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      Traditional Chinese Medicine in Cancer Care: A Review of Controlled Clinical Studies Published in Chinese

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          Abstract

          Background

          Traditional Chinese medicine (TCM) has been widely applied for cancer care in China. There have been a large number of controlled clinical studies published in Chinese literature, yet no systematic searching and analysis has been done. This study summarizes the current evidence of controlled clinical studies of TCM for cancer.

          Methods

          We searched all the controlled clinical studies of TCM therapies for all kinds of cancers published in Chinese in four main Chinese electronic databases from their inception to November 2011. We bibliometrically analyzed the included studies and assessed the reporting quality.

          Results

          A total of 2964 reports (involving 253,434 cancer patients) including 2385 randomized controlled trials and 579 non-randomized controlled studies were included. The top seven cancer types treated were lung cancer, liver cancer, stomach cancer, breast cancer, esophagus cancer, colorectal cancer and nasopharyngeal cancer by both study numbers and case numbers. The majority of studies (72%) applied TCM therapy combined with conventional treatment, whilst fewer (28%) applied only TCM therapy in the experimental groups. Herbal medicine was the most frequently applied TCM therapy (2677 studies, 90.32%). The most frequently reported outcome was clinical symptom improvement (1667 studies, 56.24%) followed by biomarker indices (1270 studies, 42.85%), quality of life (1129 studies, 38.09%), chemo/radiotherapy induced side effects (1094 studies, 36.91%), tumor size (869 studies, 29.32%) and safety (547 studies, 18.45%). Completeness and adequacy of reporting appeared to improve with time.

          Conclusions

          Data from controlled clinical studies of TCM therapies in cancer treatment is substantial, and different therapies are applied either as monotherapy or in combination with conventional medicine. Reporting of controlled clinical studies should be improved based on the CONSORT and TREND Statements in future. Further studies should address the most frequently used TCM therapy for common cancers and outcome measures should address survival, relapse/metastasis and quality of life.

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          Most cited references7

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          Trends in complementary/alternative medicine use by breast cancer survivors: Comparing survey data from 1998 and 2005

          Background Use of complementary and alternative medicine (CAM) by women with breast cancer is often said to be increasing, yet few data exist to confirm this commonly held belief. The purpose of this paper is to compare overall patterns of CAM use, as well as use of specific products and therapies at two different points in time (1998 vs 2005) by women diagnosed with breast cancer. Methods Surveys were mailed to women randomly selected from the Ontario Cancer Registry (Canada) in the spring of 1998 (n = 557) and again in the spring of 2005(n = 877). Results The response rates were 76.3% in 1998 and 63% in 2005. In 1998, 66.7% of women reported using either a CAM product/therapy or seeing a CAM therapist at some time in their lives as compared with 81.9% in 2005 (p = 0.0002). Increases were seen in both use of CAM products/therapies (62% in 1998 vs. 70.6% in 2005) and visits to CAM practitioners (39.4% of respondents in 1998 vs 57.4% of respondents in 2005). Women in 2005 reported that 41% used CAM for treating their breast cancer. The most commonly used products and practitioners for treating breast cancer as reported in 2005 were green tea, vitamin E, flaxseed, vitamin C, massage therapists and dietitians/nutritionists. Conclusion CAM use (both self-medication with products and visits to CAM practitioners) increased significantly from 1998 to 2005. Now that more than 80% of all women with breast cancer report using CAM (41% in a specific attempt to management their breast cancer), CAM use can no longer be regarded as an "alternative" or unusual approach to managing breast cancer.
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            Clinical studies with traditional Chinese medicine in the past decade and future research and development.

            Traditional Chinese medicine (TCM) is currently considered a complementary or alternative medical system in most Western countries and has been increasingly accepted worldwide. More and more clinical trials on TCM have been conducted internationally, and scientists worldwide are becoming increasingly interested in the evaluation of clinical efficacy of TCM based on clinical trials. This paper reviews the situation of clinical trials on TCM in the past decade, including systematic reviews about clinical trials either focusing on the treatment of disease with TCM approaches or focusing on one herbal product, conduction of clinical trials on TCM either with randomization and controlled methods or general observation. Some general issues on the conduct of clinical trials on TCM, such as randomization, control, quality of life (QOL), patient reported outcomes (PROs) and biomarkers, quality control, safety evaluation and case studies, are discussed, and accordingly some suggestions are proposed. © Georg Thieme Verlag KG Stuttgart · New York.
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              Use of Chinese medicine by cancer patients: a review of surveys

              Chinese medicine has been used to treat a variety of cancer-related conditions. This study aims to examine the prevalence and patterns of Chinese medicine usage by cancer patients. We reviewed articles written in English and found only the Chinese medicine usage from the studies on complementary and alternative medicine (CAM). Seventy four (74) out of 81 articles reported rates of CAM usage ranging from 2.6 to 100%. Acupuncture was reported in 71 out of 81 studies. Other less commonly reported modalities included Qigong (n = 17), Chinese herbal medicine (n = 11), Taichi (n = 10), acupressure (n = 6), moxibustion (n = 2), Chinese dietary therapy (n = 1), Chinese massage (n = 1), cupping (n = 1) and other Chinese medicine modalities (n = 19). This review also found important limitations of the English language articles on CAM usage in cancer patients. Our results show that Chinese medicine, in particular Chinese herbal medicine, is commonly used by cancer patients. Further research is warranted to include studies not written in English.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                3 April 2013
                : 8
                : 4
                : e60338
                Affiliations
                [1 ]Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
                [2 ]Centre for Complementary Medicine Research (CompleMED), University of Western Sydney, Sydney, New South Wales, Australia
                [3 ]School of Preclinical Medicine, Beijing University of Chinese Medicine, Beijing, China
                [4 ]School of Management, Beijing University of Chinese Medicine, Beijing, China
                [5 ]School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing, China
                [6 ]School of Humanities, Beijing University of Chinese Medicine, Beijing, China
                Vanderbilt University Medical Center, United States of America
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Substantial contribution to the study design and manuscript revision: JL AB. Conceived and designed the experiments: JL Xun Li. Performed the experiments: Xun Li GY Xinxue Li YZ JY JC XS XZ YG YX. Analyzed the data: Xun Li GY Xinxue Li. Wrote the paper: Xun Li.

                Article
                PONE-D-12-35499
                10.1371/journal.pone.0060338
                3616129
                23560092
                ba7a831e-105d-4fd9-869f-c7d4dac9ff98
                Copyright @ 2013

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 8 November 2012
                : 25 February 2013
                Page count
                Pages: 11
                Funding
                This work was supported by Program for Innovative Research Team of Beijing University of Chinese Medicine (No.2011-CXTD-09), and grant number 2011ZX09302-006 from the Ministry of Science and Technology of China and 101207007 from the State Administration of Traditional Chinese Medicine. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Computer Science
                Information Technology
                Medicine
                Clinical Research Design
                Systematic Reviews
                Complementary and Alternative Medicine
                Oncology
                Cancer Treatment
                Cancers and Neoplasms

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                Uncategorized

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