Efficacy of Herbal Medicine Therapy Combined With Palliative Chemotherapy in Unresectable Advanced NSCLC: A Systematic Review and Meta-Analysis

Background: Lung cancer, a leading cause of mortality, is often complicated by severe treatment-related side effects. Traditional herbal medicine (THM), particularly Fuzheng-Based Qi and Yin Therapy (FBQYT), has emerged as a promising adjuvant therapy to mitigate these effects and enhance immune response. This meta-analysis evaluates the efficacy and safety of THM as an adjunct to palliative chemotherapy. Methods: A systematic search was conducted in PubMed, EMBASE, ScienceON, RISS, KMBASE, OASIS, Cochrane Library, KISS, CNKI, and CiNii up to April 2025. Outcomes included tumor response, quality of life (QoL), adverse drug reactions (ADRs), and tumor markers. Eighty randomized controlled trials (RCTs) involving stage III/IV lung cancer patients were analyzed using Review Manager Software 5.4.1. Results: Combining chemotherapy with THM significantly improved the objective response rate (ORR, RR 1.41) and disease control rate (DCR, RR 1.20). It also enhanced quality of life, increasing Karnofsky Performance Status (KPS) score (MD 8.53) and KPS improvement (RR 1.51), alongside improvements in Quality of Life Questionnaire-Core 30 (QLQ-C30) total score (MD 13.05). Tumor markers and most ADRs were reduced, except for neutropenia, liver injury, and diarrhea (P > .05). Survival rates, progression-free survival (PFS), and median survival time (MST) were higher in the THM group. Conclusion: Integrating THM with palliative chemotherapy enhances tumor response, QoL, and survival rates while reducing adverse effects. Further rigorous RCTs are needed to confirm these findings and address methodological limitations. Registration: PROSPERO CRD 42024523418. © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).