SYSTEMATIC REVIEW article

Front. Oncol.

Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers

Efficacy of Traditional Chinese Medicine Combined with Chemotherapy for Gastric Cancer and Precancerous Gastric Lesions: A Systematic Review and Meta-Analysis

  • 1. First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China

  • 2. Anyang Tumor Hospital, Anyang, China

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Abstract

Background: Despite the advancements in therapeutic regimens, gastric cancer is still among the most concerning cancer-related public health problems. In previous literature, Traditional Chinese Medicine (TCM) proved to be an effective treatment strategy for reducing the side effects of chemotherapy and improving the quality of life among patients with gastric cancer or precancerous gastric lesions. Objectives: To analyze the efficacy of TCM combined with chemotherapy in individuals with gastric cancer and precancerous gastric lesions. Methods: PubMed, Cochrane Library, and Embase electronic databases were utilized to perform predefined search criteria for the identification and selection of studies based on eligibility criteria. The assessed outcomes include complete response rates (CRR), disease control rate (DCR), symptom scores, and quality of life (QoL), while the secondary outcomes include immune function, tumor markers, clinical symptom scores, and gastrointestinal adverse events. Random effect models were used to perform statistical tests (SMD: standardized mean difference, OR: odds ratio) with 95% confidence intervals and heterogeneity through I2 statistics. Publication bias was evaluated using funnel plots and tests like Egger's regression or Begg's correlation. Results: A total five studies reporting diverse outcomes were included in this meta-analysis. The SMD analysis for primary outcomes reported 0.35 [-0.66; 1.35] with considerable heterogeneity (I2 = 89.7%) while the CRR indicated remarkable improvement for combined therapy with OR of 4.20 [1.20; 14.71] and no heterogeneity. SMD analysis for QoL outcomes was also considerably high at 0.82 [-0.07; 1.81] with I2 = 80.0%. TCM combination group showed a significant difference in event rate with OR of 0.42 [0.32; 0.54], while the detailed analysis for symptom score of pooled -0.35 SMD [-0.76; 0.77] was obtained for fatigue, pain, acid reflux, nausea &vomiting, diarrhea. The publication bias assessment revealed significant asymmetry. Conclusion: The incorporation of TCM combined with chemotherapy for gastric cancer proved to be a safe and more effective treatment as the drug side effects were completely eradicated. The combination therapy has shown overall effectiveness with primary and secondary patient-reported outcomes, improving quality of life in gastric cancer individuals.

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Keywords

chemotherapy, gastric cancer, Precancerous lesions, Quality of Life, TCM, Traditional Chinese Medicine, Tumor response rate

Received

06 January 2026

Accepted

20 February 2026

Copyright

© 2026 Liang, Yang, Yuan, Zhang and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Yuling Zheng

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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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