Systematic review of β-elemene injection as adjunctive treatment for lung cancer.

Abstract

OBJECTIVE:

To evaluate the effectiveness and safety of β-elemene Injection as an adjunctive treatment for lung cancer by systematic review.

METHODS:

We retrieved randomized controlled clinical trials related to the use of β-elemene Injection as an adjunctive treatment for lung cancer from Chinese Biomedical (CBMweb), Chinese Medical Current Content (CMCC), China National Knowledge Infrastructure (CNKI), ChinaInfo, Cochrane Central Register of Controlled Trials; MEDLINE, EMBASE, OVID and TCMLARS. We also referred to an unpublished conference proceeding titled Clinical Use and Basic: Elemene Injection. We then divided the studies into non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) subgroups by RevMan 5.1 software.

RESULTS:

A total of 21 source documents (1,467 patients) matched pre-specified criteria for determining the effectiveness and safety of β-elemene Injection as an adjunctive treatment for lung cancer. Five studies involving 285 NSCLC patients reported a higher 24-month survival rate (39.09%) with the adjunctive treatment than with chemotherapy alone (26.17%; RR, 1.51; 95% CI, 1.03 to 2.21). Four studies involving 445 patients reported that the increased probability for improved performance status for patients treated with elemene-based combinations was higher than that of patients treated with chemotherapy alone (RR, 1.82; 95% CI, 1.45 to 2.29). The results from a subgroup analysis on 12 studies involving 974 NSCLC patients and 9 studies involving 593 patients with both SCLC and NSCLC showed that the tumor control rate for NSCLC improved more in the elemene-based combinations treatment group (78.70%) than in the chemotherapy alone control group (71.31%; RR, 1.06; 95% CI, 1.00 to 1.12). The tumor response rate for NSCLC also improved more among patients treated with elemenebased combinations (50.71%) than among patients treated with chemotherapy alone (38.04%; RR, 1.34; 95%CI, 1.17 to 1.54). In addition, the main adverse reaction to β-elemene Injection was phlebitis, but usually only to a mild degree. An Egger's test showed no publication bias in our study (P=0.7030).

CONCLUSIONS:

The effectiveness of chemotherapy for the treatment of lung cancer may improve when combined with β-elemene injection as an adjunctive treatment. The combined treatment can result in an improved quality of life and prolonged survival. However, these results require confirmation by rigorously controlled trials.

• Authors: Bin Wang, Xiao-Xia Peng, Rao Sun, Jie Li, Xiao-Ri Zhan, Li-Juan Wu, Shu-Ling Wang, Tian Xie
• Journal: Chinese journal of integrative medicine (Chin J Integr Med) Vol. 18 Issue 11 Pg. 813-23 (Nov 2012) ISSN: 1672-0415 [Print] China
• PMID: 23086485 (Publication Type: Evaluation Study, Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• Antineoplastic Agents
• Antineoplastic Agents, Phytogenic
• Drugs, Chinese Herbal
• Sesquiterpenes
• beta-elemene

Topics

• Antineoplastic Agents (administration & dosage)
• Antineoplastic Agents, Phytogenic (administration & dosage)
• Carcinoma, Non-Small-Cell Lung (drug therapy, epidemiology)
• Chemotherapy, Adjuvant
• Combined Modality Therapy
• Drugs, Chinese Herbal (administration & dosage)
• Humans
• Injections
• Lung Neoplasms (drug therapy, epidemiology)
• Sesquiterpenes (administration & dosage)
• Small Cell Lung Carcinoma (drug therapy, epidemiology)