SYSTEMATIC REVIEW article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1643598
This article is part of the Research TopicInterdisciplinary Approaches for Uncovering the Anti-tumor Mechanisms of Chinese Drugs and Natural ProductsView all 4 articles
Efficacy and Safety of Chinese Medicine Injection Combined with Concurrent Chemoradiotherapy in the Treatment of Esophageal Cancer: A Bayesian Network Meta-Analysis
Provisionally accepted
- 1Shandong University of Traditional Chinese Medicine, Jinan, China
- 2Tai 'an Hospital of Traditional Chinese Medicine, Taian, China
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Background: Esophageal cancer (EC) is a significant global health concern. Chinese medicine injections (CMIs) are widely utilized as adjunctive therapies for EC. This network meta-analysis (NMA) aimed to compare the efficacy and safety of various CMIs in combination with concurrent chemoradiotherapy (CCRT) for the treatment of EC. Methods: Relevant randomized controlled trials (RCTs) were comprehensively searched in eight electronic databases until August 2024. The quality of eligible RCTs was assessed via the Cochrane Risk of Bias tool (RoB 2.0). Bayesian NMA was conducted through R 4.2.1 and Stata 15.1, with treatment regimens ranked based on the surface under the cumulative ranking curve (SUCRA). The quality of evidence was evaluated using CINeMA. Results: 54 studies encompassing 4,201 patients and 13 types of CMIs were included. Astragalus polysaccharide injection (HQDT) combined with CCRT (SUCRA: 86.7%) ranked highest for improving clinical effectiveness rate. Kanglaite injection (KLT) combined with CCRT (SUCRA: 85.1%; 90.1%) was optimal for enhancing performance status and one-year survival rate. Kangai injection (KA) combined with CCRT (SUCRA: 97.2%) achieved the greatest improvement in CD3⁺ levels. Aidi injection (AD) combined with CCRT (SUCRA: 99.9%, 99.9%) was most effective in increasing CD4⁺ and CD8⁺ levels, while Fufangkushen injection (FFKS) combined with CCRT (SUCRA: 99.9%) yielded the greatest improvement in the CD4⁺/CD8⁺ ratio. Based on descriptive statistics, all regimens demonstrated favorable safety profiles, with no serious adverse events (AEs) reported. Conclusion: CMIs combined with CCRT appear to provide superior therapeutic efficacy over CCRT alone in the treatment of EC. In particular, HQDT, KLT, KA, AD, and FFKS exhibited the most pronounced benefits across key clinical outcomes. Nevertheless, the findings shall be validated in multicenter, better-designed RCTs.
Keywords: esophageal cancer, Chinese medicine injection, concurrentchemoradiotherapy, Network meta-analysis, Complementary medicine
Received: 09 Jun 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Wang, Xi, Chen, Xin and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fengqin Wei, Shandong University of Traditional Chinese Medicine, Jinan, China
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