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Neoadjuvant Chemotherapy for Resectable Esophageal Carcinoma: A Meta-analysis of Randomized Clinical Trials

  • Xu, Xiao-Hua;Peng, Xue-Hong;Yu, Ping;Xu, Xiao-Yuan;Cai, Er-Hui;Guo, Pi;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.103-110
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    • 2012
  • Neoadjuvant chemotherapy for resectable esophageal carcinoma has been a focus of study, but no agreement has been reached on clinical randomized controlled trials and relevant systematic evaluation. The purpose of this study was to perform a meta-analysis on published randomized controlled trials (RCTs) that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal carcinoma. Medline and manual searches was conducted in PubMed, ASCO (American Society of Clinical Oncology) meeting summary, Embase, the Cochrane Library (up to October 2010), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database, Wanfang Database. The selection contents were to identify all published and unpublished RCTs that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal carcinoma. Sixteen RCTs which included 2,594 patients were selected. The risk ratio (RR) (95% confidence interval [CI]; P value), expressed as neoadjuvant chemotherapy and surgery versus surgery alone (treatment versus control), was 1.02 (0.95, 1.10; P=0.54) for 1-year survival, 1.29 (1.13, 1.47; P=0.0001) for 3-year survival, 1.31 (1.13, 1.51; P=0.0003) for 5-year survival, 1.00 (0.95, 1.04; P= 0.85) for rate of resection and 0.89 (0.64, 1.23; P=0.48) for operative mortality. The results showed that neoadjuvant chemotherapy for resectable esophageal carcinoma can raise the overall survival rate of patients with esophageal carcinoma, but it does not affect treatment-related mortality.

Efficacy of Herbal Medicine on Sleep Disorders in Parkinson's Disease: A Review of Randomized Controlled Trials (파킨슨병에 동반된 수면장애의 한약 치료에 대한 임상 연구 동향 : 무작위 대조연구를 중심으로)

  • Ji-hyeon Kang;Kyungmin Baek
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.603-620
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    • 2023
  • Objectives: This study reviewed randomized controlled trials (RCTs) investigating the efficacy of herbal medicine on sleep disorders associated with Parkinson's disease and suggests a better research process. Methods: We searched for RCTs for herbal medicine treatments for sleep disorders related to Parkinson's disease on July 31, 2023 using eight databases (PubMed, Embase, the Cochrane library, China National Knowledge Infrastructure [CNKI], the Research Information Service System [RISS], Science ON, the Oriental Medicine Advanced Searching Integrated System [OASIS], and the Korea Citation Index [KCI]). Cochrane's risk of bias tool was used to assess the quality of the RCTs. Results: A total of 16 RCTs met all the inclusion criteria, and in most reports, the treatment group showed a significant improvement in sleep disorders compared to the control group. Total effective rate (TER), Pittsburgh Sleep Quality Index (PSQI), Unified Parkinson's Disease Rating Scale (UPDRS), TCM Symptom Score (TSS), Parkinson's Disease Sleep Scale (PDSS), etc., were used as evaluation indicators. Conclusion: Herbal medicine is a potential treatment for sleep disorders associated with Parkinson's disease. However, the selected RCTs were of poor quality, and it is necessary to perform more systematic studies.

A Literature Study on Acupuncture for Cerebral Palsy -Based on the Current Traditional Chinese Medical Journals- (뇌성마비의 침자(鍼刺) 치료에 대한 문헌적 고찰 -최근 중의잡지를 중심으로-)

  • Ha, Su-Yun;Min, Sang-Yeon;Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.23 no.1
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    • pp.205-228
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    • 2009
  • Objectives The purpose of this study is to investigate the current acupuncture therapy of cerebral palsy. Methods We investigated the Chinese clinical papers which were published in the last 10 years(from 1999 to 2008). We found these papers from the oriental medical library in university and we also used the China National Knowledge Infrastructure(CNKI) through the internet and selected 32 papers for analyzing. Results Most papers were described the effect of acupuncture or acupoint-injection. This is more effective way to treat than the general rehabilitation treatment such as the physical therapy, the occupational therapy, and the speech therapy. Acupuncture or acupoint-injection has overall $80{\sim}100%$ of rehabilitation rate. The younger the children were, the longer the treatment period was, and the more successful in treatment. The acupuncture was often used with the general acupuncture and scalp acupuncture. Commonly used major acupuncture points were sishencong(四神聰), bohui(百會), zusanli(足三里), yundongqu(運動區), pinghengqu(平衡區), quchi(曲池), and sanyinjiao(三陰交). Commonly used main meridian pathways were bladder, governor vessel, gallbladder, large intestine, stomach, small intestine meridian. Head is the common site for acupuncture. The main acupoint-injection points were zusanli(足三里), dazhui(大椎), shenshu(腎兪), yamen(啞門), neiguan(內關), and fengchi(風池). For the injection, brain activator, ganglioside M1, cerebroprotein hydrolysate, cytidine diphosphate choline, Vit B1, Vit B12, the salviae root, the safflower were commonly used. Conclusions Acupuncture and acupoint-injection have been shown as an effective treatment on cerebral palsy. The acupuncture was used often the general acupuncture and scalp acupuncture all together. Commonly used main acupuncture points were sishencong, bohui, zusanli, yundongqu, pinghengqu, quchi, sanyinjiao.

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A Study on the Import to Chosun and It's Distributions of the Saseodaejeon Published by Yongle Emperor of the Ming Dynasty (영락(永樂) 내부각본(內府刻本) <사서대전(四書大全)>의 조선(朝鮮) 전래(傳來)와 유포(流布))

  • Song, Il-Gie
    • Journal of the Korean Society for Library and Information Science
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    • v.48 no.1
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    • pp.97-116
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    • 2014
  • When the Yongle Emperor of the Ming Dynasty seized the power as the emperor of China, he issued a royal order to Hokwang and others, to publish a book entitled "Sambudaejeon," in the name of following the death-bed instruction of Taizu. The book was completed no less then 10 months after the order was issued in September 1415(Yongle 13). With the first copy imported from the Ming Dynasty as the original script, Sambudaejeon was engraved on wood by going sharing with 3 provinces including Gyeongsang-do, Jeonlla-do, and Gangwon-do, during the period of 1427~1428(Sejong 9~10). The result of surveying and analysing the distribution of the Ming Dynasty was imported to Chosun, shows that the engraving copy of the original script from the Ming was published more then 18 times in Chosun, among which only 50 types are identified to exist currently. As a result of analyzing these 50 existing types, This status of publication suggests that the books were intensively published and distributed in Gyeonggi and Gyeongsang provinces where the demands for the books were urgent, to meet the needs when the books were rapidly lost during the period of Japanese invasion.

Meta-analysis of Six Randomized Control Trials of Chemotherapy Plus Anti-HER Monoclonal Antibody for Advanced Gastric and Gastroesophageal Cancer

  • Luo, Huai-Qing;Han, Li;Jiang, Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5343-5348
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    • 2014
  • Background: A meta-analysis was performed to examine the benefit/risk ratio for the addition of anti- HER MoAbs to chemotherapy in patients with advanced gastric and gastroesophageal cancer from six randomized phase II/III trials. Materials and Methods: We searched relative trials from Pubmed, EMBASE, Cochrane library databases, China National Knowledge Infrastructure databases, Google Scholar and the NIH ClinicalTrials. Primary outcomes were overall response rate (ORR), progression-free survival (PFS), overall survival (OS). Secondary outcomes were toxicities. All analyses were performed using STATA 12.0. Results: This meta-analysis included six randomized controlled trials (RCTs) with 2, 297 patients and we demonstrated that the anti-HER MoAbs arm did have a positive effect on ORR in the anti-HER MoAbs arm (OR 1.28, 95% CI 1.00-1.64, p=0.01). There was an increasing benefit regarding OS (HR 0.74, 95% CI 0.60-0.88, p<0.05) and PFS (HR 0.72, 95% CI 0.60-0.84, p<0.05) in the anti-HER2 subgroup, but a reduction of OS (HR 1.11, 95% CI 0.87-1.36, p<0.05) and PFS (HR 1.13, 95% CI 0.98 -1.28, P<0.05) in anti-EGFR subgroup. Some grade 3-4 toxicity had a significantly higher incidence in the anti-HER MoAbs arm. There was no significant publication bias for all endpoints. Conclusions: The addition of trstuzumab MoAb to chemotherapy for gastric and gastroesophageal cancer significantly improved outcome of OS and PFS endpoints, while other MoAbs led to no improvement in results. Some adverse events were increased in anti-HER MoAbs arm compared with the control.

Current Evidence of Acupuncture in the Cochrane Databse of Systematic Reviews: an Overview (코크란 체계적 문헌고찰 내의 침구치료 임상근거 현황고찰)

  • Kim, Kun-Hyung;Noh, Seung-Hee;Lee, Myeong-Soo;Yang, Gi-Young;Shin, Byung-Cheul;Kim, Jae-Kyu;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.28 no.4
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    • pp.57-64
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    • 2011
  • Objectives : The aim of this study is to overview the current status of Cochrane systematic review of acupuncture. Methods : Published Cochrane systematic reviews and protocols for evaluating acupuncture and/or moxibustion were searched by the terms 'acupuncture' and 'moxibustion' in Issue 1, Cochrane Library, 2011. Only reviews or protocols that regarded acupuncture or moxibustion as primary methods of intervention in their reviews were included. Data regarding first author national affiliation, intervention and disease, as well as the number of reviews or protocols that included Korean, Chinese, or Japanese databases in search strategies were obtained. Results : We found 92 hits at screening, and 59 studies were eligible for this review. Included interventions were acupuncture (n=56), auricular acupuncture (n=2), and moxibustion (n=1) for various diseases and conditions. The number of publications of Cochrane systematic reviews or protocols increased gradually from 2002 to 2011. First authors' affiliations were located in China (n=32), Australia (n=8), UK (n=7), Canada (n=4), U.S. (n=4), Germany (n=2), Norway, (n=1) and Korea (n=1). 44, four and four Cochrane reviews adopted Chinese, Korean and Japanese databases, respectively. Conclusions : Search strategies in a substantial number of Cochrane reviews or protocols for acupuncture and moxibustion heavily relied on Chinese databases. Korean databases were underused in existing Cochrane reviews and protocols, and Korean authors were much less involved in the Cochrane systematic reviews or protocols than Chinese authors. Further studies need to be conducted in order to incorporate evidence of acupuncture reported in Korean databases into the Cochrane systematic reviews.

Clinical Practice Guideline for acupuncture in Post-stroke urinary incontinence (뇌졸중 후 요실금에 대한 침치료 임상진료지침)

  • Lee, Ji-Won;Shin, Byung-Cheul;Lee, Myeong-Soo;Lim, Sung-Min;Yoo, Jung-Hee;Cho, Chung-Sik;Moon, Sang-Kwan;Yook, Tae-Han;Joo, Jong-Cheon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.29 no.4
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    • pp.317-325
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    • 2017
  • Objectives This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the stroke patients with Post-stroke Urinary Incontinence(PSUI). Methods Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUI, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions 8 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUI. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as BL23, CV3, SP6, CV4, CV6, ST28, BL28, BL32, GV20, BL22, GV4 or ST36, for 15-30 minutes. 1-150 Hz frequency is suggested if electro-acupuncture treatments is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. There was a moderate evidence to support safety of acupuncture treatment for PSUI. We recommend acu-points of constitutional acupuncture for Sasangin on the healthy side.

Clinical Practice Guideline on Acupuncture for Post-stroke Spasticity (뇌졸중후 경직에 대한 침치료 임상진료지침)

  • Kim, Je-Shin;Shin, Seung-Won;Lee, Eui-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Lim, Sung-Min;Nam, Dong-Woo;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.36 no.1
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    • pp.1-8
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    • 2015
  • Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on post-stroke spasticity, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

Systematic Review of Korean Medicine for the Treatment of Sixth Cranial Nerve Palsy (외전신경마비의 한의학 치료에 대한 체계적 문헌 고찰)

  • Won, Seo-young;Kim, Min-ji;Cha, Ji-yun;Jung, Eun-sun;Cho, Hyun-kyoung;Yoo, Ho-ryong;Seol, In-chan;Kim, Yoon-sik
    • The Journal of Internal Korean Medicine
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    • v.40 no.3
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    • pp.409-424
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    • 2019
  • Objectives: This research aimed to confirm the efficacy of oriental medicine in sixth cranial nerve palsy and to evaluate the quality of the studies. Methods: Using the medical subject heading (MeSH) keywords "abducens nerve palsy", "abducens nerve paralysis", "sixth nerve palsy", "herbal medicine", "Chinese medicine", "oriental medicine" and "acupuncture", we collected the research papers through an electronic database search in Oriental Medicine Advanced Searching Integrated System (OASIS), National Discovery for Science Leaders (NDSL), PubMed, Cochran Library, and China National Knowledge Infrastructure (CNKI). Results: A total of 136 papers were searched from the databases. Among these, 15 case reports and 8 randomized controlled trials (RCTs) met our criteria. 17 articles were found on the use of acupuncture as the main intervention, 11 on the use of herbal medicine as the main intervention, and 9 on the use of electroacupuncture as the main intervention. The frequently used acupoints were LI4, EX-HN5, GB1, BL2, TE23, LR3, BL1, ST2, GB20, and ST36. All 23 studies confirmed the efficacy of Korean medicine. According to the assessment using the risk of bias, the overall quality of the RCTs was low. Conclusions: Twenty-three papers suggested that Korean medicine treatment for abducens nerve palsy was effective in many cases. Analyzing the potential bias was difficult.

Effects of Neuromuscular Electrical Stimulation on Muscle Wasting with Cancer Patient: A Systematic Review (신경근전기자극치료가 암 환자의 근육 손실에 미치는 영향: 체계적 문헌고찰)

  • Eun Soo Park;Jong Hee Kim;Soo Dam Kim;Dong Hyun Kim;Eun Jung Lee;Min Seok Oh;Hwa Seung Yoo
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.15-29
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    • 2023
  • Objectives The purpose of this study is to systematically review the effects of Neuromuscular Electrical Stimulation treatment on muscle wasting in cancer patients. Methods Randomized controlled trials (RCTs) were searched from seven online databases (PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Sharing Service. The selected RCTs were evaluated for methodological quality through the Cochrane RoB. Results A total of 126 articles were identified, and 4 randomized controlled trials were selected for systematic review. In one study, it was found that there were statistically significant improvements in the Health-Related Quality of Life (FACTH&N total score, p<0.001). Additionally, significant effects were observed in measurements that represented the size of the quadriceps muscle (cross-sectional area of Vastus lateralis and Rectus femoris, p=0.004), maximum muscle strength, the twitch response of resistance muscles, and voluntary activation (p<0.001). However, no significant differences were observed between the intervention and control groups in terms of quadriceps muscle strength in two other studies (p>0.05). Lastly, while one study showed no significant differences in muscle fiber characteristics between the two groups, it did report significant improvements in measurements related to mitochondria within muscle tissue and muscle strength in the intervention group (p<0.05). Conclusions Neuromuscular electrical stimulation can be a method used to improve muscle strength in muscle wasting of cancer patients, but it is difficult to see its effects as significant compared to other treatments.