Efficacy and safety of traditional Chinese medicine in managing bone loss post-endocrine therapy in hormone receptor-positive breast cancer patients.

Abstract

This study aims to evaluate the efficacy and safety of traditional Chinese medicine (TCM) kidney-tonifying methods in treating bone loss and osteoporosis following endocrine therapy in patients with hormone receptor-positive breast cancer. This research systematically searched 6 major medical electronic databases, initially identifying 986 articles, ultimately including 22 randomized controlled trials. These studies encompassed a total of 1579 patients and investigated the impact of TCM kidney-tonifying methods on lumbar spine bone density, lumbar spine bone density T-values, femoral neck bone density, clinical efficacy, and drug safety. The Cochrane quality scoring system was utilized to assess the quality of the literature, and data were synthesized using meta-analysis techniques. TCM kidney-tonifying methods significantly improved lumbar spine bone density (standardized mean difference [SMD] = 0.70, 95% confidence interval [CI]: 0.43-0.97) and lumbar spine bone density T-values (SMD = 1.012, 95% CI: 0.506-1.517). There was also a positive trend in enhancing femoral neck bone density (SMD = 0.645, 95% CI: 0.321-0.970). Although improvements in clinical efficacy did not reach statistical significance (relative risk [RR] = 1.122, 95% CI: 0.933-1.348), the studies indicated good safety of the treatment, with most studies reporting no significant adverse reactions. TCM kidney-tonifying methods may have a positive therapeutic effect on bone loss and osteoporosis following endocrine therapy in patients with hormone receptor-positive breast cancer, demonstrating good tolerability and safety. Given the current evidence, it is recommended to include TCM kidney-tonifying methods as a complementary therapeutic approach in treatment protocols. Future research should further validate these findings and explore their application in different patient subgroups.