National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China.
Beijing University of Chinese Medicine, Beijing, China.
Integr Cancer Ther. 2023 Jan-Dec;22:15347354231188947. doi: 10.1177/15347354231188947.
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.
癌症相关疲乏（CRF）对癌症患者的生活质量和后续治疗有巨大的负面影响。许多系统评价（SRs）报告补充和替代医学（CAM）可以改善 CRF，但由于质量和结果的差异，其效果存在争议。
从开始到 2022 年 9 月，我们在 13 个数据库中进行了搜索。仅纳入随机对照试验（RCTs）的 SR。我们使用 AMSTAR-2 工具评估纳入的 SR 质量，使用 GRADE 系统评估证据强度，使用 ROBIS 工具评估偏倚风险，使用 PRISMA 清单评估 SR 的完整性。
我们纳入了 30 项合格的 SR（27 项荟萃分析）。根据 AMSTAR-2 工具，29 项 SR 被评为“极低”质量，只有 1 项被评为“低”质量。使用 ROBIS 工具，19 项 SR 显示出低偏倚风险。根据 PRISMA 清单，没有 SR 报告了所有项目，10 项 SR 充分报告了超过 70%的项目。根据 GRADE 系统，有 7 项结局被评估为高质量证据。
本综述表明 CAM 干预在治疗成人 CRF 方面具有有前景的疗效证据。气功、音乐、耳穴疗法和膳食补充剂在 CRF 中的作用需要进一步评估。尽管结果存在差异，但建议在医生的指导下选择适当的 CAM 来管理癌症相关的疲劳。需要更多具有严格方法学设计和足够样本量的研究。
