Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-Analysis
Objectives: To assess the clinical evidence for integrative herbal medicine therapy in the management of chemotherapy-induced peripheral neuropathy (CIPN) and hand-foot syndrome (HFS) resulting from treatments for colorectal cancer (CRC). Design: Randomized controlled trials (RCTs) were identified f...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-02-01
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| Series: | Integrative Cancer Therapies |
| Online Access: | https://doi.org/10.1177/1534735418817833 |
| _version_ | 1829115633429643264 |
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| author | Yihong Liu MMed Brian H. May PhD Anthony Lin Zhang PhD Xinfeng Guo PhD Chuanjian Lu PhD Charlie Changli Xue PhD Haibo Zhang MD |
| author_facet | Yihong Liu MMed Brian H. May PhD Anthony Lin Zhang PhD Xinfeng Guo PhD Chuanjian Lu PhD Charlie Changli Xue PhD Haibo Zhang MD |
| author_sort | Yihong Liu MMed |
| collection | DOAJ |
| description | Objectives: To assess the clinical evidence for integrative herbal medicine therapy in the management of chemotherapy-induced peripheral neuropathy (CIPN) and hand-foot syndrome (HFS) resulting from treatments for colorectal cancer (CRC). Design: Randomized controlled trials (RCTs) were identified from major English and Chinese databases. Participants had been diagnosed with CRC by pathology and had received or were undergoing chemotherapy. Interventions included herbal medicines administered orally or topically. Controls were placebo, supportive care or conventional chemotherapy for CRC. Methods followed the Cochrane handbook. Meta-analyses were grouped by study design, outcome measure, severity, and chemotherapy. Random-effects models with 95% confidence intervals were used. Heterogeneity was assessed as I 2 . Results: Sixty-three RCTs (4286 participants) were included. Five used a placebo in the control groups. Fifty-eight studies tested oral herbal medicine, and 5 tested topical herbal medicine. Data were available for CIPN (60 studies) and HFS (12 studies). Fifty-seven studies combined orally administered herbal medicine with chemotherapy compared with the same chemotherapy. For CIPN, 33 studies used World Health Organization (WHO) criteria, 7 used Levi’s criteria, and 10 used the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE). These were analyzed separately. For grades III + IV CIPN, there was a significant reduction in the integrative groups for WHO (relative risk [RR] 0.42 [0.23, 0.77], I 2 = 0%) and Levi’s (RR 0.28 [0.11, 0.69], I 2 = 0%) but not NCI-CTCAE (RR 0.65 [0.37, 1.13], I 2 = 26.4%). Hand and foot baths showed no differences for Levi’s grades III + IV CIPN but a significant reduction in all grades (RR 0.69 [0.50, 0.95], I 2 = 68.8%). For HFS (all grades) there was a significant reduction in the integrative groups for WHO (RR 0.62 [0.41, 0.96], I 2 = 22%) but not for NCI-CTCAE (RR 0.93 [0.55, 1.55], I 2 = 75.7%). Sensitivity analyses explored sources of heterogeneity. Conclusions: Integrative herbal therapy appeared to reduce CIPN and HFS in people receiving chemotherapy for CRC. However, the strength of the evidence was limited by lack of blinding in most studies, potential for bias, and relatively short study durations. |
| first_indexed | 2024-12-12T16:20:29Z |
| format | Article |
| id | doaj.art-26b59955bd7446e798bb976eb8d64e65 |
| institution | Directory Open Access Journal |
| issn | 1552-695X |
| language | English |
| last_indexed | 2024-12-12T16:20:29Z |
| publishDate | 2019-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Integrative Cancer Therapies |
| spelling | doaj.art-26b59955bd7446e798bb976eb8d64e652022-12-22T00:19:00ZengSAGE PublishingIntegrative Cancer Therapies1552-695X2019-02-011810.1177/1534735418817833Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-AnalysisYihong Liu MMed0Brian H. May PhD1Anthony Lin Zhang PhD2Xinfeng Guo PhD3Chuanjian Lu PhD4Charlie Changli Xue PhD5Haibo Zhang MD6Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaChina-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, AustraliaChina-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, AustraliaGuangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaChina-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, AustraliaGuangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, ChinaObjectives: To assess the clinical evidence for integrative herbal medicine therapy in the management of chemotherapy-induced peripheral neuropathy (CIPN) and hand-foot syndrome (HFS) resulting from treatments for colorectal cancer (CRC). Design: Randomized controlled trials (RCTs) were identified from major English and Chinese databases. Participants had been diagnosed with CRC by pathology and had received or were undergoing chemotherapy. Interventions included herbal medicines administered orally or topically. Controls were placebo, supportive care or conventional chemotherapy for CRC. Methods followed the Cochrane handbook. Meta-analyses were grouped by study design, outcome measure, severity, and chemotherapy. Random-effects models with 95% confidence intervals were used. Heterogeneity was assessed as I 2 . Results: Sixty-three RCTs (4286 participants) were included. Five used a placebo in the control groups. Fifty-eight studies tested oral herbal medicine, and 5 tested topical herbal medicine. Data were available for CIPN (60 studies) and HFS (12 studies). Fifty-seven studies combined orally administered herbal medicine with chemotherapy compared with the same chemotherapy. For CIPN, 33 studies used World Health Organization (WHO) criteria, 7 used Levi’s criteria, and 10 used the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE). These were analyzed separately. For grades III + IV CIPN, there was a significant reduction in the integrative groups for WHO (relative risk [RR] 0.42 [0.23, 0.77], I 2 = 0%) and Levi’s (RR 0.28 [0.11, 0.69], I 2 = 0%) but not NCI-CTCAE (RR 0.65 [0.37, 1.13], I 2 = 26.4%). Hand and foot baths showed no differences for Levi’s grades III + IV CIPN but a significant reduction in all grades (RR 0.69 [0.50, 0.95], I 2 = 68.8%). For HFS (all grades) there was a significant reduction in the integrative groups for WHO (RR 0.62 [0.41, 0.96], I 2 = 22%) but not for NCI-CTCAE (RR 0.93 [0.55, 1.55], I 2 = 75.7%). Sensitivity analyses explored sources of heterogeneity. Conclusions: Integrative herbal therapy appeared to reduce CIPN and HFS in people receiving chemotherapy for CRC. However, the strength of the evidence was limited by lack of blinding in most studies, potential for bias, and relatively short study durations.https://doi.org/10.1177/1534735418817833 |
| spellingShingle | Yihong Liu MMed Brian H. May PhD Anthony Lin Zhang PhD Xinfeng Guo PhD Chuanjian Lu PhD Charlie Changli Xue PhD Haibo Zhang MD Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-Analysis Integrative Cancer Therapies |
| title | Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-Analysis |
| title_full | Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-Analysis |
| title_fullStr | Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-Analysis |
| title_short | Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-Analysis |
| title_sort | integrative herbal medicine for chemotherapy induced peripheral neuropathy and hand foot syndrome in colorectal cancer a systematic review and meta analysis |
| url | https://doi.org/10.1177/1534735418817833 |
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