Effectiveness of Chinese herbal medicine for cancer palliative care: overview of systematic reviews with meta-analyses

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.

Development of Evidence-Based Chinese Medicine Clinical Service Recommendations for Cancer Palliative Care Using Delphi Approach Based on the Evidence to Decision Framework

“…They were selected as they had critically appraised and summarized the most up-to-date clinical evidence on CHM, as well as acupuncture and related therapies, for cancer palliative care at the time of our study. In these rigorous syntheses, 2 - 6 methodological quality of 74 included SRs was evaluated using the AMSTAR instrument, 28 while risk of bias of 88 included randomized controlled trials (RCTs) were assessed with the Cochrane risk of bias tool. 29 Strengths and limitations on the synthesized evidence were also highlighted by the original authors.…”

“…29 Strengths and limitations on the synthesized evidence were also highlighted by the original authors. [2][3][4][5][6] By identifying statistically significant favorable results from these synthesis, [2][3][4][5][6] our study focused on a total of 7 CM interventions. Results of these interventions were displayed in 7 evidence profiles, which presented in a consistent format: number of studies; number of participants; effects of binary and continuous outcomes including their corresponding 95% confidence intervals (CIs) and P values; and quality of evidence.…”

What has traditional Chinese medicine delivered for modern medicine?

“…Beyond ATO, the general study of TCM-derived natural products and compound formulations for cancer therapy is an area of immense interest both within and outside China. Apart from the ongoing discovery and characterisation of active antineoplastics, the use of TCM as an effective adjuvant therapy in combination with conventional treatments as well as the role of TCM in pain management and palliative care should also not be overlooked (Refs 102, 103, 104, 105, 106, 107). For instance, the four-herb formulation PHY906 currently undergoing multiple clinical trials has been identified as an effective modulator of chemotherapy toxicity for multiple chemotherapy treatments (Refs 108, 109, 110).…”

Identification of Herb Pairs in Esophageal Cancer

“…Chinese herbal medicine (CHM) has been used for centuries for the treatment of various ailments in China and is believed to be beneficial to patients [7]. Many studies have examined the individual components responsible for the anticancer activities of various herbs, and these components have been shown to dramatically affect the survival of cancer cells and/or to enhance the patient's immunity when used as the sole cancer therapy [8].…”