间的临床研究<br /> [D]. 浙江中医药大学, 2018. [Hu Q. Clinical study of Hewei<br /> Jiedu Decoction during adjuvant chemotherapy after radical<br /> gastrectomy for gastric cancer[D]. Zhejiang University of<br /> traditional Chinese medicine, 2018.]<br /> [11] 钟玲玲. 健脾养胃方对Ⅱ、Ⅲ期胃癌术后化疗患者免疫功<br /> 能的影响[D]. 南京中医药大学, 2017. [Zhong LL. Effect of<br /> Jianpi Yangwei Recipe on immune function of postoperative<br /> chemotherapy patients with stage Ⅱ and Ⅲ gastric cancer[D].<br /> Nanjing University of traditional Chinese medicine, 2017.]<br /> [12] 方锦舒, 王祥, 朱宝龙. 培土固本方对进展期胃癌患者术后生<br /> 存质量的影响[J]. 中医学报, 2016, 31(9): 1258-1261. [Fang<br /> JS, Wang X, Zhu BL. Effect of Peitu Guben Prescription on the<br /> Postoperative Life Quality of Patients with Advanced Gastric<br /> Cancer[J]. Zhong Yi Xue Bao, 2016, 31(9): 1258-1261.]<br /> [13] 周铁山. 中医药联合化疗治疗胃癌[J]. 中外女性健康研究, 2015,<br /> 14: 199, 209. [Zhou TS. Traditional Chinese medicine combined<br /> with chemotherapy in the treatment of gastric cancer[J]. Zhong<br /> <p> Wai Nv Xing Jian Kang Yan Jiu, 2015, 14: 199, 209.] </p> <p> [14] 乐琳琳, 沈红燕, 黄立萍. 健脾补肾方辅治胃癌术后化疗患者<br /> 临床观察[J]. 新中医, 2015, 47(1): 195-198. [Le LL, Shen HY,<br /> Huang LP. Clinical observation of Jianpi Bushen recipe in the<br /> treatment of postoperative chemotherapy patients with gastric<br /> cancer[J]. Xin Zhong Yi, 2015, 47(1): 195-198.]<br /> [15] 刘善军, 刘孝伟, 杜贤芹. 香砂六君子汤对胃癌患者免疫功能的<br /> 影响[J]. 中医临床研究, 2014, 28: 6-8. [Liu SJ, Liu XW, Du XQ.<br /> Effects of the Xiangsha Liujunzi decoction on immune function<br /> of gastric cancer patients[J]. Zhong Yi Lin Chuang Yan Jiu, 2014,<br /> 28: 6-8.]<br /> [16] 张君儒, 姚玮. 加味四逆泻心汤对胃癌根治术后患者的疗效观<br /> 察[J]. 胃肠病学和肝病学杂志, 2014, 23(1): 57-59. [Zhang JR,<br /> Yao W. Therapeutic effect of Modified Sini Xiexin decoction for<br /> gastric cancer with radical gastrectomy[J]. Wei Chang Bing Xue<br /> He Gan Bing Xue Za Zhi, 2014, 23(1): 57-59.]<br /> [17] 应海峰, 张惟郁, 郭元彪, 等. 扶中消积方对胃癌术后化疗患<br /> 者免疫功能影响的临床观察[J]. 湖南中医药大学学报, 2014,<br /> 34(11): 43-46. [Ying HF, Zhang WY, Guo YB, et al. Clinical<br /> Observation of Fuzhong Xiaoji Decoction on the Postoperative<br /> Gastric Cancer Patients with Chemotherapy[J]. Hu'nan Zhong Yi<br /> Yao Da Xue Xue Bao, 2014, 34(11): 43-46.]<br /> [18] 舒鹏, 武雯. 健脾养胃方联合化疗对胃癌Ⅱ、Ⅲ期术后干预作<br /> 用的临床研究[J]. 实用临床医药杂志, 2013, 17(3): 16-18. [Shu<br /> P, Wu W. Clinical study of Jianpi Yangwei Formula combined<br /> with chemotherapy on postoperative intervention effects of gastric<br /> cancer at Ⅱ and Ⅲ phases[J]. Shi Yong Lin Chuang Yi Yao Za<br /> Zhi, 2013, 17(3): 16-18.]<br /> [19]江影. 基于孟河派的健脾养胃法对胃癌化疗后支持作用<br /> 评价[D]. 南京中医药大学, 2011. [Jiang Y. Evaluation of<br /> the supporting effect of strengthening spleen and nourishing<br /> stomach method based on Menghe school on gastric cancer after<br /> chemotherapy[D]. Nanjing University of traditional Chinese<br /> medicine, 2011.]<br /> [20] 蒋红妹, 蒋立新, 周锦仪, 等. 中医药联合化疗治疗胃癌术后<br /> 的临床疗效分析[J]. 中医临床研究, 2011, 3(22): 21-22. [Jiang<br /> HM, Jiang LX, Zhou JY, et al. Clinical analysis of treating gastric<br /> cancerin in TCM combined with chemotherapy[J]. Zhong Yi Lin<br /> Chuang Yan Jiu, 2011, 3(22): 21-22.]<br /> [21] 王海明, 张印, 李绍旦, 等. 自拟固胃汤减轻胃癌术后化疗不良<br /> 反应的临床观察[J]. 中华中医药学刊, 2011, 29(8): 1918-1919.<br /> [Wang HM, Zhang Y, Li SD, et al. Clinical observation of<br /> self-made Guwei Decoction in reducing adverse reactions of<br /> postoperative chemotherapy for gastric cancer[J]. Zhonghua<br /> Zhong Yi Yao Xue Kan, 2011, 29(8): 1918-1919.]<br /> [22] 周浩, 郑坚, 沈克平. “胃肠安”方治疗进展期胃癌的临床研究[J].<br /> 肿瘤, 2007, 27(6): 487-489. [Zhou H, Zheng J, Shen KP. Clinical<br /> study on Wei Chang An recipe in the treatment of advanced<br /> gastric cancer[J]. Zhong Liu, 2007, 27(6): 487-489.]<br /> [23] 李佑民, 乐凤华, 谭晓云, 等. 健脾化痰汤预防胃癌根治术后复<br /> 发转移临床观察[J]. 中医药学刊, 2004, 22(7): 1337, 1357. [Li<br /> YM, Le FH, Tan XY, et al. Clinical observation of Jianpi Huatan<br /> Decoction in preventing recurrence and metastasis after radical<br /> gastrectomy[J]. Zhong Yi Yao Xue Kan, 2004, 22(7): 1337, 1357.]<br /> [24] Liu YX, Jiang SJ, Kuang TH, et al. Treatment with yiqi<br /> bushen koufuye combined with chemotherapy for preventing<br /> postoperative metastasis of stomach cancera clinical observation<br /> of 28 cases[J]. J Tradit Chin Med, 2009, 29(4): 263-267.<br /> [25] 纪世敏, 李万胜, 赵斌. 降逆理气汤治疗胃癌术后胃瘫综合<br /> 征的临床疗效[J]. 中国现代医生, 2017, 55(10): 128-130. [Ji<br /> SM, Li WS, Zhao B. Clinical effect of Jiangni Liqi decoction in<br /> the treatment of gastric paralysis syndrome after gastric cancer<br /> surgery[J]. Zhongguo Xian Dai Yi Sheng, 2017, 55(10): 128-130.]<br /> [26] 刘乾, 尹振宇, 屈才浩, 等. 营养不良与肿瘤转移的关系及潜在<br /> 机制[J]. 肿瘤代谢与营养电子杂志, 2020, 7(2): 240-244. [Liu<br /> Q, Yin ZY, Qu CH, et al. Relationships between malnutrition and<br /> tumor metastasis and potential mechanisms[J]. Zhong Liu Dai Xie<br /> Yu Ying Yang Dian Zi Za Zhi, 2020, 7(2): 240-244.]<br /> [27] Tominaga T, Nonaka T, Sumida Y, et al. The C-Reactive Protein to<br /> Albumin Ratio as a Predictor of Severe Side Effects of Adjuvant<br /> Chemotherapy in StageⅢ Colorectal Cancer Patients[J]. PLoS<br /> One, 2016, 11(12): e167967.<br /> [28] Li S, Liu J, Virnig BA, et al. Association between adjuvant<br /> chemotherapy and risk of acute kidney injury in elderly women<br /> diagnosed with early-stage breast cancer[J]. Breast Cancer Res<br /> Treat, 2017, 161(3): 515-524.<br /> [29] 张群秀, 王丽娜, 祝微, 等. 补肾生血法对化疗后骨髓抑制小鼠<br /> 造血生长因子GM-CSF, EPO, TPO mRNA表达的影响[J]. 时<br /> 珍国医国药, 2019, 30(8): 1836-1839. [Zhang QX, Wang LN,<br /> Zhu W, et al. Effect of Bushen Shengxue method on the mRNA<br /> expr‍ession of hematopoietic growth factors GM-CSF, EPO and<br /> TPO in bone marrow suppressive mice after chemotherapy[J]. Shi<br /> Zhen Guo Yi Guo Yao, 2019, 30(8): 1836-1839.]<br /> [30] 曹迪, 张亚密, 全建峰. 中医药改善化疗毒副反应的研究进展<br /> [J]. 中国中医急症, 2020, 29(7): 1302-1305, 1308. [Cao D, Zhang<br /> YM, Quan JF. Research progress of traditional Chinese medicine<br /> in improving toxic and side effects of chemotherapy[J]. Zhongguo<br /> Zhong Yi Ji Zheng, 2020, 29(7): 1302-1305, 1308.]<br /> [31] Laforgia M, Laface C, Calabro C, et al. Peripheral Neuropathy<br /> under Oncologic Therapies: A Literature Review on Pathogenetic<br /> Mechanisms[J]. Int J Mol Sci, 2021, 22(4): 1980.<br /> [32] 闫潇, 邓毅, 马骏, 等. 顺铂毒性损伤机制及中药防治机制的研<br /> 究进展[J]. 中国实验方剂学杂志, 2021, 27(5): 233-242. [Yan X,<br /> Deng Y, Ma J, et al. Research Advance in Mechanism of Cisplatin<br /> Toxic Injury and Its Prevention and Treatment by Traditional<br /> Chinese Medicine[J]. Zhongguo Shi Yan Fang Ji Xue Za Zhi,<br /> 2021, 27(5): 233-242.]<br /> [33] 苗耀东, 李英红, 沈浩玥, 等. 恶性肿瘤化疗所致骨髓抑制的中<br /> 医药研究进展[J]. 吉林中医药, 2019, 39(2): 273-277. [Miao YD,<br /> Li YH, Shen HY, et al. Advances Research of Traditional Chinese<br /> Medicine for Myelosuppression Induced by Chemotherapy in<br /> Malignant Tumors[J]. Jilin Zhong Yi Yao, 2019, 39(2): 273-277.]<br /> [34] Yu C, Ji AJ, Lu JW, et al. The Antigastric Cancer Activity of San<br /> Leng Powder Extract Induces Apoptosis in Balb/C Bearing-<br /> SGC-7901 Mice[J]. Evid Based Complement Alternat Med, 2017,<br /> 2017: 1052125.<br /> [35] Sun Y, Zhang D, Mao M, et al. Roles of p38 and JNK protein<br /> kinase pathways activated by compound cantharidin capsules<br /> containing serum on proliferation inhibition and apoptosis of<br /> human gastric cancer cell line[J]. Exp Ther Med, 2017, 14(2):<br /> 1809-1817.<br /> [36] Hen T, Yuan S, Wan XN, et al. Chinese herb cinobufagin-reduced<br /> Cancer pain is associated with increased peripheral opioids<br /> by invaded CD3/4/8 lymphocytes[J]. Oncotarget, 2017, 8(7):<br /> 11425-11441. </p>
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