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Dan X, He YL, Tian YL, Huang Y, Ren JH. Summary of evidence on comprehensive healthcare for chemotherapy-induced peripheral neuropathy in cancer patients. Support Care Cancer 2024; 32:264. [PMID: 38564034 DOI: 10.1007/s00520-024-08466-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This paper aims to provide an evidence-based summary of the most effective strategies for comprehensive healthcare of chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients. METHOD Following the "6S" model, relevant evidence on CIPN management was collected from reputable evidence-based resource websites and databases nationally and internationally. The included articles were evaluated for methodological quality, and evidence was extracted using the Australian JBI Evidence-based Health Care Center's literature evaluation standard (2016 edition). RESULTS A total of 60 articles were included in this study, comprising 2 guidelines, 5 expert consensus statements, and 53 systematic reviews. The findings of these articles were summarized across 7 dimensions, including risk factor screening, assessment, diagnosis, prevention, treatment, management, and health education, resulting in the identification of 42 relevant pieces of evidence. CONCLUSIONS This study provides a comprehensive synthesis of evidence-based recommendations for managing CIPN in cancer patients, offering guidance for healthcare professionals engaged in clinical practice. However, when implementing these recommendations, it is crucial to consider the individual patient's clinical circumstances, preferences, and expert judgment, ensuring feasibility and applicability in real-world clinical settings.
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Affiliation(s)
- Xin Dan
- Department of Radiation Therapy and Chemotherapy for Cancer Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Ya-Lin He
- Department of Radiation Therapy and Chemotherapy for Cancer Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Ya-Lin Tian
- Department of Radiation Therapy and Chemotherapy for Cancer Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Yan Huang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China.
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Jian-Hua Ren
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China.
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
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Gu J, Zhang H, Hu M, Liu L, Chen C, Wang J, Zhu F, Wei G, Huo J. Complementary and alternative medicine in relation to chemotherapy-induced peripheral neuropathy: A narrative review. Explore (NY) 2024; 20:181-187. [PMID: 37652788 DOI: 10.1016/j.explore.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/29/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE To summarizes the available evidence on the effectiveness, safety, and feasibility of complementary and alternative medicine (CAM) in the management of chemotherapy-induced peripheral neuropathy (CIPN). METHODS We searched for systematic reviews, and meta-analyzes published up to April 2023 in the Pubmed and Web of Science databases. The latest original research on related topics was also reviewed. The search was restricted to English-language papers. Two independent reviewers performed a quality assessment of the identified literature. RESULTS The results of 35 systematic reviews and meta-analyzes were included in this study. Preliminary evidence suggests that CAM, including acupuncture, physical activity (PA), herbal and nutritional supplements, mind-body therapies, touch therapy, and non-invasive neuromodulation techniques, have shown tremendous potential for the prevention and treatment of CIPN. Of these, there is strong evidence supporting acupuncture, PA, and herbal medicine. However, existing clinical studies are also limited by the heterogeneity of study methods, insufficient sample size, and poor study design. Further studies are needed to validate the efficacy of CAM in patients with CIPN and to elucidate potential therapeutic mechanisms. CONCLUSIONS Current research has reached a preliminary conclusion suggesting the potential efficacy of certain CAMs in the management of CIPN. Future clinical trials should incorporate more robust study design protocols and larger sample sizes to enhance the validity of findings.
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Affiliation(s)
- Jialin Gu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hongqun Zhang
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Miao Hu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Ling Liu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chen Chen
- Department of Oncology, Yancheng Hospital Affiliated to Nanjing University of Chinese Medicine, Yancheng, Jiangsu, China
| | - Jianmei Wang
- Department of Oncology, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Fabing Zhu
- Department of General Surgery, Yancheng Second People's Hospital, Yancheng, Jiangsu, China
| | - Guoli Wei
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Department of Oncology, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu, China; Department of Oncology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
| | - Jiege Huo
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Department of Oncology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
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Klafke N, Bossert J, Kröger B, Neuberger P, Heyder U, Layer M, Winkler M, Idler C, Kaschdailewitsch E, Heine R, John H, Zielke T, Schmeling B, Joy S, Mertens I, Babadag-Savas B, Kohler S, Mahler C, Witt CM, Steinmann D, Voiss P, Stolz R. Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process. Med Sci (Basel) 2023; 11:medsci11010015. [PMID: 36810482 PMCID: PMC9944490 DOI: 10.3390/medsci11010015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/14/2022] [Accepted: 12/23/2022] [Indexed: 01/31/2023] Open
Abstract
Background: Most individuals affected by cancer who are treated with certain chemotherapies suffer of CIPN. Therefore, there is a high patient and provider interest in complementary non-pharmacological therapies, but its evidence base has not yet been clearly pointed out in the context of CIPN. Methods: The results of a scoping review overviewing the published clinical evidence on the application of complementary therapies for improving the complex CIPN symptomatology are synthesized with the recommendations of an expert consensus process aiming to draw attention to supportive strategies for CIPN. The scoping review, registered at PROSPERO 2020 (CRD 42020165851), followed the PRISMA-ScR and JBI guidelines. Relevant studies published in Pubmed/MEDLINE, PsycINFO, PEDro, Cochrane CENTRAL, and CINAHL between 2000 and 2021 were included. CASP was used to evaluate the methodologic quality of the studies. Results: Seventy-five studies with mixed study quality met the inclusion criteria. Manipulative therapies (including massage, reflexology, therapeutic touch), rhythmical embrocations, movement and mind-body therapies, acupuncture/acupressure, and TENS/Scrambler therapy were the most frequently analyzed in research and may be effective treatment options for CIPN. The expert panel approved 17 supportive interventions, most of them were phytotherapeutic interventions including external applications and cryotherapy, hydrotherapy, and tactile stimulation. More than two-thirds of the consented interventions were rated with moderate to high perceived clinical effectiveness in therapeutic use. Conclusions: The evidence of both the review and the expert panel supports a variety of complementary procedures regarding the supportive treatment of CIPN; however, the application on patients should be individually weighed in each case. Based on this meta-synthesis, interprofessional healthcare teams may open up a dialogue with patients interested in non-pharmacological treatment options to tailor complementary counselling and treatments to their needs.
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Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
- Correspondence:
| | - Jasmin Bossert
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Birgit Kröger
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Petra Neuberger
- National Center for Tumor Diseases, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Ute Heyder
- Women’s Clinic, Community Hospital Karlsruhe, 76133 Karlsruhe, Germany
| | - Monika Layer
- Center for Integrative Medicine, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland
| | - Marcela Winkler
- Department of Naturopathy and Integrative Medicine, Robert-Bosch-Krankenhaus, 70376 Stuttgart, Germany
| | - Christel Idler
- Department of Naturopathy and Integrative Medicine, Robert-Bosch-Krankenhaus, 70376 Stuttgart, Germany
| | - Elke Kaschdailewitsch
- Center for Integrative Oncology, Die Filderklinik, 70794 Filderstadt-Bonlanden, Germany
| | - Rolf Heine
- Anthroposophic Nursing Network in Germany, Academy for Nursing Professions at the Filderklinik, Die Filderklinik, 70794 Filderstadt-Bonlanden, Germany
| | - Heike John
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Tatjana Zielke
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Beeke Schmeling
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Sosamma Joy
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45136 Essen, Germany
| | - Isabel Mertens
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45136 Essen, Germany
| | - Burcu Babadag-Savas
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Sara Kohler
- Department of Health, Zurich University of Applied Sciences, 8401 Winterthur, Switzerland
| | - Cornelia Mahler
- Department of Nursing Science, Institute of Health Sciences, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Claudia M. Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zürich and University of Zürich, 8091 Zürich, Switzerland
| | - Diana Steinmann
- Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Petra Voiss
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45136 Essen, Germany
| | - Regina Stolz
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany
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Chung G, Kim SK. Therapeutics for Chemotherapy-Induced Peripheral Neuropathy: Approaches with Natural Compounds from Traditional Eastern Medicine. Pharmaceutics 2022; 14:pharmaceutics14071407. [PMID: 35890302 PMCID: PMC9319448 DOI: 10.3390/pharmaceutics14071407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) often develops in patients with cancer treated with commonly used anti-cancer drugs. The symptoms of CIPN can occur acutely during chemotherapy or emerge after cessation, and often accompany long-lasting intractable pain. This adverse side effect not only affects the quality of life but also limits the use of chemotherapy, leading to a reduction in the survival rate of patients with cancer. Currently, effective treatments for CIPN are limited, and various interventions are being applied by clinicians and patients because of the unmet clinical need. Potential approaches to ameliorate CIPN include traditional Eastern medicine-based methods. Medicinal substances from traditional Eastern medicine have well-established analgesic effects and are generally safe. Furthermore, many substances can also improve other comorbid symptoms in patients. This article aims to provide information regarding traditional Eastern medicine-based plant extracts and natural compounds for CIPN. In this regard, we briefly summarized the development, mechanisms, and changes in the nervous system related to CIPN, and reviewed the substances of traditional Eastern medicine that have been exploited to treat CIPN in preclinical and clinical settings.
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Affiliation(s)
- Geehoon Chung
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea;
| | - Sun Kwang Kim
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea;
- Department of Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea
- Correspondence:
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Bibi R, Maneewat K, Sangchan H, Sae-sia W. Persistent post-surgical pain and its relationship to health-related quality of life in Pakistani women after breast cancer surgery. BELITUNG NURSING JOURNAL 2022; 8:258-265. [PMID: 37547108 PMCID: PMC10401365 DOI: 10.33546/bnj.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/10/2022] [Accepted: 05/18/2022] [Indexed: 08/08/2023] Open
Abstract
Background Breast cancer is the most commonly diagnosed cancer in women; it is also the second-leading cause of death from cancer. Persistent pain after breast cancer surgery is a serious clinical problem that negatively impacts the health-related quality of life of breast cancer survivors. Although persistent post-surgical pain following breast cancer surgery has long been under-reported; however, it is less explored in Pakistan's geographical background. Objective The study aimed to examine the persistent post-surgical pain after breast cancer surgery and its relationship to health-related quality of life among Pakistani women. Methods A descriptive correlational research design was employed in this study. The Brief Pain Inventory Short Form (BPI-SF) was used to assess the persistent post-surgical pain. The Functional Assessment of Cancer Therapy-Breast (FACT-B) was used to measure the health-related quality of life. Data were collected between February and May 2019 from Pakistani women who have undergone breast cancer surgery for at least three months and attended follow-up visits at two tertiary care hospitals in Pakistan. A Spearman's correlation coefficient was used for data analysis. Results The study included 91 Pakistani women. The participants were all females, with an average age of 45.6 years (SD = 6.53). The majority received radical mastectomy (n = 84, 92.3%) with adjuvant therapy (n = 91, 100%). The prevalence of breast surgery-related persistent pain was 100%, with 63 (69.2%) rating the pain as moderate to severe and reported neuropathic pain. The data analysis revealed a statistically significant negative correlation between BPI-SF items and FACT-B dimensions (r = -.43, p < 0.01). The participants appeared to show the highest score of the FACT-B in the social/family well-being (M = 16.58, SD = 3.44). The lowest score of the FACT-B was physical well-being (M = 6.98, SD = 6.38). Conclusion Persistent post-surgical pain has a negative impact on the health-related quality of life of Pakistani women breast cancer survivors, particularly on their physical well-being. Therefore, follow-up care of breast cancer survivors after treatment completion requires proper persistent pain-relief treatments and interventions to control pain and maintain health-related quality of life in oncology and research in this sphere. This basic knowledge from this study will enlighten the nurses and health care professionals to pay more attention to pain management and regular evaluation of persistent post-surgical pain after breast cancer surgery in order to improve their health-related quality of life.
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Affiliation(s)
- Rukhsana Bibi
- Master of Nursing Science in Adult and Gerontological Nursing, Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
| | - Khomapak Maneewat
- Surgical Nursing Department, Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
| | - Hathairat Sangchan
- Surgical Nursing Department, Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
| | - Wipa Sae-sia
- Surgical Nursing Department, Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
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6
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Oral Administration of East Asian Herbal Medicine for Peripheral Neuropathy: A Systematic Review and Meta-Analysis with Association Rule Analysis to Identify Core Herb Combinations. Pharmaceuticals (Basel) 2021; 14:ph14111202. [PMID: 34832984 PMCID: PMC8622183 DOI: 10.3390/ph14111202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/11/2021] [Accepted: 11/18/2021] [Indexed: 01/04/2023] Open
Abstract
This review aimed to comprehensively assess the efficacy and safety of oral East Asian herbal medicine (EAHM) for overall peripheral neuropathy (PN). In addition, an Apriori algorithm-based association rule analysis was performed to identify the core herb combination, thereby further generating useful hypotheses for subsequent drug discovery. A total of 10 databases were searched electronically from inception to July 2021. Randomized clinical trials (RCTs) comparing EAHM with conventional analgesic medication or usual care for managing PN were included. The RCT quality was appraised using RoB 2.0, and the random effects model was used to calculate the effect sizes of the included RCTs. The overall quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation. By analyzing the constituent herb data, the potential association rules of core herb combinations were explored. A total of 67 RCTs involving 5753 patients were included in this systematic review. In a meta-analysis, EAHM monotherapy and combined EAHM and western medicine therapy demonstrated substantially improved sensory nerve conduction velocity, motor nerve conduction velocity, and response rate. Moreover, EAHM significantly improved the incidence rate, pain intensity, Toronto clinical scoring system, and Michigan diabetic neuropathy score. The evidence grade was moderate to low due to the substantial heterogeneity among the studies. Nine association rules were identified by performing the association rule analysis on the extraction data of 156 EAHM herbs. Therefore, the constituents of the herb combinations with consistent association rules were Astragali Radix, Cinnamomi Ramulus, and Spatholobi Calulis. This meta-analysis supports the hypothesis that EAHM monotherapy and combined therapy may be beneficial for PN patients, and follow-up research should be conducted to confirm the precise action target of the core herb.
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Abstract
Integrative medicine is an approach to medical care that embraces all effective therapies including complementary treatments such as acupuncture and hypnosis. There is growing use of complementary therapies in the cancer patient population, making it important that health care providers be aware of both the risks and benefits of treatments that lie outside of the traditional allopathic medicine paradigm. This chapter will explore some of the most common and well-investigated complementary therapies for the treatment and prevention of cancer-related pain. This will include discussions of: acupuncture, dietary supplements, massage, guided imagery and cryotherapy among others. The goal of this is to provide a framework for discussions between medical providers and their patients to ensure safety, discussion of all available treatments, and to facilitate open lines of communication.
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Affiliation(s)
- Anna Woodbury
- Anesthesiology, Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Decatur, GA, 30033, USA.
| | - Bati Myles
- Emergency Medicine Physician, Palliative Care Fellow, Emory University School of Medicine, Atlanta, GA, USA
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Lu CL, Li X, Zhou HM, Zhang C, Yang YY, Feng RL, Long CJ, Deng FY, Li JC, Cao ZM, Mao QY, Zhu JP, Hong YF, Huang SY, Qiu JY, Liu YX, Wang Y, Yan YQ, Dong JM, Luo YX, Chen YM, Guan YJ, Wieland LS, Robinson N, Liu JP. Traditional Chinese Medicine in Cancer Care: An Overview of 5834 Randomized Controlled Trials Published in Chinese. Integr Cancer Ther 2021; 20:15347354211031650. [PMID: 34261372 PMCID: PMC8287414 DOI: 10.1177/15347354211031650] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 06/11/2021] [Accepted: 06/23/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Traditional Chinese medicine (TCM) is widely integrated into cancer care in China. An overview in 2011 identified 2384 randomized and non-randomized controlled trials (RCTs, non-RCTs) on TCM for cancer published in the Chinese literature. This article summarizes updated evidence of RCTs on TCM for cancer care. METHODS We searched 4 main Chinese databases: China National Knowledge Infrastructure, Chinese Scientific Journal Database, SinoMed, and Wanfang. RCTs on TCM used in cancer care were analyzed in this bibliometric study. RESULTS Of 5834 RCTs (477 157 cancer patients), only 62 RCTs were indexed in MEDLINE. The top 3 cancers treated were lung, stomach, and breast cancer. About 4752 RCTs (81.45%) tested TCM combined with conventional treatment, and 1082 RCTs (18.55%) used TCM alone for treating symptoms and side-effects. Herbal medicine was the most frequently used TCM modality (5087 RCTs; 87.20%). The most frequently reported outcome was symptom improvement (3712 RCTs; 63.63%) followed by quality of life (2725 RCTs; 46.71%), and biomarkers (2384 RCTs; 40.86%). The majority of RCTs (4051; 69.44%) concluded there were beneficial effects using either TCM alone or TCM plus conventional treatment compared with conventional treatment. CONCLUSION Substantial randomized trials demonstrated different types/stages of cancer were treated by various TCM modalities, alone or in combination with conventional medicine. Further evaluation on the effects and safety of TCM modalities focusing on outcomes such as quality of life is required.
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Affiliation(s)
- Chun-Li Lu
- Beijing University of Chinese Medicine,
Beijing, China
| | - Xun Li
- Beijing University of Chinese Medicine,
Beijing, China
| | - Hong-Mei Zhou
- Dongfang Hospital of Beijing University
of Chinese Medicine, Beijing, China
| | - Chi Zhang
- Beijing University of Chinese Medicine,
Beijing, China
| | | | - Ru-Li Feng
- Dongzhimen Hospital of Beijing
University of Chinese Medicine, Beijing, China
| | - Chao-Jun Long
- Beijing University of Chinese Medicine,
Beijing, China
| | | | - Jing-Chun Li
- Dongfang Hospital of Beijing University
of Chinese Medicine, Beijing, China
| | - Ze-Ming Cao
- Beijing University of Chinese Medicine,
Beijing, China
| | - Qi-Yuan Mao
- Guang’anmen Hospital of China Academy
of Chinese Medical Sciences, Beijing, China
| | - Jin-Pu Zhu
- Beijing University of Chinese Medicine,
Beijing, China
| | - Yan-Fei Hong
- Beijing University of Chinese Medicine,
Beijing, China
| | - Shou-Yu Huang
- Wangjing Hospital of China Academy of
Chinese Medical Sciences, Beijing, China
| | - Jia-Ying Qiu
- Xiyuan Hospital of China Academy of
Chinese Medical Sciences, Beijing, China
| | - Yi-Xiu Liu
- Dongzhimen Hospital of Beijing
University of Chinese Medicine, Beijing, China
| | - Ying Wang
- China Press of Traditional Chinese
Medicine, Beijing, China
| | - Yu-Qian Yan
- University Hospital Zürich, Zurich,
Switzerland
| | - Jia-Min Dong
- Beijing University of Chinese Medicine,
Beijing, China
| | - Yu-Xin Luo
- Beijing University of Chinese Medicine,
Beijing, China
| | - Yun-Meng Chen
- Dongzhimen Hospital of Beijing
University of Chinese Medicine, Beijing, China
| | - Ying-Jie Guan
- Beijing University of Chinese Medicine,
Beijing, China
| | | | - Nicola Robinson
- Institute of Health and Social Care,
London South Bank University, London, UK
| | - Jian-Ping Liu
- Beijing University of Chinese Medicine,
Beijing, China
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How to transfer traditional knowledge about medicinal herbs? or TCM plants: a black box for modern oncologists. J Cancer Res Clin Oncol 2020; 147:351-359. [PMID: 33037900 DOI: 10.1007/s00432-020-03415-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/28/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE How could we transfer knowledge about healing plants from other cultures? We analyzed the results of literature search in two exemplary fields-oral mucositis and polyneuropathy. MATERIALS AND METHODS In both systematic searches of existing literature, we found 57 studies investigating 68 plants from different traditional cultures (16 Western Medicine, 14 Persian Medicine, 9 Japanese, 10 Chinese, and 8 other sources). We analyzed studies regarding their ingredient plants and reproducibility in relation to the system of origin. RESULTS Western and Persian Medicine trials investigate single plants, whereas Japanese and Chinese trials focus on mixtures and decoctions. European folk medicine knows of only 50% of plants used in both Asian cultures. The used ingredients and dosages were reproducible in all analyzed trials except TCM studies. CONCLUSIONS Herbal knowledge has been transferred from all folk medicines worldwide. However, Western oncologists should be aware that Traditional Chinese Medicine herbs are still a black box of knowledge for us until today.
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Hao J, Zhu X, Bensoussan A. Effects of Nonpharmacological Interventions in Chemotherapy-Induced Peripheral Neuropathy: An Overview of Systematic Reviews and Meta-Analyses. Integr Cancer Ther 2020; 19:1534735420945027. [PMID: 32875921 PMCID: PMC7476348 DOI: 10.1177/1534735420945027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Chemotherapy-induced peripheral neuropathy (CIPN) is one of the prevalent and disabling side effects of cancer treatment. However, management strategies for CIPN currently remain elusive, with treatment restricted to neuropathic pain medications, supportive care, and chemotherapy dosing adjustments. This overview explores evidence on the potential benefits and safety of nonpharmacological interventions in preventing and treating CIPN in cancer patients. METHODS Seven databases were searched for systematic reviews of randomized controlled trials (RCTs). The methodological quality of the selected reviews was assessed by AMSTAR 2, and the quality of evidence was judged by GRADE. Twenty-eight systematic reviews were considered eligible for this review. RESULTS It was found that nonpharmacological interventions (acupuncture, exercise, herbal medicine, nutritional supplements) provided potential benefits for patients with CIPN. Furthermore, Chinese herbal medicine, administered orally or externally, significantly prevented and/or relieved the incidence and severity of CIPN in comparison to control groups (no additional treatment, placebo, and conventional western medicine). However, the quality of evidence and strength of recommendations were compromised by the inconsistencies and imprecision of included studies. The main concerns regarding the quality of systematic reviews included the lack of sufficiently rigorous a priori protocols, and the lack of protocol registration adopted in the included studies. CONCLUSIONS Though looking across reviews, Chinese herbal medicine appear generally effective in CIPN, uncertainty remains about the effects of many other nonpharmacological interventions. The evidence on what works was particularly compromised by reporting and methodological limitations, which requires further investigation to be more certain of their effects.
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Affiliation(s)
- Jie Hao
- Western Sydney University, Sydney, New South Wales, Australia
| | - Xiaoshu Zhu
- Western Sydney University, Sydney, New South Wales, Australia
| | - Alan Bensoussan
- Western Sydney University, Sydney, New South Wales, Australia
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Rostami N, Mosavat SH, Heydarirad G, Arbab Tafti R, Heydari M. Efficacy of topical
Citrullus colocynthis
(bitter apple) extract oil in chemotherapy‐induced peripheral neuropathy: A pilot double‐blind randomized placebo‐controlled clinical trial. Phytother Res 2019; 33:2685-2691. [DOI: 10.1002/ptr.6442] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 06/17/2019] [Accepted: 06/26/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Nematollah Rostami
- Clinical Research and Development Center at Shahid Modarres HospitalShahid Beheshti University of Medical Sciences Tehran Iran
| | | | - Ghazaleh Heydarirad
- Department of Traditional Medicine, School of Traditional MedicineShahid Beheshti University of Medical Sciences Tehran Iran
| | - Roya Arbab Tafti
- Iranian Research Institute of Plant ProtectionAgriculture Research, Education and Extension Organization Tehran Iran
| | - Mojtaba Heydari
- Pharmaceutical Sciences Research CenterShiraz University of Medical Sciences Shiraz Iran
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The Method of Activating Blood and Dredging Collaterals for Reducing Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:1029626. [PMID: 31281395 PMCID: PMC6590582 DOI: 10.1155/2019/1029626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/16/2019] [Indexed: 12/12/2022]
Abstract
Background Chemotherapy-induced peripheral neuropathy (CIPN) remains as a big unsolved challenge for cancer patients and oncologists. However, there is no effective treatment to prevent and cure it. This systematic review and meta-analysis chiefly aimed to assess the effectiveness and safety on the method of activating blood and dredging collaterals in traditional Chinese medicine (TCM) for reducing CIPN. Methods Two authors comprehensively searched all the randomized controlled trials (RCTs) via PubMed, Cochrane, China National Knowledge Infrastructure (CNKI), and Wanfang Database of China Science Periodical Database (CSPD). The Review Manager (RevMan) 5.0 was used to conduct the meta-analysis. Results 20 trials including 1481 participants were analyzed. 15 trials tested the incidence of all-grade CIPN which was significantly lower in intervention arm and 16 trails presented that the result of high-grade CIPN was the same. The total effective rate of the use of Chinese herbs was 77.19% versus 45.79% in the comparator group. Besides, the use of Chinese herbs statistically promoted the sensory nerve conduction velocity (SNCV) and the motor nerve conduction velocity (MNCV). Besides, the quality of life (QoL) in the intervention group was better than the comparator one. Herbs-related adverse events were skin allergy, skin chap, and scald, which could be managed well. Conclusions The work involving studies of the effectiveness and safety on TCM for reducing CIPN proves to be encouraging. Herbs with the function of activating blood and dredging collaterals were found to potentially promote the curative effects as well as making improvements of SNCV and MNCV. However, in the future, more double-blind, multicenter, large-scale RCTs and more comprehensive researches are still required.
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13
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Hao J, Zhu X, Smith CA, Bensoussan A. Can External Use of Chinese Herbal Medicine Prevent Cumulative Peripheral Neuropathy Induced by Oxaliplatin? A Systematic Literature Review With Meta-analysis. Integr Cancer Ther 2019. [PMCID: PMC6902377 DOI: 10.1177/1534735419872819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background. Peripheral neurotoxicity caused by oxaliplatin (OXA)
chemotherapy is the main limitation preventing continuation of chemotherapy in
patients with gastrointestinal cancer. The purpose of this study was to
determine the efficacy of external use of Chinese herbal medicine (CHM) on the
incidence of cumulative OXA-induced peripheral neurotoxicity (OIPN).
Method. Scientific literature databases were searched to
identify controlled clinical trials analyzing CHM in OIPN. Clinical studies that
included at least 1 relevant primary outcome were analyzed by 2 independent
reviewers. Meta-analysis was performed on the software RevMan 5.3.
Results. 700 cancer patients of 9 studies were reported, of
whom 352 received external CHM and 348 received warm water baths, conventional
medicine, or no intervention as controls. Neurotoxicity incidence (Levi grade ≥
1) was significantly decreased in CHM group, compared with no intervention
(P < .01). The incidence of cumulative neurotoxicity
(Levi grade ≥2) was also significantly lower in the CHM group than in all the
control groups (P < .05), and the cumulative neurotoxicity
in the CHM group was significantly reduced (Levi grade ≥ 3) in comparision with
no intervention (P < .01). These results were consistent
with those of the subgroup analyses for preventing OIPN at each of the
chemotherapy treatment cycles. There was no difference in the incidence of
adverse events between groups (P > .05).
Conclusion. External use of CHM may be beneficial in
preventing the OXA-induced cumulative neurotoxicity. However, given the low
quality of the evidence, the results should be interpreted with caution.
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Affiliation(s)
- Jie Hao
- Western Sydney University, Sydney, NSW, Australia
| | - Xiaoshu Zhu
- Western Sydney University, Sydney, NSW, Australia
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Chen D, Zhao J, Cong W. Chinese Herbal Medicines Facilitate the Control of Chemotherapy-Induced Side Effects in Colorectal Cancer: Progress and Perspective. Front Pharmacol 2018; 9:1442. [PMID: 30581388 PMCID: PMC6294045 DOI: 10.3389/fphar.2018.01442] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 11/22/2018] [Indexed: 12/24/2022] Open
Abstract
Side effects, including nausea, vomiting, mucositis, peripheral neuropathy, and diarrhea, have been frequently reported in colorectal cancer (CRC) patients undergoing chemotherapy. Chinese Herbal Medicines (CHMs) display distinct clinical outcomes, as a result, they have been increasingly used as an adjuvant therapy to manage chemotherapy-induced side effects. In this review, we aim to intensively explore the molecular mechanisms of CHMs, underline the significance of CHMs in mitigating the side effects induced by chemotherapy, and examine the necessary studies required to understand the role of CHMs in alleviating chemotherapy-induced side effects. Specifically, ginger, Astragali Radix, and Liujunzi Decoction have been verified to ameliorate nausea and vomiting. Banxia Xiexin Decoction and Huangqin Decoction have been confirmed to be beneficial to mucositis and delayed-onset of diarrhea. Moreover, Niuche Shenqi Wan, Guilong Tongluo Decoction, Huangqi Guizhi Wuwu Decoction, and tumeric have been found to display potential therapeutic effects for preventing the genesis and development of peripheral neurotoxicity. These findings have further emphasized the pivotal role of CHMs in improving the outcomes of chemotherapy-induced side effects in CRC. Nonetheless, more molecular evidence is required to comprehensively understand and more appropriately apply CHMs in routine clinical practice for CRC.
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Affiliation(s)
- Dongmei Chen
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, Beijing University of Chinese Medicine, Beijing, China.,The University of Texas, MD Anderson Cancer Center, Houston, TX, United States
| | - Jun Zhao
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Weihong Cong
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
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Abstract
The rates of ribosome production by a nucleolus and of protein biosynthesis by ribosomes are tightly correlated with the rate of cell growth and proliferation. All these processes must be matched and appropriately regulated to provide optimal cell functioning. Deregulation of certain factors, including oncogenes, controlling these processes, especially ribosome biosynthesis, can lead to cell transformation. Cancer cells are characterized by intense ribosome biosynthesis which is advantageous for their growth and proliferation. On the other hand, this feature can be engaged as an anticancer strategy. Numerous nucleolar factors such as nucleolar and ribosomal proteins as well as different RNAs, in addition to their role in ribosome biosynthesis, have other functions, including those associated with cancer biology. Some of them can contribute to cell transformation and cancer development. Others, under stress evoked by different factors which often hamper function of nucleoli and thus induce nucleolar/ribosomal stress, can participate in combating cancer cells. In this sense, intentional application of therapeutic agents affecting ribosome biosynthesis can cause either release of these molecules from nucleoli or their de novo biosynthesis to mediate the activation of pathways leading to elimination of harmful cells. This review underlines the role of a nucleolus not only as a ribosome constituting apparatus but also as a hub of both positive and negative control of cancer development. The article is mainly based on original papers concerning mechanisms in which the nucleolus is implicated directly or indirectly in processes associated with neoplasia.
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Affiliation(s)
- Dariusz Stępiński
- Department of Cytophysiology, Faculty of Biology and Environmental Protection, University of Łódź, Pomorska 141/143, 90-236, Łódź, Poland.
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