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ObjectiveTo evaluate the effects of Physical Therapies (PTs) on improvement in psychosomatic symptoms and quality of life (QOL) in breast cancer patients.Data SourcesSeven databases (MEDLINE, EMBASE, Cochrane CENTRAL, China National Knowledge Infrastructure, Wangfang, VIP, and China Biology Medicine disc databases) were systematically searched from the database inception through May 18, 2021.Study SelectionRandomized controlled trials (RCTs) which compared acupuncture or exercise with a sham control or usual care for the treatment of aromatase inhibitors (AIs)-related psychosomatic symptoms and QOL.Data Extraction and SynthesisData were screened and extracted independently using predesigned forms. The quality of RCTs was assessed with the Cochrane Handbook for Systematic Reviews of Interventions. The effect size was calculated via random-effects modeling. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach.Main Outcomes and MeasuresThe score of pain was measured with BPI scale and Western Ontario and the McMaster Universities Index (WOMAC) scale. Emotional state was measured with Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS-A), and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). The QOL score was measured by self-reported measurements, including the Functional Assessment of Cancer Therapy-General (FACT-G) scale and 36-Item Short Form Survey (SF-36) scale.ResultsEleven RCTs (with 830 patients) were included in the systematic review, and data from 10 RCTs (with 798 patients) were used in the meta-analysis. Results showed acupuncture significantly reduced worst pain scores (P < 0.00001, I2 = 83.5%) [SMD = −0.81, 95% CI (−1.51, −0.11)], but the effect of exercise therapies was not significant in overall change in worst pain scores (P =0.006, I2 = 72.3%) [SMD = −0.30, 95% CI (−0.76, 0.16)]. Both acupuncture and exercise resulted in little to no difference in overall change in HADS-A subscale (P = 0.026I2 = 79.8%) [WMD = −0.21, 95% CI (−3.44, 3.03)], PSQI subscale (P = 0.488, I2 = 0%) [WMD = 0.98, 95% CI (−0.57, 2.53)], and FACIT-Fatigue subscale (P = 0.022I2 = 81.0%) [WMD = 1.6, 95% CI (−5.75, 8.94)]. Exercise (compared with usual care) was associated with improving overall change in health-related QOL (subscales of SF-36 tool) (P = 0, I2 = 72.1%) [WMD = 7.97, 95% CI (5.68, 10.25)] and cancer-specific QOL (subscales of FACT-G tool) (P = 0.304, I2 = 16%) [WMD = 1.16, 95% CI (0.34, 1.97)].Conclusions and RelevanceThis systematic review and meta-analysis suggested that based on moderate-level evidence, acupuncture was associated with significant reductions in pain intensity, and exercise might improve QOL in breast cancer patients treated with AIs. However, in psychosomatic symptoms such as anxiety, sleep disturbance, and fatigue, acupuncture and exercise training did not result in significant improvements.

Background: Traditional Chinese medicine (TCM) is widely integrated into cancer care in China. An overview in 2011 identified 2384 randomized and non-randomized controlled trials (RCTs, non-RCTs) on TCM for cancer published in the Chinese literature. This article summarizes updated evidence of RCTs on TCM for cancer care. Methods: We searched 4 main Chinese databases: China National Knowledge Infrastructure, Chinese Scientific Journal Database, SinoMed, and Wanfang. RCTs on TCM used in cancer care were analyzed in this bibliometric study. Results: Of 5834 RCTs (477 157 cancer patients), only 62 RCTs were indexed in MEDLINE. The top 3 cancers treated were lung, stomach, and breast cancer. About 4752 RCTs (81.45%) tested TCM combined with conventional treatment, and 1082 RCTs (18.55%) used TCM alone for treating symptoms and side-effects. Herbal medicine was the most frequently used TCM modality (5087 RCTs; 87.20%). The most frequently reported outcome was symptom improvement (3712 RCTs; 63.63%) followed by quality of life (2725 RCTs; 46.71%), and biomarkers (2384 RCTs; 40.86%). The majority of RCTs (4051; 69.44%) concluded there were beneficial effects using either TCM alone or TCM plus conventional treatment compared with conventional treatment. Conclusion: Substantial randomized trials demonstrated different types/stages of cancer were treated by various TCM modalities, alone or in combination with conventional medicine. Further evaluation on the effects and safety of TCM modalities focusing on outcomes such as quality of life is required.

Background Traditional Chinese medicine (TCM) has been widely integrated into cancer care in China. Since a review done in 2011, large numbers of randomised controlled trials (RCTs) have been published in the Chinese literature. We aimed to summarise the current evidence of relevant RCTs of TCM for cancer treatment to support further clinical practice and research. Methods The update was done in four main Chinese databases (China National Knowledge Infrastructure, Chinese Scientific Journal Database, SinoMed, and Wanfang Database) from their inception until June 18, 2017, to identify any RCTs using TCM. We bibliometrically analysed the included RCTs and the research directions of TCM for cancer treatment. Findings We included 5834 RCTs (involving 477 147 participants). Only 62 publications were indexed in MEDLINE. The main three cancers treated with TCM were lung cancer, stomach cancer, and breast cancer. 4752 RCTs (81·5%) used TCM combined with conventional treatment whereas 1082 RCTs (18·5%) used only TCM in treatment groups for symptoms and side-effects. Herbal medicine was the most frequently applied TCM therapy (5087 RCTs; 87·2%). The most frequently reported outcome was clinical symptom improvement (3712 RCTs; 63·6%) followed by quality of life (2725 RCTs; 46·7%) and biomarker indices (2384 RCTs; 40·9%). 1237 RCTs (21·2%) reported multiple indices to provide a composite outcome to measure cancer patients' general condition. 4051 RCTs (69·4%) concluded that in comparison with conventional treatment, TCM alone or combined with conventional treatment had a better effect in cancer care. Interpretation Substantial data showed that many different TCM treatments are being applied either as monotherapy for palliative treatment or in combination with conventional medicine for treatment. We need further comprehensive evaluation of the beneficial effects and safety of these TCM modalities, and we should focus on quality of life and explore why patients with cancer are taking TCM. Funding Key project of National Natural Science Foundation of China (81830115).