Comparative efficacy of various CHIs combined with western medicine for non-small cell lung cancer: A bayesian network meta-analysis of randomized controlled trials

Bayesian network meta-analysis of 389 randomized controlled trials including 31,263 patients with non-small cell lung cancer treated in hospital-based settings. The included studies compared 16 Chinese herbal injections plus Western medicine versus Western medicine alone; participants were adults with NSCLC, with no restrictions on sex, age, race, or region reported in the overview.

This review evaluated 16 Chinese herbal injections used as add-on therapy to Western medicine for non-small cell lung cancer. No dosing, route, or treatment-duration details were reported in the extracted source packet for the individual injection regimens.

Overall, Chinese herbal injections combined with Western medicine appeared more beneficial than Western medicine alone for non-small cell lung cancer, with Shenmai injection plus Western medicine and disodium cantharidinate plus vitamin B6 injection plus Western medicine ranking most favorably for disease control and survival quality. For disease control rate and survival quality score, SMI+WM reported 80.60 and 60.30, while DCI+WM reported 67.80 and 82.20; WM alone was 3.30 and 0.10, respectively. Several injections also showed favorable safety rankings, including fewer gastrointestinal adverse reactions and hematologic toxicities in some arms. The authors concluded that CHIs may improve disease control, survival quality, and adverse-event profiles, but the evidence should be interpreted cautiously.

The included randomized trials were methodologically limited, and the review noted potential publication bias. All included studies were published in Chinese, which may reduce generalizability, and some adverse-event outcomes were missing for certain arms. The network meta-analysis also pooled many different injections with varying evidence quality, increasing indirectness and heterogeneity.