Abstract: OBJECTIVE: To investigate the clinical efficacy and safety of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy in the treatment of advanced non-small celllung cancer(NCSLC) compared with chemotherapy alone.METHODS: Databases including Chinese National Knowledge Infrastructure, China Biology Medicine Disc, Wanfang, and MEDLINE were searched until April 1, 2014. Two assessors independently reviewed each trial. The primary outcome was the effective rate(ER) of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy. The secondary outcomes included quality of life improvement rate(QOLIR) and adverse reactions. Statistical calculations were performed by using Cochrane Collaboration Review Manager 5.2.RESULTS: A total of 888 patients from 15 studies,13 randomized controlled trials(RCT) and two controlled clinical trials, were included. Compared with chemotherapy alone, Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract plus chemotherapy significantly improved ER [Risk ratio(RR) =1.32, 95% CI,(1.14, 1.54)](based on 15 studies) and QOLIR [RR = 2.04, 95% CI,(1.69, 2.47)](based on 13studies). Compared with chemotherapy alone,Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract plus chemotherapy significantly inhibited chemotherapy-induced white blood cell decline [RR = 0.79, 95% CI,(0.70, 0.90)(based on 10 studies), chemotherapy-induced platelet decline[RR = 0.77, 95% CI,(0.60, 0.98)](based on 8 studies),and significantly alleviated nausea and vomiting(NV) [RR = 0.83, 95% CI,(0.71, 0.97)](based on 7studies). There was no significant difference in hemoglobin decline between the two therapies [RR =0.88, 95% CI,(0.70, 1.09)](based on 6 studies).CONCLUSION: This Meta-analysis suggests that Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy may be more efficacious in the treatment of advanced NSCLC than chemotherapy alone. This effect includes enhancing ER and QOLIR, and weakening chemotherapy toxicity. However, large-scale RCTs are required to further investigate the short- and long-term effects of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract.

Key words: Carcinoma, non-small-cell lung, Marsdenia tenacissima, Xiaoaiping injection, C21 steroidal saponins, Drug therapy, Review, Meta-analysis