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A review of traditional Korean medical treatment for cancer-related cognitive impairment

Article information

J Korean Med. 2016;37(3):74-86
Publication date (electronic) : 2016 September 30
doi : https://doi.org/10.13048/jkm.16036
Hye-Yoon Lee, Jung-Eun Kim, Mikyung Kim, Joo-Hee Kim
Clinical Research Division, Korea Institute of Oriental Medicine
Correspondence to: 김주희 (Joo-Hee Kim), 대전시 유성구 유성대로 1672 한국한의학연구원 임상연구부, Tel: +82-42-223-4052, Fax: +82-42-223-2955, E-mail: jhkim714@kiom.re.kr
Received 2016 August 22; Revised 2016 September 19; Accepted 2016 September 29.

Abstract

Objectives

This article aims to review clinical studies related to traditional Korean medicine (TKM) for cancer-related cognitive impairment (CRCI) up to date.

Methods

EMBASE, Pubmed and eight Korean databases were searched for clinical studies about TKM for CRCI up to July 2016. We selected articles about subjects with cancer, using TKM interventions including acupuncture, moxibustion or herbal medicine, containing assessment about cognitive function.

Results

Two randomized controlled trials (RCTs) and one randomized controlled feasibility study were included. Selected studies were containing assessments about cognitive function but not as primary outcomes. The three studies included one acupuncture study and two herbal-medicine studies. Only one herbal-medicine study showed improvement in cognitive function.

Conclusions

Few clinical studies mainly focusing CRCI treated with TKM have been performed and have shown contradictory results until now. Future studies should be performed considering findings from pre-clinical and clinical studies altogether, and they should be controlled to minimize risk of bias thorough out overall courses of designing, conducting and reporting them.

Keywords: Cancer-related cognitive impairment; Chemotherapy-related cognitive impairment; traditional Korean medicine (TKM); acupuncture; herbal medicine
Fig. 1

Study flow diagram about traditional Korean medicine for cancer-related cognitive impairment

KM, Korean medicine; EA, electroacupuncture; CRCI, cancer-related cognitive impairment; RCT, randomized controlled trial

Fig. 2

Risk of bias graph about traditional Korean medicine for cancer-related cognitive impairment

Fig. 3

Risk of bias summary about traditional Korean medicine for cancer-related cognitive impairment

Characteristics of Included Studies (n=3)

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Fig. 1

Fig. 1

Study flow diagram about traditional Korean medicine for cancer-related cognitive impairment

KM, Korean medicine; EA, electroacupuncture; CRCI, cancer-related cognitive impairment; RCT, randomized controlled trial

Fig. 2

Fig. 2

Risk of bias graph about traditional Korean medicine for cancer-related cognitive impairment

Fig. 3

Fig. 3

Risk of bias summary about traditional Korean medicine for cancer-related cognitive impairment

Table 1

Characteristics of Included Studies (n=3)

Study ID Subjects; N (TG: CG); mean age (TG:CG); Intervention (sessions, duration) Assessment for cognitive function (time point) Result
ATX
Johnston 201135) Breast cancer survivors, Female, 18–65yrs old, BFI ≥4, Finished primary cancer therapy; N= 5:7; Mean age= 55.0:53.0yrs old; TG: usual care + Education with ATX
(50 min*8 sessions ATX; 50 min *4 sessions education; for 8 wks)
CG: usual care only (8 wks)		 FACT-COGv2
(Prior to beginning of Tx and after Tx ends. Up to an average of 44 wks)

  1. BFI: NS but clinically meaningful with ES 1.85

  2. FACT-COGv2: NS
HM
Chan 201134) Ovarian cancer, Female, ≥18yrs old, who need chemotherapy; N= 31:28; Mean age=52.9:51.5 yrs old; TG: standard CT + TCM herb powder CG: standard CT + placebo
(b.i.d., for 1st – 6th cycles of CT†)		 EORTC-cognition
(3rd cycle of CT and 4 wks after the 6th cycle)

  1. EORTC-QLQ-C30: NS between groups, both improved

  2. EORTC-cognition:

    • After 3 cycles: Worse in TG (−9.14±5.12) than CG (7.1±4.81). The change was significantly different*

    • After 6 cycles: NS in either group

  3. Immune function: total lymphocyte count maintained in TG only
Sun 201533) Stage IV Gastric cancer, Either sex, 18–90yrs old, KPS>30, expected survival >3mos; N=19:20; Mean age=NR; TG: CHD + Jinlongshe Granule
CG: CHD + placebo
(t.i.d., for ≥ 3 mos)		 EORTC-cognition
(3, 6, 9, 12 and 15 mos after Tx)

  1. EORTC-QLQ-C30: generally improved in TG** except dyspnea, diarrhea

  2. EORTC-cognition: improved in TG with F=7.103 (p=0.001)**

BFI, brief fatigue inventory; ATX, acupuncture; TG, treatment group; CG, control group; FACT-COGv2, functional assessment of cancer treatment cognitive scale V2; NS, not significant; ES, effect size; HM, herbal medicine; TCM, traditional Chinese medicine; CT, chemotherapy; b.i.d., twice a day; CHD, Chinese herbal decoctions; t.i.d., three-times a day; KPS, Karnofsky performance score; NR, not reported; Tx, treatment; EORTC-cognition, EORTC-QLQ-C30 cognitive function subscale;

*

, statistically significant (p<0.05);

**

, statistically significant (p<0.01);

†

CT, 3 weekly;