Abstract
BACKGROUND: Standard treatments for advanced cervical cancer, such as paclitaxel-cisplatin combination (TP) chemotherapy, are often limited by reduced efficacy and significant toxicity. Cinobufacini (Huachansu), a traditional Chinese medicine, has demonstrated potential in enhancing the effectiveness of conventional cancer therapies. METHODS: A systematic search of Web of Science, PubMed, Cochrane, Embase, China National Knowledge Infrastructure, and other databases was conducted up to July 30, 2024. Studies included were randomized controlled trials comparing cinobufacini combined with TP chemotherapy to TP chemotherapy alone in patients with advanced cervical cancer. The outcomes were clinical response rate, Karnofsky Performance Status, myelosuppression, platelet count, and incidences of vomiting and diarrhea. Data analysis was performed using RevMan 5.3, and risk ratios (RRs) and mean differences (MDs) were calculated with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic, and sensitivity analysis was performed to ensure robustness. RESULTS: Six randomized controlled trials involving 814 participants were included. Cinobufacini combined with TP chemotherapy significantly improved the clinical response rate (RR 1.22, 95% CI [1.05-1.41], P = .009) and KPS (MD 7.37, 95% CI [6.40-8.34], P < .00001). The intervention also reduced myelosuppression (RR 0.53, 95% CI [0.41-0.68], P < .0001), platelet count decline (MD -94.25, 95% CI [-96.96 to -91.52], P < .00001), vomiting (RR 0.58, 95% CI [0.45-0.76], P < .0001), and diarrhea (RR 0.60, 95% CI [0.39-0.92], P = .02). Heterogeneity was moderate for the clinical response rate but reduced after sensitivity analysis, with stable overall effect estimates. CONCLUSION: Cinobufacini combined with TP chemotherapy significantly improves clinical outcomes and reduces treatment-related adverse effects. These findings suggest that cinobufacini may be a valuable adjunctive therapy in enhancing the efficacy and reducing the toxicity of TP chemotherapy, though further large-scale studies are needed to confirm its efficacy and safety.