Chinese Herbal Medicine for Cancer-Related Fatigue: A Systematic Review of Randomized Clinical Trials.

PURPOSE: To assess the effectiveness and safety of Chinese herbal medicine for the treatment of cancer-related fatigue. METHODS: We systematically searched seven electronic databases and two trial registries from their inception to February 2013 for randomized clinical trials of Chinese herbal medicine for the treatment of cancer-related fatigue. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool. Data were synthesized using RevMan 5.2 software. RESULTS: Fourteen trials involving 1076 participants with cancer-related fatigue were identified and the methodological quality of the included trials was generally poor. Eleven different herbal medicines were tested in the 14 trials. Spore powder of ganoderma lucidum, American ginseng, Kangai injection and Jianpi Yiqi decoction showed significant relief in fatigue severity compared to placebo or chemotherapy. Kangai injection, Aidi injection, Fufang Eijiao jiang and Buzhong Yiqi pill were significantly superior to chemotherapy or supportive therapy in increasing proportion of participants with fatigue relief based on single trials and meta-analysis of two trials (risk ratio 1.67, 95% confidence interval 1.17 to 2.40). American ginseng, Kangai injection, Renshen Yangrong decoction, Buzhong Yiqi decoction, Fufang Eijiao jiang exerted a greater beneficial effect on improving quality of life over placebo, chemotherapy or supportive therapy. Ten trials reported adverse events and no severe adverse effects were found in Chinese herbal medicine groups. CONCLUSION: Current evidence suggests that Chinese herbal medicine may be effective and safe in the treatment of cancer-related fatigue. However, owing to poor methodological quality of these trials, potential promising findings must be interpreted with caution. It's recommended to employ further rigorous randomized clinical trials that overcome the limitations of current trials to increase the strength of evidence.