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September 22, 2022ATHENS JOURNAL OF HEALTH & MEDICAL SCIENCESOpen Access

Identifying the Well-suited Chinese Herbal Products for Hepatocellular Carcinoma (HCC) Patients in Terms of Hazard Ratio and Child-Pugh Score Improvement: A Frequentist Statistical Analysis Applying ‘Netmeta’

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Key result

The combination of Buxu Huadu decoction and Jinshuibao capsule with western treatment ranked first for improving overall survival in patients with hepatocellular carcinoma (HR 0.1962).

Why the study?

Previous network meta-analyses did not compare all traditional Chinese medicine (TCM) formulations for hepatocellular carcinoma, leaving a lack of evidence regarding which TCM works best for specific outcomes.

Do traditional Chinese medicine formulations combined with western treatments improve survival and Child-Pugh scores in patients with hepatocellular carcinoma?

Population

Patients with hepatocellular carcinoma across 289 RCTs

Comparison

TCM integrative treatments vs conventional western treatments or each other

Design

Frequentist network meta-analysis under a random-effects model

Authors

KLKa-Cheng LoUniversity of Macau

Discussion

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Implication

May support adjunctive TCM for HCC survival; extends meta-analytic rankings but requires prospective validation before practice change.

Study Design

Type

Meta-Analysis (n=289)

Structured PICO

Do traditional Chinese medicine formulations combined with western treatments improve survival and Child-Pugh scores in patients with hepatocellular carcinoma?

P
Population
A network meta-analysis of 289 randomized controlled trials evaluating traditional Chinese medicine combined with western treatments in patients with hepatocellular carcinoma.
I
Intervention
Traditional Chinese medicine (TCM) formulations (decoctions, injections, oral products, mixed formulations/external applications) combined with western treatments
C
Comparator
Western treatments alone
O
Outcome
Survival (hazard ratio) and Child-Pugh score improvement (odds ratio)hard clinical

Main Result

Hazard Ratio: 0.1962 (95% CI 0.0705–0.5464)

Specific traditional Chinese medicine formulations, such as Buxu Huadu decoction with Jinshuibao capsule and Aidi injection, may significantly improve survival and hepatic function when added to western treatments for hepatocellular carcinoma.

Limitations

  • Net effects of each intervention are not measured exactly
  • Patients were recruited across all tumor stages, making subgroup analysis by tumor stages impossible
  • Included RCTs were all based on a single country (China), limiting external validity
  • Lack of blinding in the included RCTs may exaggerate the effect sizes
  • Net effects not measured exactly
  • Patients recruited across all tumor stages making subgroup analysis by stage impossible
  • All retrieved RCTs based on a single country (China) limiting external validity
  • Lack of blinding in included RCTs

Cite This Study

Ka-Cheng Lo (2022) conducted a meta-analysis in Hepatocellular carcinoma (HCC) (n=289). Buxu Huadu decoction and Jinshuibao capsule plus western treatment vs. Western treatment alone was evaluated on Overall survival (HR 0.1962, 95% CI 0.0705-0.5464). The combination of Buxu Huadu decoction and Jinshuibao capsule with western treatment ranked first for improving overall survival in patients with hepatocellular carcinoma (HR 0.1962).

synapsesocial.com/papers/6a81ad985d6bc1011b4cdd89https://doi.org/10.30958/ajhms.9-4-3
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Network meta-analysis-highly attractive but more methodological research is needed2011 · 368 citations
  2. 2Chinese Herbal Medicine and Chemotherapy in the Treatment of Hepatocellular Carcinoma: A Meta-analysis of Randomized Controlled Trials2005 · 78 citations
  3. 3Observer bias in randomised clinical trials with binary outcomes: systematic review of trials with both blinded and non-blinded outcome assessors2012 · 535 citations
  4. 4Role of traditional Chinese medicine in the management of patients with hepatocellular carcinoma2018 · 54 citations