Efficacy of traditional Chinese Medicine combined with chemotherapy in patients with non-small cell lung cancer (NSCLC): a meta-analysis of randomized clinical trials

Background This meta-analysis systematically evaluated the efficacy of Traditional Chinese Medicine (TCM) combined with chemotherapy and provided evidence-based evidence for the treatment of non-small cell lung cancer. Methods Biomedical databases including China National Knowledge Infrastructure (CNKI) database, Wanfang Database, PubMed, and Cochrane Library were searched from January 2005 to October 2019 for the clinical literature on Chinese medicine for treating non-small cell lung cancer. All randomized controlled trials (RCTs) concerning the TCM combined with chemotherapy for non-small cell lung cancer were selected. The total effective rate of clinical efficacy, quality of life (QOL), Karnofsky Performance Status (KPS) score, adverse drug reactions (ADRs) were extracted and analyzed. Review Manager 5.3 software was used for heterogeneity testing and combined statistical analysis. Results A total of 20 RCTs were included, with a total sample of 1669 cases, including 845 in the experimental group (TCM combined with chemotherapy) and 824 in the control group (chemotherapy alone). Compared with the control group, the experimental group significantly improved patients' QOL [OR = 2.79, 95% CI (1.87, 4.16), P < 0.00001], improved clinical efficacy [OR = 2.88, 95% CI (2.32, 3.58), P < 0.00001], increased KPS score [OR = 2.88, 95% CI (1.79, 4.62), P < 0.00001], and reduced the incidence of leukopenia [OR = 0.21, 95% CI (0.12, 0.37), P < 0.0001], thrombocytopenia [OR = 0.23, 95% CI (0.13, 0.40), P < 0.00001], hemoglobin reduction [OR = 0.17, 95% CI (0.10, 0.30), P < 0.00001], myelosuppression [OR = 0.24, 95% CI (0.10, 0.58), P < 0.001], nausea and vomiting [OR = 0.16, 95% CI (0.11, 0.22), P < 0.00001], diarrhea [OR = 0.21, 95% CI (0.12, 0.37), P < 0.00001], liver damage [OR = 0.17, 95% CI (0.10, 0.27), P < 0.00001], and kidney damage [OR = 0.30, 95% CI (0.10, 0.90), P = 0.03]. Conclusion TCM combined with chemotherapy can improve clinical efficacy and KPS score, as well as improve patients' QOL and reduce ADRs caused by chemotherapy drugs.