Can polysaccharide K improve therapeutic efficacy and safety in gastrointestinal cancer? a systematic review and network meta-analysis
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Yan Ma2, Xiaofen Wu3, Jingwen Yu3, Jinyan Zhu4, Xia Pen2 and Xianjun Meng1
1College of Food Science, Shenyang Agriculture University, Shenyang 110866, P.R. China
2Center of Experiment Teaching, Shenyang Normal University, Shenyang 110034, P.R. China
3The Sixth People’s Hospital of Shenyang, Shenyang 110005, P.R. China
4Food Inspection Monitoring Center of Zhuanghe, Dalian 116400, P.R. China
Xianjun Meng, email: firstname.lastname@example.org
Keywords: polysaccharide K, PSK, immunochemotherapy, gastrointestinal cancer, network meta-analysis
Received: May 13, 2017 Accepted: June 19, 2017 Published: July 06, 2017
Objective: To assess the comparative efficacy and safety of polysaccharide K (PSK), with or without chemotherapy, for patients with gastrointestinal cancer (GIC) through a systematic review and network meta-analysis.
Materials and Methods: We performed a network meta-analysis to identify evidence from randomized controlled trials. We searched PubMed, Embase and the Cochrane Library for publications up to May 2017. The prespecified primary efficacy outcomes were 1–7 year overall survival (OS), while the secondary efficacy outcomes were 1–7 year disease-free survival (DFS); we performed subgroup analyses and meta-regressions according to the cancer type (colorectal, esophagus and gastric cancer) and treatment arms (with or without chemotherapy). Safety outcomes were side effects of PSK. We conducted pairwise meta-analyses using a random-effects model and then performed random-effects network meta-analyses.
Results: A total of 23 trials were eligible, involving 10684 patients and 13 intervention arms. PSK treatment significantly increased 1–5 year OS and resulted in positive trends in 6–7 year OS; significant increases were also found in 1–7 year DFS, while no increase in side effects was observed. Significant efficacy outcomes obvious in colorectal and gastric cancer groups, as well as PSK combined with chemotherapy groups (iv, po, iv+po). Network meta-analysis revealed that PSK combined with chemotherapy was superior, with significantly increased 3-year and 5-year OS. The study is registered with PROSPERO (CRD42017065193)
Conclusions: The adjuvant immunochemotherapy agent PSK is effective and safe for patients with GIC. PSK combined with chemotherapy appears to be the preferred application of PSK.
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