Supplementary file 1_Meridian-based traditional Chinese medicine interventions for supportive care in children, adolescents, and young adults with cancer: a systematic review and meta-analysis.docx

Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p>Results<p>Twelve RCTs involving 732 participants were included. Compared with sham controls, meridian-based TCM interventions did not significantly reduce nausea severity (SMD: −0.25; 95% CI: −0.78 to 0.28) or vomiting frequency (SMD: −0.37; 95% CI: −0.90 to 0.16).

When added to conventional antiemetic therapy, these interventions were associated with better control of nausea and vomiting than antiemetic therapy alone (OR: 0.26; 95% CI: 0.15 to 0.47). Evidence for fatigue and other supportive-care outcomes was limited and could only be synthesized narratively. The overall certainty of evidence was low because of methodological limitations, small sample sizes, and imprecision.</p>Conclusion<p>The available sham-controlled evidence was insufficient to determine whether meridian-based TCM interventions improve chemotherapy-induced nausea and vomiting in CAYAs with cancer.

Their addition to conventional antiemetic therapy may provide symptomatic benefit, but the certainty of evidence is low. Future trials should be adequately powered and, where feasible, use multicenter designs, credible sham controls, appropriate blinding, prespecified protocols, validated and standardized symptom measures, and longer follow-up.</p>Systematic Review Registration<p>crd.york.ac.uk/prospero/display_record.php?ID=CRD42024607724, identifier: CRD42024607724.</p>