Randomised controlled trials of traditional Chinese medicine in cancer care published in Chinese: an overview

Abstract Background Traditional Chinese medicine (TCM) has been widely integrated into cancer care in China. Since a review done in 2011, large numbers of randomised controlled trials (RCTs) have been published in the Chinese literature. We aimed to summarise the current evidence of relevant RCTs of TCM for cancer treatment to support further clinical practice and research. Methods The update was done in four main Chinese databases (China National Knowledge Infrastructure, Chinese Scientific Journal Database, SinoMed, and Wanfang Database) from their inception until June 18, 2017, to identify any RCTs using TCM. We bibliometrically analysed the included RCTs and the research directions of TCM for cancer treatment. Findings We included 5834 RCTs (involving 477 147 participants). Only 62 publications were indexed in MEDLINE. The main three cancers treated with TCM were lung cancer, stomach cancer, and breast cancer. 4752 RCTs (81·5%) used TCM combined with conventional treatment whereas 1082 RCTs (18·5%) used only TCM in treatment groups for symptoms and side-effects. Herbal medicine was the most frequently applied TCM therapy (5087 RCTs; 87·2%). The most frequently reported outcome was clinical symptom improvement (3712 RCTs; 63·6%) followed by quality of life (2725 RCTs; 46·7%) and biomarker indices (2384 RCTs; 40·9%). 1237 RCTs (21·2%) reported multiple indices to provide a composite outcome to measure cancer patients' general condition. 4051 RCTs (69·4%) concluded that in comparison with conventional treatment, TCM alone or combined with conventional treatment had a better effect in cancer care. Interpretation Substantial data showed that many different TCM treatments are being applied either as monotherapy for palliative treatment or in combination with conventional medicine for treatment. We need further comprehensive evaluation of the beneficial effects and safety of these TCM modalities, and we should focus on quality of life and explore why patients with cancer are taking TCM. Funding Key project of National Natural Science Foundation of China (81830115).