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Integrated Management of Cancer
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Integrated Management of Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 63358

Special Issue Editors

Prof. Dr. Mustafa B. A. Djamgoz

E-Mail Website
Guest Editor
Department of Life Sciences, Neuroscience Solutions to Cancer Research Group, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ, UK
Interests: metastasis; epigenetics; ion channels; pH; diet; nutraceuticals; growth factors; bioelectricity
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Omer Kucuk

E-Mail Website
Guest Editor
1. Departments of Hematology-Oncology and Urology, Emory University School of Medicine, Atlanta, GA, USA
2. Winship Cancer Institute, Emory University, Atlanta, GA, USA
Interests: soy isoflavones; botanicals; nutrition and cancer; integrative oncology; prostate cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Whilst new modalities are steadily being introduced for the treatment of cancer, the global incidence of cases continues to rise, and many problems remain in the clinical management of the disease. Increasing evidence suggests that integrated management possibly offers the best chance of an effective outcome. Fueled by epigenetics, this is the central theme of this Special Issue of Cancers. “Integrated management” takes various forms. Most commonly, it represents the combination of clinical oncology with complementary medicine. The latter includes dietary factors, nutraceuticals, lifestyle issues, and Traditional Chinese Medicine. Unfortunately, ‘complementary medicine’ often suffers from insufficient evidence. Even when specific complementary agents have been tested by themselves there is often much less information on how a given agent might combine with conventional treatment such as chemotherapy. Thus, we shall pay particular attention to the quality of the available evidence, ideally from well-designed clinical trials. Meta-analyses will also be welcome. More broadly, the remit of the SI also includes combination treatments, repurposed drugs, and insights from emerging areas like artificial intelligence and cancer neuroscience. As Guest Editors and in the tradition of Cancers, we promise rapid and fair review. We welcome pre-publication inquiries from prospective authors.

Prof. Dr. Mustafa B. A. Djamgoz
Prof. Dr. Omer Kucuk
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • complementary medicine
  • epigenetics
  • diet
  • nutraceuticals
  • lifestyle
  • chemotherapy
  • radiotherapy
  • biological therapies
  • immunotherapy
  • nanotechnology
  • stem cells
  • repurposed drugs
  • combination treatments

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Published Papers (13 papers)

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25 pages, 727 KiB  
Review
Evidence for Choosing Qigong as an Integrated Intervention in Cancer Care: An Umbrella Review
by Ketti Mazzocco, Alessandra Milani, Chiara Ciccarelli, Chiara Marzorati and Gabriella Pravettoni
Cancers 2023, 15(4), 1176; https://doi.org/10.3390/cancers15041176 - 12 Feb 2023
Cited by 5 | Viewed by 3383
Abstract
Cancer is the second leading cause of noncommunicable disease death, with an increasing incidence. Qigong practice can moderate non-intrinsic, modifiable risk factors that act on the stress response using physical movements, breathing, and focused attention. The purpose of this umbrella review is to [...] Read more.
Cancer is the second leading cause of noncommunicable disease death, with an increasing incidence. Qigong practice can moderate non-intrinsic, modifiable risk factors that act on the stress response using physical movements, breathing, and focused attention. The purpose of this umbrella review is to provide a concise summary to facilitate an evidence-based decision to integrate Qigong into cancer patients’ care. Relevant systematic reviews and meta-analyses were identified and retrieved from the JBI database, Cochrane Library, PubMed, Embase, and CINAHL. Of all of the studies assessed, none found evidence of a risk to cancer patients, indicating that Qigong is a safe practice that can be used even by frail patients. The overall quality of life, cancer-related fatigue, and cognitive impairment were improved by Qigong. Different Qigong programs have different impacts on sleep quality and gastrointestinal problems, suggesting that longer practice sessions are required to achieve improvements. To maintain Qigong’s effectiveness, an ordinary practice is essential, or such effectiveness will wear off. The use of biological markers in efficacy assessments needs to be more systematically studied. However, positive WBC, RBC, and CRP trends in Qigong practitioners are evident. Higher-quality clinical studies are necessary to measure variables more closely related to Qigong functioning and consider cancer’s multifactorial nature. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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22 pages, 1496 KiB  
Review
Are Aspects of Integrative Concepts Helpful to Improve Pancreatic Cancer Therapy?
by Shiao Li Oei and Friedemann Schad
Cancers 2023, 15(4), 1116; https://doi.org/10.3390/cancers15041116 - 9 Feb 2023
Cited by 3 | Viewed by 2589
Abstract
Numerous clinical studies have been conducted to improve the outcomes of patients suffering from pancreatic cancer. Different approaches using targeted therapeutic strategies and precision medicine methods have been investigated, and synergies and further therapeutic advances may be achieved through combinations with integrative methods. [...] Read more.
Numerous clinical studies have been conducted to improve the outcomes of patients suffering from pancreatic cancer. Different approaches using targeted therapeutic strategies and precision medicine methods have been investigated, and synergies and further therapeutic advances may be achieved through combinations with integrative methods. For pancreatic tumors, a particular challenge is the presence of a microenvironment and a dense stroma, which is both a physical barrier to drug penetration and a complex entity being controlled by the immune system. Therefore, the state of immunological tolerance in the tumor microenvironment must be overcome, which is a considerable challenge. Integrative approaches, such as hyperthermia, percutaneous irreversible electroporation, intra-tumoral injections, phytotherapeutics, or vitamins, in combination with standard-oncological therapies, may potentially contribute to the control of pancreatic cancer. The combined application of standard-oncological and integrative methods is currently being studied in ongoing clinical trials. An actual overview is given here. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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23 pages, 669 KiB  
Review
Integrative Approaches to the Treatment of Cancer
by Kylie O’Brien, Karin Ried, Taufiq Binjemain and Avni Sali
Cancers 2022, 14(23), 5933; https://doi.org/10.3390/cancers14235933 - 30 Nov 2022
Cited by 11 | Viewed by 4994
Abstract
A significant proportion of cancer patients use forms of complementary medicine or therapies. An integrative approach to cancer management combines conventional medicine with evidence-based complementary medicines/therapies and lifestyle interventions, for the treatment and prevention of disease and the optimisation of health. Its basis [...] Read more.
A significant proportion of cancer patients use forms of complementary medicine or therapies. An integrative approach to cancer management combines conventional medicine with evidence-based complementary medicines/therapies and lifestyle interventions, for the treatment and prevention of disease and the optimisation of health. Its basis is a holistic one; to treat the whole person, not just the disease. It makes use of adjunct technologies which may assist the clinician in diagnosis of early carcinogenesis and monitoring of treatment effectiveness. Many factors contribute to the development of cancer including some which are largely modifiable by the patient and which oncologists may be in a position to advise on, such as stress, poor nutrition, lack of physical activity, poor sleep, and Vitamin D deficiency. An integrative approach to addressing these factors may contribute to better overall health of the patient and better outcomes. Evidence-based complementary medicine approaches include the use of supplements, herbal medicine, various practices that reduce stress, and physical therapies. Individualised to the patient, these can also help address the symptoms and signs associated with cancer and its orthodox treatment. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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15 pages, 695 KiB  
Review
Combinatorial Therapy of Cancer: Possible Advantages of Involving Modulators of Ionic Mechanisms
by Mustafa B. A. Djamgoz
Cancers 2022, 14(11), 2703; https://doi.org/10.3390/cancers14112703 - 30 May 2022
Cited by 17 | Viewed by 2688
Abstract
Cancer is a global health problem that 1 in 2–3 people can expect to experience during their lifetime. Several different modalities exist for cancer management, but all of these suffer from significant shortcomings in both diagnosis and therapy. Apart from developing completely new [...] Read more.
Cancer is a global health problem that 1 in 2–3 people can expect to experience during their lifetime. Several different modalities exist for cancer management, but all of these suffer from significant shortcomings in both diagnosis and therapy. Apart from developing completely new therapies, a viable way forward is to improve the efficacy of the existing modalities. One way is to combine these with each other or with other complementary approaches. An emerging latter approach is derived from ionic mechanisms, mainly ion channels and exchangers. We evaluate the evidence for this systematically for the main treatment methods: surgery, chemotherapy, radiotherapy and targeted therapies (including monoclonal antibodies, steroid hormones, tyrosine kinase inhibitors and immunotherapy). In surgery, the possible systemic use of local anesthetics to suppress subsequent relapse is still being discussed. For all the other methods, there is significant positive evidence for several cancers and a range of modulators of ionic mechanisms. This applies also to some of the undesirable side effects of the treatments. In chemotherapy, for example, there is evidence for co-treatment with modulators of the potassium channel (Kv11.1), pH regulation (sodium–hydrogen exchanger) and Na+-K+-ATPase (digoxin). Voltage-gated sodium channels, shown previously to promote metastasis, appear to be particularly useful for co-targeting with inhibitors of tyrosine kinases, especially epidermal growth factor. It is concluded that combining current orthodox treatment modalities with modulators of ionic mechanisms can produce beneficial effects including (i) making the treatment more effective, e.g., by lowering doses; (ii) avoiding the onset of resistance to therapy; (iii) reducing undesirable side effects. However, in many cases, prospective clinical trials are needed to put the findings firmly into clinical context. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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29 pages, 2833 KiB  
Review
Targeting Sphingolipid Metabolism as a Therapeutic Strategy in Cancer Treatment
by Alhaji H. Janneh and Besim Ogretmen
Cancers 2022, 14(9), 2183; https://doi.org/10.3390/cancers14092183 - 27 Apr 2022
Cited by 32 | Viewed by 6505
Abstract
Sphingolipids are bioactive molecules that have key roles in regulating tumor cell death and survival through, in part, the functional roles of ceramide accumulation and sphingosine-1-phosphate (S1P) production, respectively. Mechanistic studies using cell lines, mouse models, or human tumors have revealed crucial roles [...] Read more.
Sphingolipids are bioactive molecules that have key roles in regulating tumor cell death and survival through, in part, the functional roles of ceramide accumulation and sphingosine-1-phosphate (S1P) production, respectively. Mechanistic studies using cell lines, mouse models, or human tumors have revealed crucial roles of sphingolipid metabolic signaling in regulating tumor progression in response to anticancer therapy. Specifically, studies to understand ceramide and S1P production pathways with their downstream targets have provided novel therapeutic strategies for cancer treatment. In this review, we present recent evidence of the critical roles of sphingolipids and their metabolic enzymes in regulating tumor progression via mechanisms involving cell death or survival. The roles of S1P in enabling tumor growth/metastasis and conferring cancer resistance to existing therapeutics are also highlighted. Additionally, using the publicly available transcriptomic database, we assess the prognostic values of key sphingolipid enzymes on the overall survival of patients with different malignancies and present studies that highlight their clinical implications for anticancer treatment. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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18 pages, 343 KiB  
Review
Effects of Endocrine Therapy on Cognitive Function in Patients with Breast Cancer: A Comprehensive Review
by Lucy R. Haggstrom, Janette L. Vardy, Emma-Kate Carson, Davendra Segara, Elgene Lim and Belinda E. Kiely
Cancers 2022, 14(4), 920; https://doi.org/10.3390/cancers14040920 - 12 Feb 2022
Cited by 16 | Viewed by 5050
Abstract
Endocrine therapy forms the backbone of systemic therapy for the majority of persons with early and late-stage breast cancer. However, the side effects can negatively affect quality of life, and impact treatment adherence and overall oncological outcomes. Adverse effects on cognition are common, [...] Read more.
Endocrine therapy forms the backbone of systemic therapy for the majority of persons with early and late-stage breast cancer. However, the side effects can negatively affect quality of life, and impact treatment adherence and overall oncological outcomes. Adverse effects on cognition are common, underreported and challenging to manage. We aim to describe the nature, incidence, risk factors and underlying mechanisms of endocrine therapy-induced cognitive dysfunction. We conducted a comprehensive literature review of the studies reporting on cognitive dysfunction associated with endocrine therapies for breast cancer. We also summarise prevention and treatment strategies, and ongoing research. Given that patients are taking endocrine therapies for longer durations than ever before, it is essential that these side effects are managed pro-actively within a multi-disciplinary team in order to promote adherence to endocrine therapy and improve patients’ quality of life. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
24 pages, 727 KiB  
Review
Cannabidiol (CBD) in Cancer Management
by Kylie O’Brien
Cancers 2022, 14(4), 885; https://doi.org/10.3390/cancers14040885 - 10 Feb 2022
Cited by 35 | Viewed by 16267
Abstract
The plant Cannabis sativa has been in use medicinally for several thousand years. It has over 540 metabolites thought to be responsible for its therapeutic effects. Two of the key phytocannabinoids are cannabidiol (CBD) and tetrahydrocannabinol (THC). Unlike THC, CBD does not have [...] Read more.
The plant Cannabis sativa has been in use medicinally for several thousand years. It has over 540 metabolites thought to be responsible for its therapeutic effects. Two of the key phytocannabinoids are cannabidiol (CBD) and tetrahydrocannabinol (THC). Unlike THC, CBD does not have potentially intoxicating effects. Preclinical and clinical research indicates that CBD has a wide range of therapeutic effects, and many of them are relevant to the management of cancer. In this article, we explore some of the potential mechanisms of action of CBD in cancer, and evidence of its efficacy in the integrative management of cancer including the side effects associated with its treatment, demonstrating its potential for integration with orthodox cancer care. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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Other

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21 pages, 712 KiB  
Systematic Review
The Effects of Complementary Therapies on Patient-Reported Outcomes: An Overview of Recent Systematic Reviews in Oncology
by Marit Mentink, Daniëlle Verbeek, Janneke Noordman, Anja Timmer-Bonte, Ines von Rosenstiel and Sandra van Dulmen
Cancers 2023, 15(18), 4513; https://doi.org/10.3390/cancers15184513 - 11 Sep 2023
Cited by 2 | Viewed by 4538
Abstract
Many patients with cancer make use of complementary medicine alongside conventional medicine, but clinicians in oncology often lack the knowledge to adequately advise patients on the evidence base for complementary therapies. This study aims to provide an overview of recently published systematic reviews [...] Read more.
Many patients with cancer make use of complementary medicine alongside conventional medicine, but clinicians in oncology often lack the knowledge to adequately advise patients on the evidence base for complementary therapies. This study aims to provide an overview of recently published systematic reviews that assess the effects of complementary therapies on patient-reported health outcomes in patients with cancer. Systematic reviews, including a meta-analysis of at least two randomized controlled trials, were identified from the PubMed, Embase, Cochrane Library, CINAHL and PsycINFO databases. The methodological quality was assessed with AMSTAR 2. One hundred systematic reviews were included. The results suggest that several complementary therapies can improve health outcomes reported by patients with cancer, such as acupuncture to relieve pain, music interventions to reduce anxiety and yoga to improve cancer-related fatigue. The side effects related to complementary therapy use are generally mild. The results remain inconclusive for some intervention–outcome combinations. Many of the included systematic reviews insufficiently assessed the causes and impact of bias in their interpretation of the results. This overview of systematic reviews can support clinicians in counselling their patients on this topic and provide directions for future research and clinical practice guidelines in the field of complementary medicine. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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3 pages, 184 KiB  
Reply
Using Acupuncture for Adjunct Treatment for Cancer-Related Fatigue in Breast Cancer Patients Is Practicable. Reply to Hu et al. Is Acupuncture an Ideal Adjunctive Treatment for Cancer-Related Fatigue? Comment on “Choi et al. Acupuncture for Managing Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Cancers 2022, 14, 4419”
by Terje Alraek, Stephen Birch, Tae-Young Choi, Lin Ang, Ji Hee Jun, Weidong Lu and Myeong Soo Lee
Cancers 2023, 15(8), 2227; https://doi.org/10.3390/cancers15082227 - 10 Apr 2023
Cited by 1 | Viewed by 1405
Abstract
We are grateful for the relevant comments by Hu et al. [...] Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
20 pages, 756 KiB  
Systematic Review
Surgical Prehabilitation in Patients with Gastrointestinal Cancers: Impact of Unimodal and Multimodal Programs on Postoperative Outcomes and Prospects for New Therapeutic Strategies—A Systematic Review
by Julie Mareschal, Alexandra Hemmer, Jonathan Douissard, Yves Marc Dupertuis, Tinh-Hai Collet, Thibaud Koessler, Christian Toso, Frédéric Ris and Laurence Genton
Cancers 2023, 15(6), 1881; https://doi.org/10.3390/cancers15061881 - 21 Mar 2023
Cited by 16 | Viewed by 3129
Abstract
The advantages of prehabilitation in surgical oncology are unclear. This systematic review aims to (1) evaluate the latest evidence of preoperative prehabilitation interventions on postoperative outcomes after gastrointestinal (GI) cancer surgery and (2) discuss new potential therapeutic targets as part of prehabilitation. Randomized [...] Read more.
The advantages of prehabilitation in surgical oncology are unclear. This systematic review aims to (1) evaluate the latest evidence of preoperative prehabilitation interventions on postoperative outcomes after gastrointestinal (GI) cancer surgery and (2) discuss new potential therapeutic targets as part of prehabilitation. Randomized controlled trials published between January 2017 and August 2022 were identified through Medline. The population of interest was oncological patients undergoing GI surgery. Trials were considered if they evaluated prehabilitation interventions (nutrition, physical activity, probiotics and symbiotics, fecal microbiota transplantation, and ghrelin receptor agonists), alone or combined, on postoperative outcomes. Out of 1180 records initially identified, 15 studies were retained. Evidence for the benefits of unimodal interventions was limited. Preoperative multimodal programs, including nutrition and physical activity with or without psychological support, showed improvement in postoperative physical performance, muscle strength, and quality of life in patients with esophagogastric and colorectal cancers. However, there was no benefit for postoperative complications, hospital length of stay, hospital readmissions, and mortality. No trial evaluated the impact of fecal microbiota transplantation or oral ghrelin receptor agonists. Further studies are needed to confirm our findings, identify patients who are more likely to benefit from surgical prehabilitation, and harmonize interventions. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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3 pages, 183 KiB  
Comment
Is Acupuncture an Ideal Adjunctive Treatment for Cancer-Related Fatigue? Comment on Choi et al. Acupuncture for Managing Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Cancers 2022, 14, 4419
by Xiaoqian Hu, Beibei Feng, Jindong Xie, Xinpei Deng and Yutian Zou
Cancers 2023, 15(1), 223; https://doi.org/10.3390/cancers15010223 - 30 Dec 2022
Cited by 2 | Viewed by 1718
Abstract
We read with great interest the results of the systematic review and meta-analysis conducted by Choi et al. showing the beneficial effects of acupuncture (AT) on cancer-related fatigue (CRF) in patients with breast cancer that was published in your esteemed journal (Volume 14, [...] Read more.
We read with great interest the results of the systematic review and meta-analysis conducted by Choi et al. showing the beneficial effects of acupuncture (AT) on cancer-related fatigue (CRF) in patients with breast cancer that was published in your esteemed journal (Volume 14, Issue 18) and congratulate the authors [...] Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
14 pages, 1351 KiB  
Systematic Review
Acupuncture for Managing Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis
by Tae-Young Choi, Lin Ang, Ji Hee Jun, Terje Alraek, Stephen Birch, Weidong Lu and Myeong Soo Lee
Cancers 2022, 14(18), 4419; https://doi.org/10.3390/cancers14184419 - 11 Sep 2022
Cited by 19 | Viewed by 4385
Abstract
Breast cancer (BC) is the most common cancer in women and is a serious threat to women’s health. Cancer-related fatigue (CRF) is a distressing symptom in BC patients during and after chemotherapy or radiation therapy that severely affects quality of life (QoL). AT [...] Read more.
Breast cancer (BC) is the most common cancer in women and is a serious threat to women’s health. Cancer-related fatigue (CRF) is a distressing symptom in BC patients during and after chemotherapy or radiation therapy that severely affects quality of life (QoL). AT is widely used for fatigue management. However, the effect of AT on CRF is still uncertain. This study aimed to evaluate the efficacy and safety of AT in the management of CRF in patients with BC. Eleven databases were searched through June 2022. Two researchers independently performed the database search, study selection, data extraction, and risk of bias assessment. Study selection was performed based on predefined Participants, Intervention, Comparators, Outcomes, Study design (PICOS) criteria, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed when reporting the results. A meta-analysis was performed according to the Cochrane systematic review method using RevMan 5.3. A total of 12 studies including a total of 1084 participants were included. The results showed that AT had a beneficial effect compared with sham AT (n = 256, SMD = −0.26, 95% CI [−0.51, −0.01], p = 0.04, I2 = 0%) and a long-term effect on fatigue score (n = 209, MD = −0.32, 95% CI [–0.59, −0.04], p = 0.02, I2 = 0%). Meta-analysis showed that AT had a beneficial effect compared with usual care (UC) on fatigue scores (n = 238, SMD = −0.39, 95% CI [−0.66 to −0.12], p = 0.005, I2 = 0%). Of the 12 articles, 3 articles were judged as having a low risk of bias in all domains and hence were of high quality. No serious adverse effects were identified. AT is an effective and safe treatment for CRF, and AT is more effective than sham AT or UC or wait-list control (WLC). Nevertheless, the methodological quality of most of these studies was low, and the included studies/sample sizes were small, so the ability to derive decisive implications was limited. Further research is needed to confirm these findings. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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14 pages, 1153 KiB  
Systematic Review
Acupuncture and Moxibustion for Cancer-Related Fatigue: An Overview of Systematic Reviews and Meta-Analysis
by Tae-Young Choi, Lin Ang, Ji Hee Jun, Terje Alraek and Myeong Soo Lee
Cancers 2022, 14(10), 2347; https://doi.org/10.3390/cancers14102347 - 10 May 2022
Cited by 12 | Viewed by 4011
Abstract
Although acupuncture (AT) is used in the treatment of CRF, the evidence from different systematic reviews (SRs) of AT has not yet been comprehensively evaluated. Moxibustion, which is a treatment method that is well established within Traditional East Asian Medicine, applies the heat [...] Read more.
Although acupuncture (AT) is used in the treatment of CRF, the evidence from different systematic reviews (SRs) of AT has not yet been comprehensively evaluated. Moxibustion, which is a treatment method that is well established within Traditional East Asian Medicine, applies the heat of burning herbs towards or onto special points on the skin. Commonly, the herb Artemisia vulgaris, is used. It has been used for palliative cancer care, as well as for CRF. The aim of this overview was to evaluate the efficacy of AT and moxibustion in the management of CRF. Eleven databases were searched through for studies that were published from their dates of inception to February 2022. The study selection, the data extraction, and the assessment were performed independently by two researchers. The methodological and report quality were assessed by using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. The evidence quality was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Fifteen SRs on AT (n = 10) and moxibustion (n = 5) treatments for CRF were included, and they include 169 randomized controlled trials and 14,392 participants. All of the SRs that were evaluated by the AMASTAR-2 had more than one deficiency, and so all of the SRs were rated as either low or critically low. For the GRADE, 18 outcomes were rated as very-low-quality evidence, 13 as low-quality evidence, 3 as moderate-quality evidence, and 0 as high-quality evidence. Most of the SRs reached the potential benefits of AT for CRF. No serious adverse effects were identified. In conclusion, the evidence suggests that, despite the advantages of AT in terms of the improvement in and the safety of the treatment of CRF, the methodological quality of most of these studies is low, which limits our ability to draw definitive meanings. Further research of high quality is needed in order to confirm these findings. Full article
(This article belongs to the Special Issue Integrated Management of Cancer)
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