Abstract
Chinese herbal medicines (CHM) are often used in managing cancer related symptoms but their effectiveness and safety is controversial. We conducted this overview of meta-analyses to summarize evidence on CHM for cancer palliative care. We included systematic reviews (SRs) with meta-analyses of CHM clinical trials on patients diagnosed with any type of cancer. Methodological quality of included meta-analyses was assessed with the Methodological Quality of Systematic Reviews (AMSTAR) Instrument. Fifty-one SRs with meta-analyses were included. They covered patients with lung (20 SRs), gastric (8 SRs), colorectal (6 SRs), liver (6 SRs), breast (2 SRs), cervical (1 SR), esophageal (1 SR), and nasopharyngeal (1 SR) cancers. Six SRs summarized evidence on various types of cancer. Methodological quality of included meta-analyses was not satisfactory. Overall, favorable therapeutic effects in improving quality of life among cancer patients have been reported. Conflicting evidence exists for the effectiveness of CHM in prolonging survival and in reducing chemotherapy and/or radiotherapy related toxicities. No serious adverse effects were reported in all included studies. Evidence indicated that CHM could be considered as an option for improving quality of life among patients receiving palliative care. It is unclear if CHM may increase survival, or reduce therapy related toxicities.
Highlights
In view of limitations in conventional palliative care, the potential role of traditional Chinese medicine can be explored
One systematic reviews (SRs) showed significant add-on benefits of Chinese herbal medicine (CHM) in reducing grade II–IV chemotherapy induced leucopenia (CIL)
We described results from SRs that did not set any restrictions on cancer diagnoses nor types of CHM interventions, which may increase the external validity of this overview as this indicates the real world practice of traditional Chinese medicine
Summary
In view of limitations in conventional palliative care, the potential role of traditional Chinese medicine can be explored. It has long been used as a supportive intervention for cancer patients in China and other Asian countries[9]. One of the SRs published in English has synthesized evidence on the effectiveness of CHM on cancer symptom management. The results indicated mixed results for improving nutritional status, pain and quality of life but it is likely to be outdated[12]. There are some reports on CHM’s effectiveness in reducing side effect of chemotherapy and in improving survival[13]. We aim to provide a broad overview on available evidence, which will inform clinicians, cancer patients and policy makers, and to identify methodological limitations of existing SRs so as to guide future research in this area
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