Table 6 Quality of evidence in the included SRs/MAs based on GRADE
References | Outcomes(participants) | Certainty assessment | Interventions | Effect | Certainty | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Test group | Control group | Relative(95% CI) | Absolute(95% CI) | |||||||||
Study design (number) | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||||||
Yang AL 2018 [29] | RR | RCT (5) | seriousa | not serious | not serious | not serious | seriousd | 151/211 ( 71.6%) | 106/202 ( 52.5%) | RR 1.37 (1.17 to 1.60) | 194 more per 1000 (from 89 more to 315 more) | ⨁⨁◯◯Low |
CD3+ | RCT (5) | seriousa | seriousb | not serious | not serious | seriousd | 209 | 197 | SMD 0.63 higher (0.15 higher to 1.11 higher) | ⨁◯◯◯Very low | ||
CD4+ | RCT (7) | seriousa | seriousb | not serious | not serious | seriousd | 281 | 261 | SMD 1.36 higher (0.59 higher to 2.14 higher) | ⨁◯◯◯Very low | ||
CD8+ | RCT (7) | seriousa | seriousb | not serious | not serious | seriousd | 281 | 261 | SMD 0.07 lower (0.4 lower to 0.25 higher) | ⨁◯◯◯Very low | ||
CD4+/CD8+ | RCT (7) | seriousa | seriousb | not serious | not serious | seriousd | 281 | 261 | SMD 0.56 higher (0.26 higher to 0.87 higher) | ⨁◯◯◯Very low | ||
NK cell | RCT (3) | seriousa | seriousb | not serious | not serious | seriousd | 143 | 131 | SMD 1 higher (0.39 higher to 1.61 higher) | ⨁◯◯◯Very low | ||
Wu JH 2019 [8] | RR | RCT (11) | seriousa | not serious | not serious | not serious | not serious | 325/510 ( 63.7%) | 223/496 ( 45.0%) | RR 1.41 (1.26 to 1.58) | 184 more per 1000 (from 117 more to 261 more) | ⨁⨁⨁◯Moderate |
KPS score | RCT (10) | seriousa | not serious | not serious | not serious | seriousd | 266/592 ( 44.9%) | 129/573 ( 22.5%) | RR 1.95 (1.65 to 2.31) | 214 more per 1000 (from 146 more to 295 more) | ⨁⨁◯◯Low | |
CD3+ | RCT (7) | seriousa | seriousb | not serious | not serious | seriousd | 311 | 297 | SMD 1.5 higher (0.52 higher to 2.48 higher) | ⨁◯◯◯Very low | ||
CD4+ | RCT (9) | seriousa | seriousb | not serious | not serious | seriousd | 365 | 346 | SMD 2.42 higher (1.42 higher to 3.41 higher) | ⨁◯◯◯Very low | ||
CD8+ | RCT (9) | seriousa | seriousb | not serious | not serious | seriousd | 373 | 351 | SMD 0.32 lower (1.11 lower to 0.46 higher) | ⨁◯◯◯Very low | ||
CD4+/CD8+ | RCT (9) | seriousa | seriousb | not serious | not serious | seriousd | 373 | 351 | SMD 0.32 lower (1.11 lower to 0.46 higher) | ⨁◯◯◯Very low | ||
Th-cell | RCT (4) | seriousa | not serious | not serious | seriousc | seriousd | 231 | 226 | SMD 3.4 higher (1.52 higher to 5.29 higher) | ⨁◯◯◯Very low | ||
Thrombocytopenia | RCT (7) | seriousa | not serious | not serious | not serious | seriousd | 357 | 342 | SMD 0.29 higher (0.08 higher to 0.49 higher) | ⨁⨁◯◯Low | ||
Leukopenia | RCT (6) | seriousa | not serious | not serious | not serious | seriousd | 120/393 ( 30.5%) | 192/388 ( 49.5%) | RR 0.62 (0.52 to 0.74) | 188 fewer per 1000 (from 238 fewer to 129 fewer) | ⨁⨁◯◯Low | |
Liu SY 2018 [6] | RR | RCT (13) | seriousa | not serious | not serious | not serious | seriouse | 390/577 ( 67.6%) | 299/573 ( 52.2%) | RR 1.30 (1.18 to 1.43) | 157 more per 1000 (from 94 more to 224 more) | ⨁⨁◯◯Low |
KPS score | RCT (15) | seriousa | not serious | not serious | not serious | seriousd | 278/534 ( 52.1%) | 120/505 ( 23.8%) | RR 2.18 (1.84 to 2.57) | 280 more per 1000 (from 200 more to 373 more) | ⨁⨁◯◯Low | |
Leukopenia | RCT (12) | seriousa | not serious | not serious | not serious | seriousd | 85/449 ( 18.9%) | 164/440 ( 37.3%) | RR 0.51 (0.41 to 0.63) | 183 fewer per 1000 (from 220 fewer to 138 fewer) | ⨁⨁◯◯Low | |
Gastrointestinal reaction | RCT (8) | seriousa | not serious | not serious | not serious | seriousd | 60/304 ( 19.7%) | 117/304 ( 38.5%) | RR 0.51 (0.40 to 0.66) | 189 fewer per 1000 (from 231 fewer to 131 fewer) | ⨁⨁◯◯Low | |
Hepatorenal dysfunction | RCT (7) | seriousa | not serious | not serious | not serious | seriousd | 24/298 ( 8.10%) | 64/298 ( 21.5%) | RR 0.38 (0.25 to 0.59) | 133 fewer per 1000 (from 161 fewer to 88 fewer) | ⨁⨁◯◯Low | |
Lv YH 2015 [30] | RR | RCT (8) | seriousa | not serious | not serious | not serious | seriouse | 193/303 ( 63.7%) | 140/293 ( 47.8%) | RR 1.33 (1.15 to 1.53) | 158 more per 1000 (from 72 more to 253 more) | ⨁⨁◯◯Low |
KPS score | RCT (8) | seriousa | not serious | not serious | not serious | seriousd | 236/285 ( 82.8%) | 145/260 ( 55.8%) | RR 1.44 (1.20 to 1.73) | 245 more per 1000 (from 112 more to 407 more) | ⨁⨁◯◯Low | |
CD3+ | RCT (5) | seriousa | seriousb | not serious | not serious | seriousd | 228 | 214 | SMD 1.33 higher (0.18 higher to 2.49 higher) | ⨁◯◯◯Very low | ||
CD4+ | RCT (6) | seriousa | seriousb | not serious | not serious | seriousd | 260 | 238 | SMD 1.72 higher (0.61 higher to 2.84 higher) | ⨁◯◯◯Very low | ||
CD8+ | RCT (6) | seriousa | seriousb | not serious | not serious | seriousd | 260 | 238 | SMD 0.19 higher (0.51 lower to 0.89 higher) | ⨁◯◯◯Very low | ||
CD4+/CD8+ | RCT (6) | seriousa | seriousb | not serious | not serious | seriousd | 260 | 238 | SMD 0.62 higher (0.25 higher to 0.98 higher) | ⨁◯◯◯Very low | ||
NK cell | RCT (4) | seriousa | seriousb | not serious | not serious | seriousd | 198 | 184 | SMD 1.09 higher (0.65 higher to 1.53 higher) | ⨁◯◯◯Very low | ||
Leukopenia | RCT (8) | seriousa | not serious | not serious | not serious | seriouse | 50/250 ( 20.0%) | 108/248 ( 43.5%) | RR 0.45 (0.34 to 0.60) | 240 fewer per 1000 (from 287 fewer to 174 fewer) | ⨁⨁◯◯Low | |
Thrombocytopenia | RCT (5) | seriousa | not serious | not serious | not serious | seriouse | 20/169 ( 11.8%) | 42/168 ( 25.0%) | RR 0.48 (0.30 to 0.76) | 130 fewer per 1000 (from 175 fewer to 60 fewer) | ⨁⨁◯◯Low | |
Gastrointestinal reaction | RCT (7) | seriousa | not serious | not serious | not serious | seriouse | 66/238 ( 27.7%) | 142/232 ( 61.2%) | RR 0.45 (0.36 to 0.56) | 337 fewer per 1000 (from 392 fewer to 269 fewer) | ⨁⨁◯◯Low | |
Electrocardiogram | RCT (5) | seriousa | not serious | not serious | not serious | seriouse | 16/171 ( 9.4%) | 40/160 ( 25.0%) | RR 0.36 (0.22 to 0.61) | 160 fewer per 1000 (from 195 fewer to 98 fewer) | ⨁⨁◯◯Low | |
Li Y 2016 [31] | RR | RCT (5) | seriousa | seriousb | not serious | not serious | seriousd | 175/265 ( 66.0%) | 138/261 ( 52.9%) | RR 1.29 (1.04 to 1.61) | 153 more per 1000 (from 21 more to 323 more) | ⨁◯◯◯Very low |
KPS score | RCT (8) | seriousa | not serious | not serious | not serious | seriousd | 253/321 ( 78.8%) | 143/289 ( 49.5%) | RR 1.51 (1.34 to 1.71) | 252 more per 1000 (from 168 more to 351 more) | ⨁⨁◯◯Low | |
Weight gain | RCT (2) | seriousa | seriousb | not serious | seriousc | seriousd | 93/113 ( 82.3%) | 32/105 ( 30.5%) | RR 2.70 (1.62 to 4.52) | 518 more per 1000 (from 189 more to 1000 more) | ⨁◯◯◯Very low | |
Reduction of fatigue | RCT (2) | seriousa | seriousb | not serious | seriousc | seriousd | 23/66 ( 34.8%) | 52/66 ( 78.8%) | RR 0.44 (0.24 to 0.79) | 441 fewer per 1000 (from 599 fewer to 165 fewer) | ⨁◯◯◯Very low | |
Zhang HB 2019 [7] | RR | RCT (24) | seriousa | not serious | not serious | not serious | seriouse | 739/1110 ( 66.6%) | 541/1096 ( 49.4%) | RR 1.35 (1.26 to 1.45) | 173 more per 1000 (from 128 more to 222 more) | ⨁⨁◯◯Low |
KPS score | RCT (19) | seriousa | seriousb | not serious | not serious | seriouse | 668/949 ( 70.4%) | 380/901 ( 42.2%) | RR 1.56 (1.35 to 1.81) | 236 more per 1000 (from 148 more to 342 more) | ⨁◯◯◯Very low | |
CD3+ | RCT (11) | seriousa | seriousb | not serious | not serious | seriousd | 484 | 474 | SMD 0.97 higher (0.24 higher to 1.71 higher) | ⨁◯◯◯Very low | ||
CD4+ | RCT (14) | seriousa | seriousb | not serious | not serious | seriousd | 587 | 569 | SMD 1.66 higher (0.95 higher to 2.38 higher) | ⨁◯◯◯Very low | ||
CD8+ | RCT (14) | seriousa | seriousb | not serious | not serious | seriousd | 587 | 569 | SMD 0.04 higher (0.59 lower to 0.67 higher) | ⨁◯◯◯Very low | ||
CD4+/CD8+ | RCT (14) | seriousa | seriousb | not serious | not serious | seriousd | 587 | 569 | SMD 0.8 higher (0.38 higher to 1.22 higher) | ⨁◯◯◯Very low | ||
NK cell | RCT (10) | seriousa | seriousb | not serious | not serious | seriousd | 485 | 458 | SMD 0.94 higher (0.63 higher to 1.24 higher) | ⨁◯◯◯Very low | ||