Traditional Chinese Medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#carcinoma-hepatocellular #china #combined-modality-therapy #drugs-chinese-herbal #humans

Traditional Chinese Medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis

Wu et al., 2009 | J Exp Clin Cancer Res | Meta Analysis

Citation

Wu Ping, Dugoua Jean Jacques, ... Mills Edward J. Traditional Chinese Medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis. J Exp Clin Cancer Res. 2009-Aug-12;28(1):112. doi:10.1186/1756-9966-28-112

Abstract

BACKGROUND: Liver cancer is a common malignancy with a high mortality rate. Given the poor prognosis associated with this cancer, many patients seek additional therapies that may improve quality of life or survival. Several Traditional Chinese Medicines (TCM) have been evaluated in clinical trials, but little is known about them outside of China. METHODS: We searched independently and in duplicate 8 electronic databases, including 2 Chinese language databases, until February 2009. We included any randomized clinical trials (RCT) evaluating a TCM oral preparation for the treatment of hepatocellular cancers. We abstracted data on survival, tumor response, and performance scores. We conducted a random-effects meta-analysis and applied a meta-regression analysis. RESULTS: We included 45 RCTs (n = 3,236). All studies employed an active control group. In general, the reporting of methodological issues was poor. We analyzed data from 37 trials reporting on complete response effects score (Relative Risk [RR] of 1.26 (95 CI, 1.04-1.52, P = 0.01, I2 = 0%, P = 0.99). Products containing ginseng, astragalus and mylabris had a larger treatment effect (OR 1.34, 95% CI, 1.04-1.71, P = 0.01) than the pooled broad estimate, also the case for astragalus-based treatments (OR 1.35, 95% CI, 1.001-1.80. P = 0.048). We examined survival rates and pooled 15 studies reporting on 6 month outcomes (RR 1.10, 95% CI, 1.04-1.15, P = < 0.0001, I2 = 0%, P = 0.60). This effect was consistent at other prospective dates, including 12 months (22 trials, RR 1.26, 95% CI, 1.17-1.36, P = < 0.0001, I2 = 7%, P = 0.36), 24 months (15 trials, 1.72, 95% CI, 1.40-2.03, P = < 0.0001, I2 = 0%, P = 0.75); and, at 36 months (8 trials, RR 2.40, 95% CI, 1.65-3.49, P = < 0.0001, I2 = 0%, P = 0.62). LIMITATIONS: All included trials were conducted in China where emerging evidence suggests many RCTs are not, in fact, randomized. Publication bias may exist, favouring positive reports. CONCLUSION: Our meta-analysis displays compelling evidence of effectiveness for hepatocellular cancers that should be evaluated in high-quality and transparent clinical trials.

Key Findings

We included 45 RCTs (n = 3,236). All studies employed an active control group. In general, the reporting of methodological issues was poor. We analyzed data from 37 trials reporting on complete response effects score (Relative Risk [RR] of 1.26 (95 CI, 1.04-1.52, P = 0.01, I2 = 0%, P = 0.99). Products containing ginseng, astragalus and mylabris had a larger treatment effect (OR 1.34, 95% CI, 1.04-1.71, P = 0.01) than the pooled broad estimate, also the case for astragalus-based treatments (OR 1.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 3236
Age Range See abstract
Condition See abstract

MeSH Terms

  • Carcinoma, Hepatocellular
  • China
  • Combined Modality Therapy
  • Drugs, Chinese Herbal
  • Humans
  • Liver Neoplasms
  • Medicine, Chinese Traditional
  • Phytotherapy

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: ginseng

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09