Hoshino, N., Ganeko, R., Hida, K., & Sakai, Y. (2018). Goshajinkigan for reducing chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis. International Journal of Clinical Oncology, 23, 434–442.

STUDY PURPOSE: To evaluate the efficacy and safety of Goshajinkigan for prevention of CIPN

TYPE OF STUDY: Meta analysis and systematic review

DATABASES USED: SCOPUS, Ovid, Medline, Cochrane Central Register of Controlled Trials, ICHUSHI, Google Scholar 

YEARS INCLUDED: Not specified

INCLUSION CRITERIA: Randomized controlled trials, cluster-randomized, crossover, and quasi-randomized trials evaluating goshajinigan for CIPN; studies needed to include adult patients (aged 18 years or older) receiving hospital-based chemotherapy

EXCLUSION CRITERIA: Articles that did not meet this criteria

TOTAL REFERENCES RETRIEVED: 1,345 originally; 9 selected for full-text review; 5 included in the final analysis

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Potential biases were evaluated for each study using methods described in the Cochrane Handbook for Systematic Reviews of Interventions

FINAL NUMBER STUDIES INCLUDED: 5

TOTAL PATIENTS INCLUDED IN REVIEW: 386

SAMPLE RANGE ACROSS STUDIES: 10-182

KEY SAMPLE CHARACTERISTICS: Three of the studies were in colorectal cancer and two in breast cancer; three focused on oxaliplatin, one on paclitaxel, and one on docetaxel; two studies did not include a comparison, two compared goshajinigan to placebo, and one compared goshajinigan to Vitamin B12

PHASE OF CARE: Active anti-tumor treatment

Goshajinkigan did not reduce the incidence of grade 2 or 3 CIPN in studies that reported CTCAE results.

The article reports trends toward decreased risk of developing grade 2 or 3 CIPN in studies using neurotoxicity criteria of debiopharm; however, these findings were not statistically significant. 

No severe adverse events seen with Goshajinkigan.

Goshajinkigan did not influence the response to chemotherapy.

This article does not provide evidence to support the use of Goshajinkigan for prevention of CIPN

• Limited number of studies included
• Mostly low quality/high risk of bias studies   
• High heterogeneity
• Low sample sizes

Based on this meta-analysis, Goshajinkigan should not be recommended to patients. Further study, using rigorous, randomized, double blinded methods and large sample sizes are needed.