Upper digestive tract cancers, such as oral cavity, laryngeal, esophageal, and gastric cancers, account for 10% of cancer cases and 14.5% of cancer-related deaths worldwide. Conventional treatments often provide limited survival benefits and are frequently associated with adverse effects and drug resistance. Chinese herbal drugs (CHDs) are widely used in the Far East for managing these cancers. In this narrative review, we summarize current clinical studies (published up to June 2024) on the use of 138 CHDs in the treatment of cancers and precancerous lesions of the upper digestive tract. For cancer treatment, 126 CHDs were tested, all in combination with conventional therapies. Each CHD increased the clinical efficacy and/or reduced the adverse effects of conventional therapies. The five-year survival rate is a critical metric for evaluating the clinical benefits of cancer treatments. Four of the CHDs were reported to increase five-year survival rates of patients receiving conventional therapies. The four CHDs are Sishen Jiedu Decoction, Pingxiao Tablet, Fuzheng Guben Granule, and Buyang Huanwu Tang. For managing precancerous lesions, 12 CHDs were tested: six used alone and six in combination with conventional therapies. Zengshengping is one of the CHDs used alone and is the only one that has been proven to prevent the development of esophageal cancer with convincing evidence. This review provides information about the clinical benefits of CHDs and offers a reference for their rational application in treating upper digestive tract cancers. The reviewed studies have limitations: most trials had small sample sizes and were not multi-center; only one study investigated the mechanisms of action of the studied CHD; and the active components of CHDs were not explored. To promote international recognition of CHDs, rigorously designed studies on clinical outcomes, mechanisms of action, and active components are warranted. Moreover, the studied CHDs should be standardized.

中文翻译：

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中医治疗上消化道癌


上消化道癌症，如口腔癌、喉癌、食道癌和胃癌，占全球癌症病例的 10% 和癌症相关死亡的 14.5%。常规治疗的生存获益通常有限，并且经常与不良反应和耐药性有关。中草药 （CHD） 在远东地区广泛用于治疗这些癌症。在本叙述性综述中，我们总结了当前关于 138 种 CHD 用于治疗癌症和上消化道癌前病变的临床研究（截至 2024 年 6 月）。对于癌症治疗，测试了 126 例 CHD，全部与常规疗法联合使用。每种 CHD 都提高了常规疗法的临床疗效和/或减少了不良反应。五年生存率是评估癌症治疗临床益处的关键指标。据报道，其中 4 种 CHD 可提高接受常规治疗的患者的 5 年生存率。四种先心病是四神解毒汤、平小片、扶正孤本颗粒和不阳还武汤。为了治疗癌前病变，测试了 12 种 CHD：6 种单独使用，6 种与常规疗法联合使用。增生平是单独使用的冠心病之一，也是唯一一种已被证明可以预防食管癌发展且证据令人信服的冠心病。本文就 CHDs 的临床获益进行了综述，并为其在治疗上消化道癌中的合理应用提供了参考。综述研究存在局限性：大多数试验样本量小，不是多中心试验;只有一项研究调查了所研究的 CHD 的作用机制;并且没有探索 CHDs 的活性成分。 为了促进 CHD 的国际认可，有必要对临床结局、作用机制和活性成分进行严格设计的研究。此外，研究的 CHD 应标准化。