Annals of Oncology Advance Access originally published online on January 17, 2007
Annals of Oncology 2007 18(4):768-774; doi:10.1093/annonc/mdl465
© 2007 European Society for Medical Oncology
quality of life and supportive care |
A double-blind placebo-controlled randomized study of Chinese herbal medicine as complementary therapy for reduction of chemotherapy-induced toxicity
1 Department of Clinical Oncology, Prince of Wales Hospital, Institute of Chinese Medicine, Hong Kong Cancer Institute, Chinese University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), China
2 Department of Oncology, University of Birmingham, Birmingham, UK
3 School of Chinese Medicine, Baptist Hospital, Hong Kong Special Administrative Region (HKSAR), China
4 Centre for Clinical Trials, School of Public Health, Chinese University of Hong Kong, China
* Correspondence to: Dr T. S. K. Mok, Department of Clinical Oncology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, HKSAR, China. Tel: +852-2632-1032; Fax: +852-2632-5816; E-mail: tony{at}clo.cuhk.edu.hk
Background: Chinese herbal medicine (CHM) is a common complementary therapy used by patients with cancer for reduction of chemotherapy-induced toxic effects. This study applied the highest standard of clinical trial methodology to examine the role of CHM in reducing chemotherapy-induced toxicity, while maintaining a tailored approach to therapy.
Patients and methods: Patients with early-stage breast or colon cancer who required postoperative adjuvant chemotherapy were eligible for the study. Enrolled patients were randomly assigned to one of three Chinese herbalists who evaluated and prescribed a combination of single-item packaged herbal extract granules. Patients received either CHM or placebo packages with a corresponding serial number. The placebo package contained nontherapeutic herbs with an artificial smell and taste similar to a typical herbal tea. The primary end points were hematologic and non-hematologic toxicity according to the National Cancer Institute Common Toxicity Criteria Version 2.
Results: One hundred and twenty patients were accrued at the time of premature study termination. Patient characteristics of the two groups were similar. The incidence of grade 3/4 anemia, leukopenia, neutropenia, and thrombocytopenia for the CHM and placebo groups were 5.4%, 47.3%, 52.7%, and 1.8% and 1.8%, 32.2%, 44.7%, and 3.6%, respectively (P = 0.27, 0.37, 0.63, and 0.13, respectively). Incidence of grade 2 nausea was the only non-hematologic toxicity that was significantly reduced in the CHM group (14.6% versus 35.7%, P = 0.04).
Conclusions: Traditional CHM does not reduce the hematologic toxicity associated with chemotherapy. CHM, however, does have a significant impact on control of nausea.
Key words: alternative and complementary medicine, chemotherapy, Chinese herbal medicine, colonic neoplasms, emesis, toxicity
Received for publication August 20, 2006. Revision received November 14, 2006. Accepted for publication November 14, 2006.
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