06 Traditional Chinese Medicine In Pediatric Oncology A Systematic Review Of Clinical Studies Published In The Chinese Literature

Introduction: The use of traditional and complementary medicine in oncology has become increasingly prevalent. In Asian countries like China, Traditional Chinese Medicine (TCM) is commonly used as a supportive treatment though the overview of its clinical evidence is scarce. Based on the existing Chinese literature, this systematic review summarizes clinical studies of TCM use in pediatric oncology.Methods: A systematic search was conducted in six major Chinese biomedical databases for clinical studies (published before December 2018) of TCM therapies in pediatric patients (u226418 years) with cancer. Methodological quality of studies was assessed using the Jadad Scale.Results: Forty-three reports were included, comprising randomized controlled trials (n=23, 53.5%) and controlled clinical studies (n=27, 62.8%). Studies focused on children with leukemia (60.5%), neuroblastoma (11.6%), and heterogenous cancer diagnoses (23.3%). Methodological quality of most studies (n=25, 58.1%) was modest due to suboptimal reporting on randomization method or sample inclusion/criteria. Herbal medicine was the most common intervention, with a total of 147 herbs in 50 formulae reported. The most frequently reported endpoints were reduction in chemotherapy-induced adverse effects (n=33, 76.7%), such as nausea/vomiting and fatigue, as well as response/survival outcomes (n=17, 39.5%), and quality of life (n=9, 20.9%). The herbs with warm(45.0%) or cold(26.3%) nature were most frequently used and the top three flavors included sweet(62.0%), bitter( 36.7%) and acrid(23.0%). The herbs that have high affinity to spleen(51.9%), lung(40.2%) and stomach(37.1%) channels were the top three used herbs. Six acupoints and two auricular acupuncture points were identified in 7 (16.3%) studies. tConclusions: Preliminary evidence seems to support TCM as supportive therapy to alleviate treatment-related symptoms and improve health status in children with cancer. Reporting of clinical studies could be improved to synthesize more quality evidence and guide the use of TCM in pediatric oncology. Based on the categorized ingredients, association rules mining would be applied as future development to identify compatibility pattern.