The use of phytotherapy in hepatocellular carcinoma – a systematic review

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignant tumours and the second most frequent cause of cancer-related death worldwide. The aim of this review is to identify whether phytotherapy has an effect over the treatment of HCC or if it is suitable as a combination with chemotherapy. A systematic review was performed in order to offer current information over the use of phytotherapy in HCC. We conducted an electronic search of articles published in English in peer reviewed journals between 2012-2022. After keywords were associated, 302 articles were found. After the exclusion of articles which did not meet the inclusion criteria, there were 77 articles eligible for abstract evaluation. The following were discarded: two case report, one systematic review, 36 in vitro studies and nine studies which discussed other pathologies or with no regard to phytotherapy. The remaining articles encompassed 27 in vivo studies of phytotherapy in hepatocellular carcinoma and two randomized control trials. This selection process is illustrated in the Prisma Flow Diagram. Amongst the evaluated articles, two of them researched the effect of phytotherapy over human subjects in two randomized control trials, while the others illustrated the outcomes of phytotherapy over hepatocellular carcinoma cells and murine specimens. To sum up, phytotherapy has proven its usefulness in hepatocellular carcinoma, especially throughout the following mechanisms: anti-inflammatory effect, suppressing malignant cell proliferation, inhibiting angiogenesis, stimulating apoptosis, and even sensitizing cells to chemotherapy.