华蟾素胶囊联合化疗治疗胃癌的Meta分析

Objective: To evaluate the efficacy and safety of Cinobufagin capsules combined with chemotherapy in the treatment of gastric cancer by Meta-analysis. Methods: Randomized controlled trials (RCTs) of Cinobufagin capsules combined with chemotherapy for gastric cancer included in Chinese database (VIP, CNKI, WanFang, CBM) and English database (PubMed, Cochrane Library, EMBase) were retrieved from the inception to June 2020. Data extraction and methodological quality evaluation were carried out for the included literature. The methodological quality assessment was based on Cochrane bias risk assessment tool. RevMan 5.3 and GRADEpro 3.6 were used for meta-analysis and evidence quality assessment, respectively. Results: 12 trials with 830 patients were included in the review. Meta-analysis results showed that: the addition of Cinobufagin capsules for gastric cancer enhanced the objective remission rate (ORR) (RR=1.65, 95％CI[1.41, 1.93], P < 0.00001);improved quality of Life Score (KPS score) (RR=1.77, 95％CI[1.43, 2.19], P < 0.00001);reduced the incidence of nausea and vomiting (RR=0.46, 95％CI[0.29, 0.74], P=0.001), leukocyte toxicity (RR=0.40, 95％CI[0.25, 0.64], P < 0.0001), and platelet toxicity (RR=0.45, 95％CI[0.22, 0.93], P=0.03);increased the level of CD4+ (MD=6.99, 95％CI[4.32, 9.66], P < 0.00001) was better than chemotherapy alone, with statistically significant differences. The quality of evidence is low by GRADE evaluation. Conclusion: In chemotherapy for gastric cancer, combined with Cinobufagin capsule has better efficacy and safety.