Eighteen RCTs were included in the review (n=1,732).One trial had a Jadad score of 4, four a score of 3 and 13 a score of 2.
Traditional Chinese medicine was associated with significantly improved survival rate greater than one year (OR 2.51, 95% CI 1.74 to 3.60, p<0.00001; 12 RCTs) and greater than three years (OR 1.49, 95% CI 1.08 to 2.07, p=0.02; seven RCTs) compared with conventional cancer therapy alone. There was no significant effect for survival greater than five years.
Traditional Chinese medicine was associated with significantly greater immediate tumour response (OR 2.04, 95% CI 1.27 to 3.29, p=0.003; six RCTs), improved quality of life (OR 4.30, 95% CI 1.85 to 10.00, p=0.0007; two RCTs), lower risk of grade 2-4 oral mucositis (OR 0.38, 95% CI 0.24 to 0.59, p<0.0001; four RCTs) and grade 2-4 nausea and vomiting (OR 0.22, 95% CI 0.08 to 0.55, p=0.001; two RCTs) than conventional cancer therapy alone.
Traditional Chinese medicine had significantly greater positive effects on immuno-stimulation compared with conventional cancer therapy alone: mean T cell CD4 level was greater in the traditional Chinese medicine groups (SMD 1.31, 95% CI 0.99 to 1.63, p<0.00001; two RCTs); mean T cell CD4/CD8 ratio was in favour of traditional Chinese medicine (SMD 1.61, 95% CI 1.27 to 1.95, p<0.00001; three RCTs); and mean NK cell level was greater with traditional Chinese medicine (SMD 1.38, 95% CI 0.98 to 1.78, p<0.00001; two RCTs).
Statistical heterogeneity was not detected in any of the analyses.