Therapeutic potential of modified Yukgunja-tang (Liujunzi Decoction, Rikkunshito) as an adjuvant treatment for lung cancer: a systematic review and meta-analysis

TL;DR

This study reviews evidence that modified Yukgunja-tang, a traditional herbal formula, may improve lung cancer treatment outcomes and reduce side effects when used alongside standard therapies.

Contribution

The study provides a systematic review and meta-analysis of modified Yukgunja-tang as an adjuvant therapy for lung cancer.

Findings

Modified Yukgunja-tang improved objective response rate, disease control rate, and Karnofsky Performance Status in lung cancer patients.

The treatment enhanced immune markers and reduced tumor markers and adverse events like myelosuppression and gastrointestinal reactions.

Symptom relief was significantly better with modified Yukgunja-tang compared to standard therapy alone.

Abstract

Yukgunja-tang (YGJT), also known as Liujunzi Decoction or Rikkunshito, is a traditional East Asian herbal formula widely used to manage symptoms associated with cancer and chemotherapy. This study aimed to systematically evaluate the efficacy and safety of modified YGJT combined with standard antitumor therapy in patients with lung cancer.

A comprehensive search was conducted in 10 databases through March 2025. Randomized controlled trials comparing modified YGJT plus antitumor therapy versus antitumor therapy alone or placebo were included. Studies involving other herbal combinations or East Asian therapies were excluded. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. A random-effects model was used for meta-analysis.

Thirty-one trials involving 2,496 participants were included. Modified YGJT significantly improved the objective response rate (ORR; RR 1.69, 95% CI 1.41–2.04), disease control rate (DCR; RR 1.21, 95% CI 1.11–1.31), and Karnofsky Performance Status (KPS; RR 1.79, 95% CI 1.23–2.60; MD 8.62, 95% CI 3.86–13.38). Symptom relief was observed (RR 1.52, 95% CI 1.25–1.85; MD -10.87, 95% CI -12.51 to −9.22), along with improvements in immune markers (CD3+, CD4+, CD8+, CD4+/CD8+ ratio) and reductions in tumor markers (CEA, CYFRA 21-1, NSE, SCC, CA19-9) and adverse events (myelosuppression, leukopenia, gastrointestinal reactions).

Modified YGJT may offer clinical benefits as an adjuvant to standard lung cancer therapy by improving treatment outcomes and reducing toxicity. Large-scale, high-quality trials are needed to confirm these findings.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024619038, identifier CRD42024619038.

Title: Therapeutic Potential of Modified Yukgunja-Tang as Adjuvant Therapy for Lung Cancer. Background indicates Yukgunja-Tang may enhance treatment efficacy and reduce side effects. Methods involve searching major databases and conducting a meta-analysis. Eligibility criteria focus on lung cancer patients with specific treatments. Results from 31 studies with 2,496 patients show improved objective response rate, disease control rate, and clinical symptom scores with Modified YGJT and antitumor treatment compared to antitumor treatment alone. Additional indicators show improvements in immune function and reduced adverse effects.

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