Effectiveness of Herbal Medicine for Leukopenia/Neutropenia Induced by Chemotherapy in Adults with Colorectal Cancer: A Systematic Review and Meta-analysis

Clinical characteristics and survival outcomes in patients aged 75 years or older with advanced colorectal cancer treated using traditional Chinese medicine: an observational retrospective study

Limited evidence suggests that elderly patients with advanced colorectal cancer (ACRC) may benefit from traditional Chinese medicine (TCM). This study investigated the efficacy and safety of TCM in old ACRC patients treated in the Oncology Department of Xiyuan Hospital between January 2012 and December 2021. The clinical characteristics of these patients were retrospectively reviewed. Their progression-free survival (PFS) and total duration of TCM therapy (TTCM) were analyzed using the Kaplan-Meier curve. Forty-eight patients (F:M 13:35) with a mean age of 78.75 ± 2.99 years (range, 75-87) met the inclusion criteria. There were 18 cases of rectal cancer and 30 of colon cancer. The median PFS was 4 months (range, 1-26; 95% CI 3.26-4.73). The median TTCM was 5.5 months (range, 1-50; 95% CI 1.76-8.24). Subgroup analysis revealed that PFS and TTCM were shorter in patients with bone metastases and an ECOG performance status score of 2-3 (p < 0.05). No hematological toxicity or serious adverse reactions occurred during the study period. This real-world study demonstrates that TCM may be a potentially beneficial therapy for old ACRC patients, including when the ECOG performance status score is 2-3.

Effectiveness of Acupuncture in Relieving Chemotherapy-induced Leukopenia in Patients With Breast Cancer: A Systematic Review With A Meta-Analysis and Trial Sequential Analysis

Background:

Breast cancer is one of the most common cancers and a major cause of death in women worldwide. Chemotherapy is mainly used to treat and control the progression of breast cancer. Leukopenia is the most common side effect of chemotherapy which may decrease immune function and further lead to serious fatal infections. The purpose of this study was to evaluate the effect of acupuncture on regulating hematopoietic function in chemotherapy-induced leukopenia among patients with breast cancer.

Methods:

PubMed, Embase, Cochrane Library, CINAHL Plus, Web of Science, and Chinese articles in the Airiti Library and China National Knowledge Infrastructure (CNKI) databases were searched to August 2021 for papers to include in a systematic review and meta-analysis. A random-effects model was applied. The effect size was calculated by Hedges’ g. Heterogeneity was determined using Cochran’s Q test. Moderator analyses were performed to examine potential sources of heterogeneity. A trial sequential analysis (TSA) was conducted to determine whether the current sample size was sufficient.

Results:

Ten randomized controlled trials involving 650 participants were eligible for inclusion. Analysis by the random-effects model showed a significant effect by acupuncture of ameliorating leukopenia during chemotherapy. Levels of white blood cells (WBCs) were increased (Hedges’ g = 0.70, P < .001, I² = 34%), neutrophil counts (Hedges’ g = 0.80, P < .001, I² = 0%) were significantly enhanced. Moreover, regardless of the manner through which acupuncture was applied, overall values of WBCs increased.

Conclusions:

The current meta-analysis supports acupuncture possibly ameliorating chemotherapy-induced leukopenia, as WBC and neutrophil values significantly increased after acupuncture in patients undergoing chemotherapy. Additionally, regardless of the type of acupuncture, values of WBCs increased. These findings are actionable and support both the clinical use of acupuncture to relieve chemotherapy-induced leukopenia and further research regarding the use of acupuncture in patients experiencing immunosuppression when undergoing chemotherapy.

Trial Registration: PROSPERO-CRD42020215759.