The Role of Complementary and Alternative Medicine on Cancer-Related Fatigue in Adults: An Overview of Systematic Reviews

Author: Peijin Li1,2, Qian Wang2, Lixing Liu1, Qinglin Zhang1,2, Rui Zhou1,2, Yue Wang3, Tingting Liu1,2, Li Feng1
1 National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China.
2 Beijing University of Chinese Medicine, Beijing, China.
3 Beijing Hospital of Traditional Chinese Medicine, Beijing, China.
Conference/Journal: Integr Cancer Ther
Date published: 2023 Jan-Dec
Other: Volume ID: 22 , Pages: 15347354231188947 , Special Notes: doi: 10.1177/15347354231188947. , Word Count: 247

Cancer-related fatigue (CRF) has an enormous adverse impact on quality of life and subsequent therapy of cancer patients. Complementary and alternative medicine (CAM) is reported to improve CRF in many systematic reviews (SRs), but the effects are controversial because of variations in the quality and outcomes.

Thirteen databases were searched from inception to September 2022. Only SRs of randomized controlled trials (RCTs) were included. We assessed the quality of included SRs with the AMSTAR-2 tool, the strength of evidence with the GRADE system, the risk of bias with the ROBIS tool, and the integrity of SRs with the PRISMA checklist.

We included 30 eligible SRs (27 meta-analyses). Based on the AMSTAR-2 tool, 29 SRs were rated as "critically low" quality, and only one was rated as "low" quality. With the ROBIS tool, 19 SRs demonstrated a low risk of bias. According to the PRISMA checklist, no SRs reported all the items, and 10 SRs sufficiently reported over 70%. Based on the GRADE system, 7 outcomes were assessed as high-quality evidence.

This overview demonstrates promising evidence for the effectiveness of CAM interventions in the treatment of CRF in adults. The roles of qigong, music, auricular point therapy, and dietary supplements in CRF need further evaluation. Although findings are mixed, it is recommend to select appropriate CAM to manage cancer-related fatigue under the guidance of physicians. More studies with rigorous methodological designs and sufficient sample sizes are needed.

Keywords: acupuncture; cancer-related fatigue; complementary and alternative medicine; overview; systematic reviews.

PMID: 37515495 PMCID: PMC10387784 DOI: 10.1177/15347354231188947