A systematic review and meta-analysis of traditional Chinese medicine with chemotherapy in breast cancer

Gang Shi; Dan Yu; Juan Wu; Yanru Liu; Ruizhen Huang; Cheng Shun Zhang

doi:10.21037/gs-21-284

A systematic review and meta-analysis of traditional Chinese medicine with chemotherapy in breast cancer

Gland Surg. 2021 May;10(5):1744-1755. doi: 10.21037/gs-21-284.

Authors

Gang Shi¹, Dan Yu¹, Juan Wu¹, Yanru Liu², Ruizhen Huang³, Cheng Shun Zhang⁴

Affiliations

¹ Department of Pharmacy Service, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
² Department of Cardiovascular, Chengdu Qingbajiang District Traditional Chinese Medicine Hospital, Chengdu, China.
³ Department of Cardiovascular, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
⁴ Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Abstract

Background: With the continuous progression of a new generation of adjuvant chemotherapy, the survival time of breast cancer patients has also been significantly improved. Chemotherapy alone will cause a series of side effects, which will seriously affect the quality of life of breast cancer patients. Chinese medicine combined with neoadjuvant chemotherapy has a unique advantage in the treatment of breast cancer.

Methods: English databases were searched using combinations of the following search terms: "traditional Chinese medicine", "neoadjuvant hemotherapy", "breast cancer", and "tumor of breast". Publications in which traditional Chinese medicine (TCM) combined with neoadjuvant therapy was the experimental group and chemotherapy alone was the control group were screened.

Results: A total of 12 publications were included in the meta-analysis. The efficiency of the performance status score was used to test for heterogeneity, Chi²=2.95, df=5, P=0.71>0.1, I²=0%, Z=3.36, odds ratio (OR) =2.61, and 95% confidence interval (CI), 1.49-4.58. The results of the heterogeneity test of the effective rate of the objective curative effect were as follows: Chi²=1.04, df=7, P=0.99>0.1, I²=0%<50%, Z=2.42, OR =2.00, and 95% CI, 1.14-3.49. The results for the heterogeneity test of the TCM syndrome score were as follows: I²=83%, P<0.00001, mean difference (MD) =8.84, 95% CI, 6.43-11.25, P<0.05. The results for the heterogeneity test of the incidence of adverse reactions in the digestive system after chemotherapy were as follows: Chi²=1.15, df=8, P=1.00>0.1, I²=0%<50%, Z=1.68, OR =0.04, 95% CI, -0.01 to 0.09.

Discussion: The meta-analysis confirmed that using TCM combined with neoadjuvant chemotherapy to treat breast cancer has obvious advantages over chemotherapy alone in terms of the objective curative effect, the performance status score effective rate, the TCM syndrome score change, and the incidence of gastrointestinal adverse reactions after chemotherapy.

Keywords: Traditional Chinese medicine (TCM); breast cancer; neoadjuvant chemotherapy.