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Introduction
Liver cancer is the fourth leading cause of cancer-related death worldwide. The main risk factors for its development are liver cirrhosis, chronic hepatitis B or C virus infection, and alcoholic and non-alcoholic fatty liver diseases (1-3). According to the latest global cancer burden statistics released by the International Agency for Research on Cancer of the World Health Organization, China reported the highest incidence of liver cancer cases in 2020, with ~4,568,754 new cases that year. Moreover, liver cancer is the second leading cause of all cancer deaths in China, posing a serious threat to overall health and quality of life (4). Exhaustive research on liver cancer has yielded a considerable improvement in the monitoring methods and treatment strategies available for this disease (1). However, most patients with liver cancer are diagnosed in the middle and advanced stages of the disease, and therefore cannot undergo surgical resection. Additionally, most available drugs for liver cancer are non-specific, which causes liver cancer cells to easily develop resistance to single-target drugs (2). Consequently, the mortality rate of liver cancer remains high, with a 5-year survival rate of <5% (3). Therefore, there is an urgent need to develop new and effective drugs to improve the overall survival of patients with liver cancer and their quality of life.
Traditional Chinese medicine is widely used for cancer treatment in China, as the numerous natural compounds employed target various cellular processes and cause relatively few adverse reactions (5,6). Additionally, certain compounds have demonstrated high efficiency and reduced toxicity as curative agents for liver cancer (7). Curcuma zedoaria (referred to as Ezhu in traditional Chinese medicine) is a herb commonly used for alleviating blood stasis and stagnation (8) or for treating heart and abdominal pain, swelling or food stagnation (9,10); it is also widely prescribed in traditional Chinese medicine for anti-tumor therapy and displays anti-carcinogenic properties believed to promote the flow of Qi, a concept in traditional Chinese medicine that represents the vital life force dredging the meridians, reducing lumps and relieving pain (11,12). Several studies have confirmed that Curcuma zedoaria yields a beneficial effect in the treatment of various tumors; it also exerts a substantial inhibitory effect on the proliferation of cervical and breast cancer, and other tumors (13-15). The chemical...