Non-Cochrane · intervention · PM42930516
Clinical Evidence of Orally Administered Herbal Preparations for Supportive Cancer Care: A PRISMA Systematic Review of Randomized Clinical Trials (1990-2026).
Moreno-Ponce Rebeca, Díaz-Llerenas Uriel, Hernández-Fuentes Gustavo A, et al. · Medical sciences (Basel, Switzerland) · 2026 · PubMed · doi:10.3390/medsci14060597
Findings
24 findings
| Population | ||||
|---|---|---|---|---|
| Gastrointestinal, breast or lung cancer | Gamiguibi-tang | Wait-list | Sleep quality (ISI) 2 weeks | MD -5.6 Very low Downgraded: risk of bias, imprecision 1 study · 30 participants |
| Gastrointestinal, breast or lung cancer | Gamiguibi-tang | Wait-list | Fatigue (BFI) 2 weeks | Mean change: −0.8 versus 0.0; p = 0.002; 95% CI NR Very low Downgraded: risk of bias, imprecision 1 study · 30 participants |
| Gastrointestinal, breast or lung cancer | Gamiguibi-tang | Wait-list | Adverse events 2 weeks | Mild dyspepsia was reported following treatment with Gamiguibi-tang. GRADE not reported 1 study · 30 participants |
| Lung cancer receiving cisplatin chemotherapy | Rikkunshito | No treatment crossover | Anorexia (caloric intake reduction) 14 days | percentage point difference -7 Very low Downgraded: risk of bias, imprecision 1 study · 31 participants |
| Lung cancer receiving cisplatin chemotherapy | Rikkunshito | No treatment crossover | Plasma acylated ghrelin recovery 14 days | Greater recovery by day 5 with Rikkunshito versus control; p = 0.025; 95% CI NR Very low Downgraded: risk of bias, imprecision, indirectness 1 study · 31 participants |
| Lung cancer receiving cisplatin chemotherapy | Rikkunshito | No treatment crossover | Adverse events 14 days | No clinically significant adverse events during the intervention period. GRADE not reported 1 study · 31 participants |
| Differentiated thyroid cancer receiving radioiodine | Holy basil tea | Control without placebo tea | Salivary gland function 4 days | Better preservation versus control; p < 0.05; numerical effect estimate and 95% CI NR Very low Downgraded: risk of bias, imprecision 1 study |
| Differentiated thyroid cancer receiving radioiodine | Holy basil tea | Control without placebo tea | Anxiety (STAI) 4 days | Significant reduction versus control; p < 0.05; numerical effect estimate and 95% CI NR Very low Downgraded: risk of bias, imprecision 1 study |
| Differentiated thyroid cancer receiving radioiodine | Holy basil tea | Control without placebo tea | Adverse events 4 days | Persistent nausea was observed in some participants receiving holy basil tea. GRADE not reported 1 study |
| Head and neck cancer with radiation-induced xerostomia | Alcea digitata and Malva sylvestris infusion | Artificial saliva | Adverse events 4 weeks | Mild nausea, gastric discomfort, and polyuria were reported. GRADE not reported 1 study |
| Head and neck cancer with radiation-induced xerostomia | Alcea digitata and Malva sylvestris infusion | Artificial saliva | Xerostomia and quality of life (EORTC QLQ-H&N35) 4 weeks | Significant improvement versus artificial saliva; p < 0.05; numerical effect estimate and 95% CI NR Very low Downgraded: risk of bias, imprecision 1 study |
| Colorectal cancer | Annona muricata aqueous leaf extract | Maltose placebo | Nutritional status 8 weeks | No statistically significant between-group difference; numerical effect estimate and 95% CI NR Very low Downgraded: risk of bias, imprecision 1 study · 28 participants |
| Colorectal cancer | Annona muricata aqueous leaf extract | Maltose placebo | Ex vivo cytotoxic activity 8 weeks | Greater cytotoxic activity in participant serum than with placebo; numerical effect estimate and 95% CI NR Very low Downgraded: risk of bias, imprecision, indirectness 1 study · 28 participants |
| Colorectal cancer | Annona muricata aqueous leaf extract | Maltose placebo | Adverse events 8 weeks | No clinically significant adverse events during the intervention period. GRADE not reported 1 study · 28 participants |
| Prostate cancer receiving pelvic radiotherapy | Malva sylvestris and Althaea digitata | Placebo infusion | Adverse events 5 weeks | Mild nausea and abdominal distension were reported. GRADE not reported 1 study |
| Prostate cancer receiving pelvic radiotherapy | Malva sylvestris and Althaea digitata | Placebo infusion | Anal burning (VAS) 5 weeks | MD -2.3 Very low Downgraded: risk of bias, imprecision 1 study |
| Prostate cancer receiving pelvic radiotherapy | Malva sylvestris and Althaea digitata | Placebo infusion | Diarrhea severity (RTOG grading) 5 weeks | Between-group difference in RTOG grading was not statistically significant; numerical effect estimate and 95% CI NR Very low Downgraded: risk of bias, imprecision 1 study |
| Gynecologic cancer with fatigue | Jing Si herbal tea | Placebo followed by delayed tea | Quality of life (FACT-G7) 3-week placebo comparison; 6 weeks total | No statistically significant between-group difference in improvement; numerical effect estimate and 95% CI NR Very low Downgraded: risk of bias, imprecision 1 study · 19 participants |
| Gynecologic cancer with fatigue | Jing Si herbal tea | Placebo followed by delayed tea | Fatigue (BFI-T) 3-week placebo comparison; 6 weeks total | No statistically significant between-group difference in improvement; numerical effect estimate and 95% CI NR Very low Downgraded: risk of bias, imprecision 1 study · 19 participants |
| Cancer survivors with fatigue | Renshen Yangrong Tang | Low-dose huangqi | Fatigue reduction of at least 2 points 6 weeks | A reduction of ≥2 points was reported in 90.2% versus 52.4% of participants. Very low Downgraded: risk of bias, imprecision 1 study · 83 participants |
| Cancer survivors with fatigue | Renshen Yangrong Tang | Low-dose huangqi | Fatigue (MDASI) 6 weeks | time-by-group interaction estimate -0.61 Very low Downgraded: risk of bias, imprecision 1 study · 83 participants |
| Cancer survivors with fatigue | Renshen Yangrong Tang | Low-dose huangqi | Adverse events 6 weeks | Intervention described as tolerable; comparative or long-term safety profile insufficiently reported. GRADE not reported 1 study · 83 participants |
| Cancer survivors with fatigue | Renshen Yangrong Tang | Low-dose huangqi | Fatigue (MDASI) 4 weeks | Cohen d 1.0 Very low Downgraded: risk of bias, imprecision 1 study · 83 participants |
| Cancer survivors with fatigue | Renshen Yangrong Tang | Low-dose huangqi | Functioning 6 weeks | Greater short-term improvement in functioning compared with low-dose huangqi control. GRADE not reported 1 study · 83 participants |
Included primary studies 8
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Heydarirad et al., 2017 Efficacy of a traditional Persian medicine preparation for radiation-induced xerostomia: a randomized, open-label, active-controlled trial. PMID:28494850 | 2017 | this review only | not stated | not extracted yet |
| Indrawati et al., 2017 The effect of an Annona muricata leaf extract on nutritional status and cytotoxicity in colorectal cancer: a randomized controlled trial. PMID:28582808 | 2017 | this review only | not stated | not extracted yet |
| Lee et al., 2018 Efficacy and Safety of the Traditional Herbal Medicine, Gamiguibi-tang, in Patients With Cancer-Related Sleep Disturbance: A Prospective,… PMID:29034740 | 2018 | this review only | not stated | not extracted yet |
| Li et al., 2025 The effect of Jing Si herbal tea on cancer-related fatigue in gynecologic cancer patients: A randomized controlled trial. PMID:41189208 | 2025 | this review only | not stated | not extracted yet |
| Moeini et al., 2018 The effect of the combination of Malva sylvestris L. and Althaea digitata Boiss. on prevention of acute radiation proctitis in patients… DOI:10.1016/j.hermed.2018.01.005 | 2018 | this review only | not stated | not extracted yet |
| Nomura et al., 2023 Benefits of basil tea for patients with differentiated thyroid cancer during radioiodine therapy: A randomized controlled trial. PMID:37829808 | 2023 | this review only | not stated | not extracted yet |
| Xu et al., 2020 A Phase II Randomized Controlled Trial of Renshen Yangrong Tang Herbal Extract Granules for Fatigue Reduction in Cancer Survivors. PMID:31668965 | 2020 | this review only | not stated | not extracted yet |
| Yoshiya et al., 2020 Prospective, randomized, cross-over pilot study of the effects of Rikkunshito, a Japanese traditional herbal medicine, on anorexia and… PMID:31428894 | 2020 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with a confirmed diagnosis of cancer; no restriction on age, sex, cancer type or stage | Patients with gastrointestinal, breast, lung, colorectal, prostate, head and neck, differentiated thyroid and gynecologic cancers, and cancer survivors (n=8 trials) |
| Intervention | Orally administered plant-based preparations originating from infusion, decoction or aqueous-extraction practices | Gamiguibi-tang (n=1); Rikkunshito (n=1); holy basil tea (n=1); Alcea digitata-Malva sylvestris infusion (n=1); Annona muricata leaf preparation (n=1); Malva sylvestris-Althaea digitata preparation (n=1); Jing Si herbal tea (n=1); Renshen Yangrong Tang (n=1) |
| Comparison | Not specified (any comparator in randomized trials) | Wait-list control; no-treatment crossover control; control without placebo tea; artificial saliva; maltose placebo capsule; placebo infusion; placebo delayed-treatment; low-dose huangqi active control |
| Outcomes | Clinical outcomes related to efficacy, safety, or both | Sleep quality, cancer-related fatigue, chemotherapy-induced anorexia, anxiety, salivary-gland function, xerostomia, quality of life, anal burning/diarrhea, nutritional status, ex vivo cytotoxicity, adverse events (each n=1 trial) |
| Study designs | Randomized clinical trials published in English, 1990 to 2026 | Randomized clinical trials (n=8) |
| Timing | Not specified | Intervention duration 4 days to 8 weeks |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Yes | Partial Yes | no |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: N/A | RCT: N/A | no |
| 12Impact of risk of bias on the pooled results | N/A | N/A | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | N/A | N/A | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | High | High | yes |