A Survey of the Clinical Use of Kampo Medicines in Anticancer Drug Therapy and its Application to the Investigation of the Efficacy of Goshajinkigan in the Treatment of Chemotherapy-induced Peripheral Neuropathy

Kampo medicines are expected to treat adverse reactions to anticancer drug therapy; however, substantial objective clinical evidence is lacking. Aiming to generate foundational information that will contribute to the future active evaluation of the efficacy and promotion of the prescription of Kampo medicines, i) a detailed survey of the prescriptions of Kampo medicines was conducted for 2,158 patients aged 15 – 65 years who underwent anticancer drug therapy at Kumamoto University Hospital between January – December 2020. Kampo medicines were prescribed to 318 patients (2,121 prescriptions in total): Daikenchuto (123 patients; 1,019 prescriptions), Shakuyakukanzoto (59; 247), Goshajinkigan (39; 312), Hangeshashinto (34; 229), Rikkunshito (22; 106), Goreisan (15; 82), and others (26; 126). Goshajinkigan is most commonly prescribed for supportive care of patients with cancer. Unlike other Kampo medicines, Goshajinkigan tended to be prescribed in outpatient settings and was most frequently prescribed in the gynecology department (21 patients, 53.8％). Then, ii) the effect of Goshajinkigan on chemotherapy-induced peripheral neuropathy (CIPN) was retrospectively analyzed in 13 patients who were treated with paclitaxel/carboplatin therapy in gynecology from January 2017 to December 2021 and developed CIPN (CTCAE Grade ≥1). CIPN Grade was significantly lower after the administration of Goshajinkigan compared with that before (P = 0.020). In conclusion, we have clarified for the first time the actual prescription status of Kampo medicine for patients with various cancers. Furthermore, Goshajinkigan, which was the most commonly used Kampo medicine for supportive care in the above survey, was found to be effective for CIPN.