FOLFOX 4 combined with herbal medicine for advanced colorectal cancer: a systematic review

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#antineoplastic-combined-chemotherapy-protocols #colorectal-neoplasms #fluorouracil #humans #leucovorin

FOLFOX 4 combined with herbal medicine for advanced colorectal cancer: a systematic review

Chen et al., 2014 | Phytother Res | Meta Analysis

Citation

Chen Menghua, May Brian H, ... Zhang Anthony L. FOLFOX 4 combined with herbal medicine for advanced colorectal cancer: a systematic review. Phytother Res. 2014-Jul;28(7):976-91. doi:10.1002/ptr.5092

Abstract

This systematic review evaluates the clinical evidence for the addition of herbal medicines (HMs) to FOLFOX 4 for advanced colorectal cancer (ACRC) in terms of tumor response rate (tRR), survival, quality of life and reduction in adverse events (AEs). Seven electronic databases were searched for randomized controlled trials (RCTs) of FOLFOX4 combined with HMs compared to FOLFOX4 alone. Outcome data for 13 randomized controlled trials were analysed using Review Manager 5.1. Risk of bias for objective outcomes including tumor response and survival was judged as low. Publication bias was not evident. Meta-analyses found the addition of HMs improved tRR (RR 1.25, 95%CI 1.06-1.47, I(2)  = 0%), one year survival (RR 1.51, 95%CI 1.19-1.90, I(2)  = 0%) and quality of life in terms of Karnofsky Performance Status (KPS) gained (RR 1.84, 95%CI 1.54-2.19, I(2)  = 0%); alleviated grade 3 and 4 chemotherapy-related AEs for neutropenia (RR 0.33, 95%CI 0.18-0.60, I(2)  = 0%), nausea and vomiting (RR 0.34, 95%CI 0.17-0.67, I(2)  = 0%) and neurotoxicity (RR 0.39, 95%CI 0.15-1.00, I(2)  = 0%), compared to FOLFOX4 alone. The most frequently used herbs were Astragalus membranaceus, Panax ginseng, Atractylodes macrocephala, Poria cocos, Coix lachryma-jobi and Sophora flavescens. In experimental studies, each of these herbs has shown actions that could have contributed to improved tumor response.

Key Findings

In experimental studies, each of these herbs has shown actions that could have contributed to improved tumor response.

Outcomes Measured

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Population

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

MeSH Terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Colorectal Neoplasms
  • Fluorouracil
  • Humans
  • Leucovorin
  • Organoplatinum Compounds
  • Phytotherapy
  • Plants, Medicinal
  • Randomized Controlled Trials as Topic

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