Cancer Management and Research (Jul 2019)
Efficacy of complementary and integrative medicine on health-related quality of life in cancer patients: a systematic review and meta-analysis
Abstract
Wan-Fu Lin,1,* Mao-Feng Zhong,2,* Qing-Hui Zhou,1 Yu-Ren Zhang,1 Huan Wang,1 Zhi-Hao Zhao,1 Bin-Bin Cheng,1 Chang-Quan Ling11Department of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai 200433, People’s Republic of China; 2Graduate School of Shanghai University of Chinese Medicine, Shanghai 201203, People’s Republic of China*These authors contributed equally to this workAbstract: Complementary and integrative medicine (CIM) has been used for improving health-related quality of life (HRQOL) in patients with cancer. The objective of this review is to evaluate the effects of CIMs on the HRQOL of cancer patients. We identified randomized controlled trials (RCTs) involving patients with cancer at any stage by retrieving electronic databases from the inception to February 14, 2018 (Systematic Review Registration: PROSPERO CRD42018091609). The main outcomes were HRQOL scores and related domains such as physical well-being scores. The standardized mean difference was used for the analysis and heterogeneity was assessed with the I2, statistic. A Bayesian framework was used to estimate the ranking order of efficacy in HRQOL change. Finally, 34 RCTs with 3,010 patients were included. As a whole, the results showed clearly superior efficacy of CIM in improving HRQOL. For different domains of HRQOL, different CIM interventions may play different roles. The ranking order of efficacy in change HRQOL was qigong plus mindfulness, Chinese herbal medicine, multimodal complementary medicine, qigong, nutritional supplement, mindfulness, acupuncture, yoga, and massage, and it was different among different domains. There was no evidence of publication bias. In conclusion, CIM may improve the HRQOL of cancer patients. More studies, especially focusing on male cancer patients, are needed to increase the confidence level of our findings.Keywords: complementary medicine, alternative medicine, integrative medicine, health-related quality of life, randomized controlled trials