Treatment of Cancer-Related Fatigue with Ginseng: A Systematic Review and Meta-analysis

Abstract Cancer-related fatigue is one of the main problems in cancer patients. Physicians and cancer patients might seek complementary treatments to improve well- being since it is believed that ginseng has numerous beneficial effects. The main aim of this paper is to assess the effects of ginseng supplements to improve cancer-related fatigue in cancer patients. A systematic literature review was conducted using the Cochrane Library, MEDLINE, Embase, and Scopus from inspection until December 2018. Keywords and phrases are separated by the Boolean operator "AND". The keywords Ginseng "AND" fatigue "AND" cancer "AND" clinical trial" "randomized clinical trial" "OR" neoplasm in the title, abstract, or keywords of the mentioned websites were searched. All randomized controlled trials (RCTs) and quasi-randomized RCTs were included to compare the use of ginseng alone or with any alternative treatment or placebo in cancer patients. In total five RCTs comprising 347 individuals in the ginseng group and 336 individuals in the control group were included. There was a significant heterogeneity between studies (chi-squared Q = 152.29 (df = 4, p-value ≤ 0.001). Based on the proportion of total variance due to between-study variance, this heterogeneity was high (I2 = 97.4%). After pooling the data based on the random effect model, the authors observed that ginseng significantly improved fatigue compared to the control group (pooled SMD = 1.24; 95% CI: 0.05-2.42). This study suggests that ginseng can improve fatigue in cancer patient. However more well-designed randomized trials are needed.