TABLE 1.
Characteristics of included studies.
| First author (Year) | Type of cancer | Trial design | Number of participants (male/female); age (mean ± SD) | Interventions | Outcome index (intergroup differences p-value) | Course of treatment | Adverse event (case/symptom) | ||
|---|---|---|---|---|---|---|---|---|---|
| Trial | Control | Trial | Control | ||||||
| Lin et al. (2001) | Mixed (including esophageal cancer, gastric cancer, lung cancer, liver cancer, breast cancer, rectal cancers) | RCT | 30 (19/11); 57.23 ± 14.62 years | 30 (18/12); 55.81 ± 15.74 years | 1) Jianwei niantong capsules (4 c, p.o., q.i.d.) 2) WHO 3-step analgesic ladder treatment: aspirin tablets (0.5 g, p.o., q.i.d.); tramadol capsules (50 mg, p.o., q.i.d.); meperidine tablets (50 mg, p.o., q.i.d.) |
1) WHO 3-step analgesic ladder treatment: aspirin tablets (0.5 g, p.o., q.i.d.); tramadol capsules (50 mg, p.o., q.i.d.); meperidine tablets (50 mg, p.o., q.i.d.) | 1) Response rate (p < 0.05) 2) Duration of pain relief (p < 0.01) |
10 h | E: 18 cases (7 nausea, 6 dizziness, 3 constipation, 2 mild diarrhea) C: 45 cases (13 nausea, 8 vomiting, 6 dizziness, 18 constipation) |
| Zhang (2001) | Mixed (including gastric, liver, colon, lung, breast cancers) | RCT | 82 (NR gender info); mean 62.4 years (both groups) | 28 (NR gender info); mean 62.4 years (both groups) | 1) Compound strynchnos capsule (1 c, p.o., t.i.d.) | 1) Indomethacin suppositories (50 mg, p.r., b.i.d.) | 1) Response rate (p > 0.05) | 3 weeks | E: 5 cases (due to overdosage, 1 muscle stiffness, 4 dysesthesia of mouth) C: 10 cases (3 hepatic and renal dysfunction, 7 nausea with anorexia) |
| Li et al. (2002) | Mixed (including lung, gastric, gallbladder, colon, pancreatic, bladder, renal, ovarian, prostate cancers) | RCT | 46 (60/24; both groups); range 46–64 years (both groups) | 38 (60/24; both groups); range 46–64 years (both groups) | 1) Tibetan medicine duyiwei (3 c, 0.3 mg/c, p.o., t.i.d.) | 1) Indomethacin (25 mg, p.o., t.i.d.) | 1) Response rate (p > 0.05) | 3 days | E: 2 cases (2 nausea with stomach discomfort) C: 16 cases (14 gastrointestinal reactions, 2 dizziness with headache) |
| Ma et al. (2003) | Gastric cancer | RCT | 31 (25/6); 53.1 years, range 28–79 | 31 (24/7); 52.8 years, range 25–75 | 1) Jiaweibaoankeli (9 g, p.o., t.i.d.) | 1) Propoxyaminophen compound tablets (1 t, p.o., b.i.d.) | 1) Response rate (p > 0.05) 2) Duration of pain relief (p > 0.05) 3) Pain intensity (p > 0.05) 4) Performance status (p > 0.05) |
15 days | NR |
| Chen (2004) | Mixed (including liver, gastric, esophageal, pancreatic, colon, metastatic cancers) | RCT | 73 in both groups (46/27) 51 years, range 13–82 years | 51 in both groups (46/27) Only reports that there is no statistical difference between groups. |
1) Shitong decoction 2) WHO 3-step analgesic ladder treatment: morphine sulfate controlled-release tablets (30–60 mg, p.o., b.i.d.); aspirin 0.6 g or indomethacin 25 mg (p.o., t.i.d.) | 1) WHO 3-step analgesic ladder treatment: morphine sulfate controlled-release tablets (30–60 mg, p.o., b.i.d.); aspirin 0.6 g or indomethacin 25 mg (p.o., t.i.d.) | 1) Response rate (p < 0.05) | 1 week | NR |
| Chen et al. (2005) | Mixed (including lung, esophageal, gastric, colon, liver, pancreatic cancers) | RCT | 25 (16/9); 54.60 ± 11.35 years | 25 (17/8); 53.20 ± 10.28 years | 1) Zhitong capsules (4 c, p.o., t.i.d.) 2) tramadol capsules; morphine surfate | 1) WHO 3-step analgesic ladder treatment: indomethacin (25 mg, p.o., t.i.d.); tramadol capsules (100 mg, p.o., b.i.d.); morphine surfate (30 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) 2) Performance status (p > 0.05) | 3 days | E: 12 cases (3 constipation, 2 dizziness, 5 nausea, 2 drowsiness) C: 28 cases (3 stomach discomfort, 11 constipation, 2 dizziness, 7 nausea, 5 drowsiness) |
| Wu et al. (2005) | Mixed (including lung, esophageal, gastric, colon, liver, pancreatic, other type cancers) | RCT | 30 (17/13); 58.23 ± 7.32 years | 30 (18/12); 58.90 ± 5.18 years | 1) Aitongping capsules (0.4 g, 4 c, p.o., t.i.d.) | 1) Compound ciclofenac sodium and Codein tablets (40 mg, p.o., t.i.d.) | 1) Response rate (p > 0.05) | 1 week | E: 0 case C: 3 cases (1 nausea, 1 vomiting, 1 constipation) |
| Cao and Xu (2006) | Bone metastasis (including lung, prostate, breast, esophageal, nasopharyngeal, thyroid primary cancers) | RCT | 41 (26/15); 59.82 years | 41 (25/16); 57.36 years | 1) Zhuanggu zhitong san decoction (200 ml, p.o., b.i.d.) 2) WHO 3-step analgesic ladder treatment: aspirin tablets (0.3 g, p.o., q.i.d.); tramadol capsules (50 mg, p.o., q.i.d.); meperidine tablets (50 mg, p.o., q.i.d.) |
1) WHO 3-step analgesic ladder treatment: aspirin tablets (0.3 g, p.o., q.i.d.); tramadol capsules (50 mg, p.o., q.i.d.); meperidine tablets (50 mg, p.o., q.i.d.) | 1) Response rate (p < 0.05) 2) Duration of pain relief (p < 0.01) |
10 h | E: 28 cases (8 nausea, 7 vomiting, 6 dizziness, 7 constipation) C: 46 cases (13 nausea, 8 vomiting, 7 dizziness, 18 constipation) |
| Zhang et al. (2006) | Mixed (including lung, gastric, liver, esophageal, colon cancers) | RCT | 41 (28/13); 56.2 ± 8.4 years | 43 (25/18); 52.7 ± 9.5 y | 1) EAHM formula for individual research (100 ml, p.o., b.i.d.) 2) Morphine hydrochloride sustained-release tablets (30 mg, p.o., t.i.d.) |
1) Morphine hydrochloride sustained-release tablets (30 mg, p.o., t.i.d.) | 1) Response rate (p < 0.05) | 2 weeks | E: 2 cases (1 nausea and vomiting, 1 constipation) C: 4 cases (1 burning sensation of dorsal region, 3 nausea and vomiting) |
| Chen (2009) | Bone metastasis (no specific types of primary cancer reported) | RCT | 35 (19/16); median 52 years, range 39–65 years | 35 (18/17); median 53 years, range 40–66 years | 1) Jiawei Shentong Zhuyu decoction (100 ml, p.o., b.i.d.) 2) Zoledronic acid with normal saline (4 mg, i.v., at least 2 times in 4 weeks) |
1) Zoledronic acid with normal saline (4 mg, i.v., at least 2 times in 4 weeks) | 1) Response rate (p > 0.05) 2) Duration of pain relief (p < 0.05) | 8 weeks | E: 13 cases (8 fever, 4 nausea and vomiting, 1 myalgia) C: 21 cases (10 fever, 6 nausea and vomiting, 5 myalgia) |
| Hao (2009) | Bone metastasis (including lung, prostate, breast, esophageal, nasopharyngeal, thyroid primary cancers) | RCT | 29 (13/16); NR | 29 (13/16); NR | 1) EAHM formula for individual research (150 ml, p.o., b.i.d.) 2) Zoledronic acid with 0.9% sodium chloride or 5% glucose 100 ml (4 mg, i.v., once every 3 wees) |
1) Zoledronic acid with 0.9% sodium chloride or 5% glucose 100 ml (4 mg, i.v., once every 3 wees) | 1) Response rate (p < 0.05) | 30 days | NR |
| Zhai et al. (2009) | Mixed (including lung, liver, gastric, pancreatic, cervical, ovarian, rectal, colon, other type cancers) | RCT | 89 (51/38); 56.92 years, range 18–86 years | 80 (48/32); 56.83 years, range 28–89 years | 1) Anti-cancer zhitong decoction (150 ml, p.o., b.i.d.) | 1) Bucinnazine tablets (60 mg, p.o., t.i.d.) | 1) Response rate (p < 0.05) 2) Pain intensity (p < 0.01) 3) Performance status (p < 0.01) |
2 weeks | E: 2 cases (1 nausea, 1 stomach discomfort) C: 12 cases (5 nausea, 2 vomiting, 3 stomach discomfort, 1 excitation, 1 fatigue) |
| Zhang (2009) | Liver cancer | RCT | 80 (42/38); range 31–68 years (both groups) | 80 (42/38); range 31–68 years (both groups) | 1) Tuqi powder (12 g, p.o., t.i.d.) | 1) WHO 3-step analgesic ladder treatment: Tramadol capsules (50 mg, p.o., t.i.d.); Morphine sulfate tablets (10 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) | 2 weeks | E: 2 cases (No details reported) C: 14 cases (No details reported) |
| Zhang (2009) | Mixed (specific cancer type NR) | RCT | 40 (29/11); 59 years, range 50–79 years) | 40 (25/15); 57.6 years, range 49–81 years) | 1) Wendan decoction (100 ml, p.o., b.i.d.) 2) Morphine sustained-release tablets (30 mg, p.o., b.i.d.) |
1) Morphine sustained-release tablets (30 mg, p.o., b.i.d.) | 1) Response rate (p > 0.05) | 1 week | E: 2 cases (2 nausea and vomiting) C: 8 cases (8 nausea and vomiting) |
| Cai (2010) | Bone metastasis (including prostate, breast, lung, liver, renal, thyroid, colon, nasopharyngeal primary cancers) | RCT | 40 (NR gender info); 52.1 y, range 42–70 years (both groups) | 40 (NR gender info); 52.1 y, range 42–70 years (both groups) | 1) Yanghe decoction (p.o.) 2) Zoledronic acid with normal saline 50 ml (4 mg, i.v., q.1.m.) | 1) Zoledronic acid with normal saline 50 ml (4 mg, i.v., q.1.m.) | 1) Response rate (p < 0.05) | 4 weeks | NR |
| Li et al. (2010) | Esophageal cancer | RCT | 20 (15/5); 58.90 ± 10.17 years | 20 (14/6); 57.95 ± 6.75 years | 1) Taohongsiwu decoction (p.o.) 2) Ondansetron with normal saline 10 ml (8 mg, i.v., 15 min before each chemotherapy) | 1) Ondansetron with normal saline 10 ml (8 mg, i.v., 15 min before each chemotherapy) | 1) Response rate (p > 0.05) | 8 days | NR |
| Fu (2011) | Mixed (including lung, colon, gastric, liver, breast cancers, cholangioma) | RCT | 64 (43/21); median 55 years, range 45–70 years (both groups) | 64 (43/21); median 55 years, range 45–70 years (both groups) | 1) Qigetongbu decoction (p.o., b.i.d.) 2) Fentanyl transdermal patches (4.2 mg, t.d., q.72.h.) |
1) Fentanyl transdermal patches (4.2 mg, t.d., q.72.h.) | 1) Response rate (p > 0.05) | 15 days | E: 7 cases (2 constipation, 2 nausea and vomiting, 1 dizziness, 2 drowsiness) C: 31 cases (9 constipation, 10 nausea and vomiting, 8 dizziness, 4 drowsiness) |
| Wang et al. (2011) | Bone metastasis (including lung, prostate, breast, esophageal primary cancers) | RCT | 35 (19/16); 55.7 years | 35 (17/18); 56.2 years | 1) EAHM formula for individual research (200 ml, p.o., b.i.d.) | 1) Pamidronate disodium with normal saline 500 ml (60 mg, i.v., q.d.) | 1) Response rate (p < 0.01) | 30 days | E: 4 cases (4 diarrhea) C: 4 cases (1 vomiting, 2 fever, 1 hypocalcemia) |
| Zhou (2011) | Liver cancer | RCT | 160 (109/51); range 31–68 years (both groups) | 160 (109/51); range 31–68 years (both groups) | 1) Modified Tuqi powder (12 g, p.o., t.i.d.) | 1) WHO 3-step analgesic ladder treatment: tramadol capsules (50 mg, p.o., t.i.d.); morphine sulfate controlled-release tablets (10 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) | 1 week | E: incidence of adverse events was 4.8% (nausea, vomiting, dizziness, drowsiness, etc.) C: incidence of adverse events was 36.8% (nausea, vomiting, dizziness, drowsiness etc.) |
| Cheng et al. (2012) | Bone metastasis (including breast primary cancer) | RCT | 15 (NR gender info); 42.00 ± 12.32 years, range 27–58 years (both groups) | 15 (NR gender info); 42.00 ± 12.32 years, range 27–58 years (both groups) | 1) Baizhu fuzi decoction (200 ml, p.o., b.i.d.) | 1) Zoledronic acid with 5% glucose 250 ml (4 mg, i.v., q.1.m.) | 1) Response rate (p < 0.05) | 16 weeks | E: 0 case C: 5 cases (2 fever with chilling sign, 1 headache, 1 muscular pain, 1 anorexia, 1 diarrhea) |
| He (2012) | Bone metastasis (including lung, breast, gastrointestinal, liver, prostate, cervical primary cancers) | RCT | 28 (18/10); 58 years, range 46–76 years | 28 (20/8); 56 years, range 47–70 years | 1) EAHM formula for individual research (p.o.) 2) Zoledronic acid with normal saline 1000 ml (4 mg, i.v., q.1.m.) | 1) Zoledronic acid with normal saline 1000 ml (4 mg, i.v., q.1.m.) | 1) Response rate (p < 0.05) | 8 weeks | E: 5 cases (2 transient exacerbation of bone pain, 3 nausea and vomiting with anorexia) C: 12 cases (4 transient exacerbation of bone pain, 5 nausea and vomiting with anorexia, 2 fever, 1 facial eruption) |
| Meng (2012) | Bone metastasis (including lung primary cancer) | RCT | 21 (10/11); 49 years, range 41–64 years (both groups) | 21 (11/10); 49 years, range 41–64 years (both groups) | 1) EAHM formula for individual research (150 ml, p.o., b.i.d.) | 1) Zoledronic acid with normal saline 100 ml (4 mg, i.v., q.1.w.) | 1) Response rate (p-value NR) 2) Pain intensity (p-value NR ) |
2 weeks | Incidence of adverse events (both groups): fever 6.5%, bone and joint pain 3.1%, gastrointestinal reaction 7.8%. |
| Jiang et al. (2013) | Colorectal cancer | RCT | 32 (18/14); 53.2 ± 12.4 years | 31 (18/13); 53.1 ± 12.8 years | 1) EAHM formula for individual research (200 ml, p.o., b.i.d.) 2) Oxaliplatin with 5% glucose (135 mg, i.v., q.2.w.) 3) Folinic acid and calcium salt hydrate (200 mg, i.v., q.2.w.) 4) 5-Fluorouracil (400 mg, i.v., q.2.w.) |
1) Oxaliplatin with 5% glucose (135 mg, i.v., q.2.w.) 2) Folinic acid and calcium salt hydrate (200 mg, i.v., q.2.w.) 3) 5-Fluorouracil (400 mg, i.v., q.2.w.) |
1) Response rate (p < 0.05) 2) Pain intensity (p < 0.05) |
8 weeks | NR |
| Wang S. J. et al. (2013) | Mixed (including lung, liver, gastric, pancreatic, esophageal, breast cancers) | RCT | 40 (25/14); 41.2 ± 9.7 years | 40 (29/11); 41.8 ± 8.6 years | 1) Gexia zhuyu decoction combined Shixiao powder 2) WHO 3-step analgesic ladder treatment: non-opioids (aspirin); weak opioids (codeine); strong opioids (morphine) | 1) WHO 3-step analgesic ladder treatment: non-opioids (aspirin); weak opioids (codeine); strong opioids (morphine) | 1) Response rate (p = 0.025) | 90 days | E: 0 cases C: 0 cases |
| Chen H. et al. (2014) | Mixed (including lung, liver, gastric, colon cancers) | RCT | 50 (26/24); 62 ± 13 years |
50 (28/22); 59 ± 15 years | 1) Xuefu Zhuyu decoction (250 ml, p.o., b.i.d.) 2) Morphine sulfate sustained-release tablets (10–30 mg, p.o., b.i.d.) | 1) Morphine sulfate sustained-release tablets (10–30 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) | 24 weeks | E: 43 cases (21 constipation, 11 nausea, 5 vomiting, 3 pruritus, 3 other symptom) C: 74 cases (35 constipation, 18 nausea, 6 vomiting, 7 pruritus, 8 other symptom) |
| Liu and Zhou (2014) | Gastric cancer | RCT | 31 (23/8); 63.45 ± 11.51 years | 31 (24/7); 62.85 ± 12.76y | 1) Buqi Huoxue decoction (p.o.) 2) Pantoprazole with normal saline 100 ml (40 mg, i.v., q.d.) 3) Granisetron with 5% glucose 50 ml (3 mg, i.v., q.d.) 4) Oxaliplatin with 5% glucose 500 ml (20 mg, i.v., q.d.) 5) Tegafur with 5% glucose 500 ml (0.8 g, i.v., q.d.) 6) Calcium folinate with 5% glucose 250 ml (200 mg, i.v., q.d.) |
1) Pantoprazole with normal saline 100 ml (40 mg, i.v., q.d.) 2) Granisetron with 5% glucose 50ml (3 mg, i.v., q.d.) 3) Oxaliplatin with 5% glucose 500 ml (20 mg, i.v., q.d.) 4) Tegafur with 5% glucose 500 ml (0.8 g, i.v., q.d.) 5) Calcium folinate with 5% glucose 250 ml (200 mg, i.v., q.d.) |
1) Recurrence rate (p < 0.01) 2) Other analgesics usage (p < 0.05) |
12 weeks | NR |
| Wan et al. (2014) | Bone metastasis (including lung, breast, prostate, cervical, gastric, other type primary cancers) | RCT | 38 (19/19); 53 ± 6.2 years | 34 (17/17); 56.3 ± 2.0 years | 1) Compound Sangzhi mixture (p.o., b.i.d.) 2) Morphine sulfate sustained-release tablets (30 mg, p.o., b.i.d.) |
1) Morphine sulfate sustained-release tablets (30 mg, p.o., b.i.d.) | 1) Response rate (p-value NR) | 30 days | E: 7 cases (3 gastrointestinal reactions including nausea and vomiting, 4 constipation) C: 7 cases (10 gastrointestinal reaction including nausea and vomiting, 7 constipation, 2 urinary retention, 1 central nervous system toxicity) |
| Song et al. (2015) | Mixed (including liver, abdominal and retroperitoneal lymph node, bone metastasis, lung, pelvis metastatic cancer) | RCT | 42 (28/14); range 43–69 years (both groups) | 42 (28/14); range 43–69 years (both groups) | 1) Total glucoside of paeony capsule (0.6 g, p.o., b.i.d.) 2) Morphine sulfate sustained-release tablets (10 mg, p.o., b.i.d.) |
1) Morphine sulfate sustained-release tablets (10 mg, p.o., b.i.d.) | 1) Pain intensity (p > 0.05) | 7 days | E: 4 cases (2 constipation, 1 pruritus, 1 drowsiness) C: 14 cases (4 constipation, 3 pruritus, 1 urinary retention, 5 drowsiness, 1 dyspnea) |
| Chen et al. (2017) | Bone metastasis (including lung, breast, prostate, ovarian, gastric, renal primary cancers) | RCT | 16 (9/7); range 38–77 years | 16 (11/5); range 43–78 years | 1) Hogu Xioaji prescription (p.o., q.d.) 2) Zoledronic acid with normal saline 250 ml (4 mg, i.v., q.1.w.) |
1) Zoledronic acid with normal saline 250 ml (4 mg, i.v., q.1.w.) | 1) Response rate (p > 0.05) 2) Performance status (p > 0.05) |
60 days | NR |
| Li et al. (2017a) | Mixed (including lung, gastric, colon, esophageal, liver, breast cancers) | RCT | 90 (50/40); 57.86 ± 16.45 years | 90 (48/42); 58.36 ± 15.96 years | 1) Xuefu Zhuyu decoction (150 ml, p.o., b.i.d.) 2) Oxycodone hydrochloride sustained-release tablets (10–120 mg, p.o., b.i.d.) |
1) Oxycodone hydrochloride sustained-release tablets (10–120 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) 2) Pain intensity (p < 0.05) 3) Performance status (p < 0.05) 4) Opioid usage (p < 0.05) |
4 week | E: 104 cases (38 constipation, 20 nausea, 18 vomiting, 12 dizziness, 16 anorexia) C: 194 cases (58 constipation, 38 nausea, 30 vomiting, 32 dizziness, 36 anorexia) |
| Li et al. (2017b) | Mixed (including lung, gastric, colon, esophageal, liver, breast cancers) | RCT | 60 (38/22); 51.14 ± 18.42 years | 60 (39/21); 50.88 ± 18.42 years | 1) Gexia Zhuyu decoction (150 ml, p.o., b.i.d.) 2) Oxycodone hydrochloride sustained-release tablets (10–120 mg, p.o., b.i.d.) |
1) Oxycodone hydrochloride sustained-release tablets (10–120 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) 2) Pain intensity (p < 0.05) 3) Performance status (p < 0.05) 4) Duration of pain relief (p < 0.05) 5) Opioid usage (p < 0.05) |
4 weeks | Both groups of patients experienced adverse events such as constipation, nausea, vomiting, dizziness, anorexia, and dysuria. Detailed information NR. |
| Bao (2018) | Mixed (including lung, gastric, colon, liver, cancers) | RCT | 26 (13/13); 57.54 ± 7.11 years | 26 (12/14); 56.87 ± 4.54 years | 1) Xuefu Zhuyu decoction (200 ml, p.o., b.i.d.) 2) Morphine sulfate controlled-release tablets (10–30 mg, p.o., b.i.d.) |
1) Morphine sulfate controlled-release tablets (10–30 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) | 30 days | E: 6 cases (1 nausea and vomiting, 1 thirst, 1 drowsiness, 3 constipation) C: 13 cases (3 nausea and vomiting, 2 thirst, 1 drowsiness, 7 constipation) |
| Dong et al. (2018) | Mixed (including lung, gastric, colon, liver, esophageal, breast, prostate cancers) | RCT | 120 (65/6); 53.24 ± 16.10 years | 120 (67/53); 52.52 ± 16.83 years | 1) Cinobufotalin capsules (2 c, p.o., t.i.d.) 2) Morphine sulfate controlled-release tablets (10 mg, p.o., b.i.d.) | 1) Morphine sulfate controlled-release tablets (10 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) 2) Pain intensity (p < 0.01) 3) Performance status (p < 0.01) 4) Duration of pain relief (p < 0.01) 5) Opioid usage (p < 0.01) | 30 days | Both groups of patients experienced adverse events such as constipation, nausea, vomiting, dizziness, anorexia, dysuria, etc. Detailed information NR. |
| Miu and Quan (2018) | Mixed (including lung, gastric, colon, liver, breast cancers) | RCT | 23 (13/10); 61.35 ± 9.89 years | 23 (14/9); 59.49 ± 10.34 years | 1) Cinobufotaling capsules (0.5 g, p.o., t.i.d.) 2) WHO 3-step analgesic ladder treatment: diclofenac sodium sustained-release tablets, profenbeine sustained-release tablets, morphine sulfate sustained-release tablets, etc. |
1) WHO 3-step analgesic ladder treatment: diclofenac sodium sustained-release tablets, Profenbeine sustained-release tablets, Morphine sulfate sustained-release tablets, etc. | 1) Response rate (p < 0.05) 2) Pain intensity (p < 0.05) 3) Performance status (p < 0.05) |
4 weeks | E: 23 cases (9 anorexia, 10 constipation, 4 vomiting) C: 44 cases (16 anorexia, 17 constipation, 11 vomiting) |
| Ouyang (2018) | Mixed (including gastric, colorectal, liver, breast cancers) | RCT | 43 (21/22); 60.04 ± 10.02 years | 43 (22/21); 58.76 ± 8.13 years | 1) Modified Shaogan fuzi decoction (100 ml, p.o., b.i.d.) 2) Morphine sulfate controlled-release tablets (10–20 mg, p.o., b.i.d.) | 1) Morphine sulfate controlled-release tablets (10–20 mg, p.o., b.i.d.) | 1) Response rate (p < 0.05) 2) Duration of pain relief (p < 0.05) |
4 weeks | E: 11 cases (9 constipation, 2 nausea and vomiting) C: 32 cases (23 constipation, 9 nausea and vomiting) |
| Liu (2020) | Rectal cancer | RCT | 30 (17/13); 60.6 ± 5.4 years | 30 (15/15); 60.5 ± 5.3 years | 1) Liuhunzi decoction (150 ml, p.o., b.i.d.) 2) Irinotecan hydrochloride (40 mg, i.v., first treatment) 3) Capecitabine (500 mg, p.o., b.i.d.) |
1) Irinotecan hydrochloride (40 mg, i.v., first treatment) 2) Capecitabine (500 mg, p.o., b.i.d.) |
1) Response rate (p < 0.05) 2) Pain intensity (p < 0.05) |
6 weeks | NR |
| Yang (2020) | Mixed (including lung primary cancer) | RCT | 35 (17/13); 56.98 ± 3.62 years | 35 (25/10) 57.59 ± 3.58 years | 1) EAHM formula for individual research (200 ml, p.o., b.i.d.) 2) Zoledronic acid with normal saline 100 ml (40 mg, i.v., first treatment) |
1) Zoledronic acid with normal saline 100 ml (40 mg, i.v., first treatment) | 1) Response rate (p < 0.05) 2) Pain intensity (p < 0.05) |
2 weeks | E: 4 cases (1 fever, 1 bone joint pain, 2 gastrointestinal reaction) C: 3 cases (1 fever, 1 bone joint pain, 1 gastrointestinal reaction) |
| Liang et al. (2021) | Mixed (including lung, gastric, liver, colon, breast, cervical cancers) | RCT | 39 (23/16); 59.6 ± 7.5 years | 39 (22/17); 58.2 ± 7.2 years | 1) Cinobufotalin capsules (0.5 g, p.o., t.i.d.) 2) WHO 3-step analgesic ladder treatment: diclofenac sodium sustained-release tablets (1 t, p.o., q.d.); profenbeine sustained-release tablets (2–4 t, p.o., b.i.d.); morphine sulfate sustained-release tablets (1–2 t, p.o., b.i.d.) |
1) WHO 3-step analgesic ladder treatment: diclofenac sodium sustained-release tablets (1 t, p.o., q.d.); profenbeine sustained-release tablets (2–4 t, p.o., b.i.d.); morphine sulfate sustained-release tablets (1–2 t, p.o., b.i.d.) | 1) Response rate (p < 0.01) 2) Pain intensity (p < 0.01) 3) Performance status (p < 0.01) |
4 weeks | E: 34 cases (14 anorexia, 14 constipation, 6 vomiting) C: 67 cases (23 anorexia, 24 constipation, 20 vomiting) |
AE, adverse event; b.i.d, bis in die; c: capsule; EAHM, East Asian herbal medicine; d, days; g, gram; i.m., intramuscular; i.v., intravenous; m, months; mg, milligram; mL, milliliter; NR, not reported; p.o, per os; p.r, per rectum; q.d., quaque die; RCT, randomized controlled trial; SD, standard deviation; t, tablet; t.i.d, ter in die; WHO, world health organizations; y, years; ㎍, microgram.