Table 2.
Results of Meta-Analyses of Randomized Trials, Chinese Herbal Medicine Combined With Fluorouracil-Based Chemotherapy, Compared With Chemotherapy Alone for Colon Cancer.a
| Endpoint | Cochrane Risk of Bias | No. of Studies | No. of Patients | RR | 95% CI | P | Test for Between-Study Heterogeneity (P)b | Test for no Publication Bias (P)c | Clinical Evidence of Benefit Found That Has Low ROB |
|---|---|---|---|---|---|---|---|---|---|
| Anemia (WHO Scale ≥2) | High ROB | 4 | 306 | 0.64 | (0.20, 2.03) | .44 | .03 | .03 | No |
| Low ROB | 1 | n/a | n/a | n/a | n/a | n/a | Nod | ||
| Chemotherapy completion | High ROB | 6 | 470 | 1.17 | (1.01, 1.37) | .04 | <.01 | .55 | No |
| Low ROB | None found | ||||||||
| Diarrhea (incidence) | High ROB | 3 | 268 | 0.33 | (0.21, 0.54) | <.01 | .54 | .21 | No |
| Low ROB | None found | ||||||||
| Diarrhea (WHO Scale ≥2) | High ROB | 5 | 316 | 0.34 | (0.20, 0.58) | <.01 | .84 | .65 | No |
| Low ROB | 2 | 224 | 0.43 | (0.19, 1.01) | .05 | .61 | Nondetectable | Yes | |
| Fatigue (incidence) | High ROB | 4 | 319 | 0.42 | (0.29, 0.61) | <.01 | .19 | .06 | No |
| Low ROB | None | ||||||||
| Karnofsky performance status | High ROB | 18 | 1.37 | (1.27, 1.48) | <.01 | .18 | <.01 | No | |
| Low ROB | 1 | n/a | n/a | n/a | n/a | n/a | Nod | ||
| Kidney toxicity (WHO Scale ≥2) | High ROB | 2 | 222 | 0.33 | (0.04, 2.46) | .28 | .66 | Nondetectable | No |
| Low ROB | None found | ||||||||
| Liver toxicity WHO Scale ≥2) | High ROB | 3 | 204 | 0.83 | (0.38, 1.80) | .64 | .87 | .83 | No |
| Low ROB | None found | ||||||||
| Neurotoxicity (WHO Scale ≥2) | High ROB | 5 | 309 | 0.63 | (0.37, 1.06) | .08 | .93 | .44 | No |
| Low ROB | 2 | 220 | 0.79 | (0.31, 1.31) | .27 | .77 | Nondetectable | No | |
| Platelet toxicity (WHO Scale ≥1) | High ROB | 4 | 265 | 0.35 | (0.15, 0.84) | .02 | .90 | .61 | No |
| Low ROB | 2 | 224 | 0.65 | (0.11, 3.92) | .64 | .74 | Nondetectable | Yes | |
| Recurrence, at 1 year | High ROB | 2 | 172 | 0.24 | (0.04, 1.53) | .13 | .58 | Nondetectable | No |
| Low ROB | None found | ||||||||
| Recurrence, at 3 years | High ROB | 3 | 237 | 0.43 | (0.25, 0.75) | <.01 | .85 | .08 | No |
| Low ROB | None found | ||||||||
| Survival, at 1 year | High ROB | 5 | 391 | 0.53 | (0.35, 0.78) | <.01 | .23 | .74 | No |
| Low ROB | None found | ||||||||
| Survival, at 2 year | High ROB | 2 | 216 | 0.50 | (0.35, 0.71) | <.01 | .59 | .85 | No |
| Low ROB | None found | ||||||||
| Survival, at 3 years | High ROB | 4 | 274 | 0.70 | (0.57, 0.88) | <.01 | .88 | .60 | No |
| Low ROB | None found | ||||||||
| Tumor response | High ROB | 15 | 967 | 1.39 | (1.18, 1.63) | <.01 | .93 | .68 | No |
| Low ROB | 2 | 198 | 1.20 | (0.81, 1.79) | .38 | .84 | Nondetectable | Yes | |
| Vomiting (incidence) | High ROB | 8 | 446 | 0.35 | (0.25, 0.48) | <.01 | .35 | .03 | No |
| Low ROB | None found | ||||||||
| Vomiting (WHO Scale ≥2) | High ROB | 8 | 481 | 0.45 | (0.33, 0.61) | <.01 | .75 | .03 | No |
| Low ROB | 2 | 224 | 0.87 | (0.48, 1.58) | .64 | .85 | Nondetectable | Yes | |
| WBC <4.0 (incidence) | High ROB | 3 | 293 | 0.24 | (0.14, 0.41) | <.01 | .98 | .78 | No |
| Low ROB | None found | ||||||||
| WBC toxicity (WHO Scale) | High ROB | 9 | 607 | 0.32 | (0.22, 0.47) | <.01 | .85 | .42 | No |
| Low ROB | 2 | 224 | 0.34 | (0.16, 0.72) | <.01 | .86 | Nondetectable | Yes |
Abbreviations: CI, confidence interval; n/a, not applicable; ROB, risk of bias; RR, relative risk; WBC, white blood cells; WHO, World Health Organization.
Significant therapeutic effects were allowed when meta-analysis results satisfied all 4 of these criteria: Within studies with low risk of bias, a significant finding for the pooled relative risk or clinical benefit, a significant finding of the test for no publication bias, and a nonsignificant finding of the test for between-study heterogeneity.
If P < .05: unbalanced effects between studies.
If P > .05: evidence of publication bias.
Only one study with low risk of bias found for this outcome, so no meta-analysis could be calculated.