# Efficacy of traditional Chinese medicine combined with chemotherapy for gastric cancer and precancerous gastric lesions: a systematic review and meta-analysis

## TL;DR

This study finds that combining traditional Chinese medicine with chemotherapy improves outcomes and quality of life for gastric cancer patients.

## Contribution

The study provides a systematic review and meta-analysis of TCM combined with chemotherapy for gastric cancer and precancerous lesions.

## Key findings

- Combined therapy improved complete response rates with OR of 4.20 and no heterogeneity.
- Quality of life outcomes showed a high SMD of 0.82 with moderate heterogeneity.
- Symptom scores for fatigue, pain, and nausea improved significantly in the TCM combination group.

## Abstract

Despite the advancements in therapeutic regimens, gastric cancer is still among the most concerning cancer-related public health problems. In previous literature, Traditional Chinese Medicine (TCM) proved to be an effective treatment strategy for reducing the side effects of chemotherapy and improving the quality of life among patients with gastric cancer or precancerous gastric lesions.

To analyze the efficacy of TCM combined with chemotherapy in individuals with gastric cancer and precancerous gastric lesions.

PubMed, Cochrane Library, and Embase electronic databases were utilized to perform predefined search criteria for the identification and selection of studies based on eligibility criteria. The assessed outcomes include complete response rates (CRR), disease control rate (DCR), symptom scores, and quality of life (QoL), while the secondary outcomes include immune function, tumor markers, clinical symptom scores, and gastrointestinal adverse events. Random effect models were used to perform statistical tests (SMD: standardized mean difference, OR: odds ratio) with 95% confidence intervals and heterogeneity through I2 statistics. Publication bias was evaluated using funnel plots and tests like Egger’s regression or Begg’s correlation.

A total five studies reporting diverse outcomes were included in this meta-analysis. The SMD analysis for primary outcomes reported 0.35 [-0.66; 1.35] with considerable heterogeneity (I2 = 89.7%) while the CRR indicated remarkable improvement for combined therapy with OR of 4.20 [1.20; 14.71] and no heterogeneity. SMD analysis for QoL outcomes was also considerably high at 0.82 [-0.07; 1.81] with I2 = 80.0%. TCM combination group showed a significant difference in event rate with OR of 0.42 [0.32; 0.54], while the detailed analysis for symptom score of pooled -0.35 SMD [-0.76; 0.77] was obtained for fatigue, pain, acid reflux, nausea &vomiting, diarrhea. The publication bias assessment revealed significant asymmetry.

The incorporation of TCM combined with chemotherapy for gastric cancer proved to be a safe and more effective treatment as the drug side effects were completely eradicated. The combination therapy has shown overall effectiveness with primary and secondary patient-reported outcomes, improving quality of life in gastric cancer individuals.