Systematic evaluation and meta-analysis of the efficacy and safety of cinobufagin injection combined with western medicine in the treatment of liver cancer

Objective:To evaluate the clinical efficacy and safety of cinobufagin injection in the treatment of liver cancer.Methods:PubMed database,Embase database and Cochrane Library database,CNKI,Wanfang database,VIP database and Sinomed database were used to search for the randomized controlled trials of cinobufagin injection combined with Western medicine in the treatment of primary liver cancer.The retrieval time was from the establishment to December 15,2020.Two independent researchers conducted systematic screening,literature inclusion and quality assessment of the articles according to the inclusion criteria,respectively.Meta-analysis of the data was performed using RevMan 5.4 software.Results:A total of 30 studies with a total of 2355 patients were included.Compared with conventional western medicine treatment,the clinical effective rate of Hububutin injection combined with western medicine was significantly higher[RR=1.16,95%CI=(1.11,1.22),P<0.00001].It could effectively reduce the tumor size[RR=1.33,95%CI=(1.17,1.51),P<0.00001],prolong the survival time of patients[RR=1.41,95%CI=(1.31,1.52),P<0.00001],improve the quality of life[RR=1.37,95%CI=(1.19,1.57),P<0.00001],improve the liver function of patients[RR=-14.52,95%CI=(-16.15,-12.88),P<0.00001],and reduce the occurrence of adverse reactions[RR=0.94,95%CI=(0.85,1.42),P=0.25]such as bone marrow suppression[RR=0.44,95%CI=(0.31,0.62),P<0.00001].Conclusion:Cinobufagin injection combined with western medicine therapy can effectively improve the clinical symptoms of primary liver cancer,and the safety is good.However,the methodological quality of the included literature is low,which affects the objectivity of the outcome,and it still needs to be verified by multi-sample,multi-center,randomized double-blind controlled trial.

Clinical Study on TACE Combined with Elemene Injection and Cinobufagin Injection Respectively for Middle and Advanced Primary Hepatic Carcinoma

Objective: To observe and compare the differences in the clinical effect and the incidences of adverse reactions oftranscatheter arterial chemoembolization(TACE) combined with elemene injection and cinobufagin injection respectively for middleand advanced primary hepatic carcinoma. Methods: A total of 104 cases of patients with middle and advanced primary hepaticcarcinoma who were treated in the oncology department from August 2018 to January 2020 were included as the study objects, andwere randomly divided into two groups according to different treatment regimens, 52 cases in each group. Both groups were treatedwith TACE once;the cinobufagin injection group was given intravenous infusion with 500 mL of 5% glucose injection and 10 mLof cinobufagin injection once a day. The elemene injection group was given intravenous infusion with elemene injection of 0.4 geach time and once a day. Both groups were treated for two courses, 15 days of continuous treatment with a rest of 15 days beingone course. The clinical effect, the changes in the indexes of liver function including alanine amino transferase(ALT), aspartatetransaminase(AST) and total bilirubin(TBil), the scores of alpha-fetoprotein(AFP) and Karnofsky (KPS) and tumor volumes aswell as the difference in the incidences of adverse reactions between the two groups were observed and compared. Results: Thetotal clinical effective rate was 88.46% in the elemene injection group and 71.15% in the cinobufagin injection group, and thedifference was significant(P<0.05). After treatment, the levels of ALT, AST and TBil in serum in the two groups were significantlydecreased when compared with those before treatment, differences being significant(P<0.05). There was no significant differencebeing found in the comparison of the levels of ALT, AST and TBil in serum between the two groups (P>0.05). After treatment, thedecrease of AFP, tumor volume and the increase of KPS scores in the elemene injection group were significantly more than thosein the cinobufagin injection group, differences being significant (P<0.01). During treatment, there was no significant differencebeing found in the comparison of the total incidences of adverse reactions between the two groups(P>0.05). The adverse reactionsin the cinobufagin injection group were mainly nausea and vomiting, with higher incidence than that in the elemene injection group,the difference being significant (P<0.05). The adverse reactions in the elemene injection group were mainly pain at the injectionsite, with higher incidence than that in the cinobufagin injection group, the difference being significant (P<0.05). Conclusion: Thetherapy of elemene injection combined with TACE for middle and advanced primary hepatic carcinoma has better clinical effect thanthat of cinobufagin injection, but the occ.