Effects of Shenfu injection on chemotherapy-induced adverse effects and quality of life in patients with advanced nonsmall cell lung cancer: A systematic review and meta-analysis.

Objective: To investigate the efficacy of Shenfu injection (SFI) in reducing chemotherapy-induced adverse effects in nonsmall cell lung cancer (NSCLC) patients by conducting a meta-analysis.

Methods: A systematic review of Cochrane Library, PubMed, Embase, CNKI, Chinese Biomedical Literature Database, VIP, and Wanfang Database was performed from their inception to December 2015. Eligible studies were randomized controlled trials (RCTs) comparing chemotherapy with or without SFI for patients with NSCLC. The main outcomes were improvement in chemotherapy-induced grade 3/4 marrow suppression (leukopenia, neutropenia, anemia, and thrombocytopenia) or gastrointestinal toxicities (nausea and vomiting, diarrhea, and constipation), quality of life, and T-lymphocytes subsets.

Results: Sixteen RCTs involving 948 patients were identified. Compared with chemotherapy alone, SFI plus chemotherapy had lower 3/4 grade toxicity for leukopenia (risk ratio [RR] 0.34; 95% confidence intervals [95% CIs] 0.21-0.55), thrombocytopenia (RR 0.36; 95% CI 0.19-0.71), anemia (RR 0.39; 95% CI 0.16-0.99), nausea and vomiting (RR 0.29; 95% CI 0.14-0.58), and diarrhea (RR 0.21; 95% CI 0.07-0.63), Moreover, SFI plus chemotherapy significantly increased Karnofsky Performance Status (weighted mean difference 11.34; 95% CI 7.26-15.42).

Conclusions: Adjuvant treatment with SFI improves the quality of life, attenuates the chemotherapy-induced gastrointestinal toxicities and bone marrow suppression, thus improving compliance to chemotherapy in patients with NSCLC. As for limited English literature about SFI and NSCLC, only trials publishing in the Chinese were included in the meta-analysis. More well-designed multicenter RCTs are needed before a definitive conclusion can be drawn.