Chinese herbal medicines for esophageal cancer

Background Esophageal cancer is the seventh leading cause of cancer death worldwide. Traditional Chinese herbal medicines are sometimes used as an adjunct to radiotherapy or chemotherapy for this type of cancer. Objectives To assess the efficacy and possible adverse effects of the addition of Chinese herbal medicines to treatment with radiotherapy or chemotherapy for esophageal cancer. Selection criteria We searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Trials Register, The Cochrane Library, MEDLINE, EMBASE, AMED(Allied and Complementary Medicine Database), CBM(Chinese Biomedical Database), China National Knowledge Infrastructure, the Chinese Cochrane Centre Controlled Trials Register and CISCOM (The Research Council for Complementary Medicine) (up to 10 July, 2008). Databases of ongoing trials, the Internet and reference lists were also searched. Selection criteria Randomised controlled trials comparing the use of radiotherapy or chemotherapy with and without the addition of Chinese herbal medicines. Data collection and analysis At least two review authors extracted data and assessed trial quality. Main results We identified 43 trials which claimed to use random allocation. The first authors of all the RCTs we initially identified were contacted by telephone and we discovered that the authors had misunderstood the randomisation procedure. Using this new information, we reassigned all the identified RCTs as non-randomised trials. Because we identified no authentic randomised controlled trials, we were unable to perform a meta-analysis. Authors' conclusions We were unable to find any evidence from RCTs on the effectiveness of TCM in the treatment of esophageal cancer. New trials should be carried out and we recommend that they are large scaled, correctly randomised and that the assessors of the results are blinded to the conditions of allocation.