Network Meta-Analysis Assesses Traditional Chinese Medicine External Therapies for Cancer-Related Fatigue Management
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Key Takeaway
Consider these findings cautiously as low-certainty evidence requires further validation before clinical adoption.
This systematic review and network meta-analysis investigated the comparative effectiveness of multiple traditional Chinese medicine external therapies for managing cancer-related fatigue. The review incorporated data from eighty-seven randomized controlled trials evaluating diverse interventions such as acupuncture, moxibustion, acupoint injection, and Chinese medicine foot baths against standard usual care.
Regarding outcomes, the analysis utilized SUCRA rankings to determine relative efficacy. The authors noted that warming needle therapy appeared most effective in relieving cancer-related fatigue symptoms. Other approaches, including Chinese medicine foot baths and TCM emotional care, also demonstrated positive effects, though the hierarchy of benefit varied across the different modalities tested.
Significant limitations were highlighted by the researchers regarding the quality of the underlying data. The authors assessed the certainty of evidence as low using the CINeMA framework and emphasized that results should be interpreted with great caution. Safety data regarding adverse events, serious adverse events, and discontinuations were not reported in the included studies.
Consequently, while the findings provide significant support for future research and clinical trials, immediate clinical adoption requires careful consideration. Further validation through additional high-quality clinical trials is necessary to confirm these observations before widespread implementation in oncology practice settings.
View Original Abstract ↓
ObjectivesThe purpose of this network meta-analysis was to compare and evaluate the effectiveness of several traditional Chinese medicine (TCM) external therapies in reducing cancer-related fatigue(CRF).MethodsA search of eight databases was conducted to obtain randomized controlled trials (RCTs) on different external therapies of traditional Chinese medicine for alleviating CRF. The Cochrane ROB 2.0 tool was used to assess the included studies’ bias risk. Network meta-analysis and comparative effect ranking were conducted using STATA MP 17.0. The primary outcome was the CRF score. Standardized mean difference (SMD) and 95% confidence interval (95% CI) were used to calculate the effect size. The Confidence in Network Meta-Analysis (CINeMA) tool was used to assess the certainty of the evidence.ResultsThe systematic review included eighty-seven RCTs covering 13 different external therapies. Among the treatments studied, acupuncture, acupressure, traditional Chinese exercises, transcutaneous acupoint electrical stimulation, moxibustion, Chinese medicine foot bath, traditional Chinese medicine (TCM)emotional care, acupoint injection, acupoint application, warming needle were demonstrated to be effective in alleviating CRF in comparison to usual care. The surface under cumulative ranking curve (SUCRA) indicated that warming needle was most effective in relieving CRF, followed by Chinese medicine foot bath, TCM emotional care, acupoint injections, moxibustion, etc.ConclusionsThis review indicated that warming needle might be the most effective traditional Chinese medicine external therapy for treating CRF. But, the low certainty of evidence (assessed via CINeMA) must be emphasized in this low confidence means the results should be interpreted with great caution. Further validation is required through additional clinical trials. These findings provide significant support for future research and clinical trials.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023479194.
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