Effects of Shengmai injection add-on therapy to chemotherapy in patients with non-small cell lung cancer: a meta-analysis

Abstract

Purpose: Shengmai injection (SMI) has shown promising outcomes in the management of non-small cell lung cancer (NSCLC). This meta-analysis aimed to investigate the add-on effects of SMI to chemotherapy in NSCLC patients. Methods: A comprehensive literature search was performed in the Cochrane Library, PubMed, Embase, CNKI, VIP, and Wanfang up to December 2017. Only randomized controlled trials (RCTs) evaluating SMI in combination with chemotherapy versus chemotherapy alone in NSCLC patients were eligible. The outcome measures were quality of life, chemotherapy-induced grade 3/4 myelosuppression or gastrointestinal reactions, and objective tumor response (equals complete response plus partial response). Pooled risk ratio (RR) with 95% confidence interval (CI) was used to evaluate dichotomous and continuous outcome, respectively. Results: A total of 15 RCTs were included and analyzed. Meta-analysis showed that SMI combined with chemotherapy was associated with a significant improvement in Karnofsky Performance Status (RR 2.36; 95% CI 1.50–3.96) compared with the chemotherapy alone. Moreover, adjunctive treatment with SMI significantly reduced grade 3/4 myelosuppression (RR 0.61; 95% CI 0.46–0.81) and gastrointestinal reactions (RR 0.64; 95% CI 0.46–0.90). However, there was no significant difference in objective tumor response (RR 1.17; 95% CI 0.99–1.37) between two groups. Conclusions: SMI add-on therapy appeared to be more effective in improving quality of life and reducing chemotherapy-induced adverse effects. However, more well-designed RCTs are warranted to confirm the findings of this meta-analysis because of the suboptimal methodological quality of the included trials.