Oral Chinese patent medicine combined with transarterial chemoembolization for the treatment of unresectable hepatocellular carcinoma: A Bayesian network meta-analysis.

[BACKGROUND] This network meta-analysis (NMA) aims to compare the relative efficacy of oral Chinese patent medicine combined with transarterial chemoembolization (TACE) for treating hepatocellular carcinoma (HCC).

[METHODS] Databases, including China National Knowledge Infrastructure, Wanfang, Weipu, PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL), were accessed from inception to the present to collect randomized controlled trials of different oral Chinese patent medicines (OCPMs). Objective response rate, 1-year survival rate, lymphocytes, nausea and vomiting were used as efficacy or tolerability outcomes. A Bayesian NMA was performed.

[RESULTS] Seventy-five randomized controlled trials involving 6912 participants and 9 OCPMs were included. The results of the NMA showed that the comparisons were all indirect. The NMA demonstrated that, regarding the objective response rate, TACE combined with all OCPMs showed the advantages over TACE monotherapy, of which Cidan capsule (odds ratio [OR] 3.5, 95% credible interval 2.3-4.9) was the most effective treatment. Among 9 OCPMs, Cidan capsule was the most effective for survival improvement (OR 5.1, 95% CrI 2.7-8.7)." Jinlong for immune function (OR 0.35, 95% CrI 0.14-0.57), and Shenyi for adverse event reduction (OR 0.39, 95% CrI: 0.18-0.87).

[CONCLUSION] OCPMs have significant efficacy in treating HCC combined with TACE. Cidan, Jinlong, and Shenyi capsules might be the optimum drugs for HCC adjuvant therapy.