Abstract | PURPOSE: METHODS: A systematic literature search was conducted in nine databases until December 2012 to identify randomized controlled trials (RCTs) of CKI versus current western therapies for bone cancer pain. The primary outcome was total pain relief rate. The secondary outcomes were the quality of life and adverse events at the end of treatment course. The methodological quality of RCTs was assessed independently using six-item criteria according to the Cochrane Collaboration, and the level of evidence was assessed by the GRADE approach. All data were analyzed using Review Manager 5.1.0. RESULTS: Seven RCTs with 521 patients from 2010 to 2012 were identified. Compared with radiotherapy or bisphosphonates, seven RCTs showed significant effects of CKI for improving pain relief in patients with bone cancer pain (n = 521, risk ratio (RR) = 1.25, 95 % CI (95 % confidence intervals (CI)), 1.13 to 1.38, p < 0.0001)), three RCTs for improving Karnofsky scoring (KPS) increase rate (n = 305, RR = 1.62, 95 % CI, 1.32 to 1.99, p < 0.00001), 1 RCT for increasing KPS scores (n = 78, mean difference (MD) = 10.43, 95 % CI 4.76 to 16.10, p = 0.0003). 4 RCTs reported adverse effects in both the treatment and control groups. The patients treated with CKI achieved statistically significant reductions of incidences of leukopenia (n = 276, RR = 0.32, 95 % CI, 0.21 to 0.47, p < 0.00001) and nausea (n = 78, RR = 0.15, 95 % CI, 0.06 to 0.34, p < 0.00001). No severe adverse events were found and no treatment was stopped because of adverse events of CKI in the treatment groups. However, the studies were deemed to have a high risk of bias. CONCLUSION: This systematic review showed positive but weak evidence of CKI for bone cancer pain because of the poor methodological quality and the small quantity of the included trials. Future rigorously designed RCTs are required.
|
Authors | Bao Yanju, Liping Yang, Baojin Hua, Wei Hou, Zhan Shi, Weidong Li, Conghuang Li, Cihui Chen, Rui Liu, Yinggang Qin, Wenliang Lv |
Journal | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
(Support Care Cancer)
Vol. 22
Issue 3
Pg. 825-36
(Mar 2014)
ISSN: 1433-7339 [Electronic] Germany |
PMID | 24276956
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
|
Chemical References |
- Drugs, Chinese Herbal
- kushen
|
Topics |
- Adult
- Aged
- Bone Neoplasms
(physiopathology)
- Drugs, Chinese Herbal
(administration & dosage, adverse effects, therapeutic use)
- Female
- Humans
- Male
- Medicine, Chinese Traditional
- Middle Aged
- Pain
(drug therapy)
- Randomized Controlled Trials as Topic
|