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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
Tai Chi for treating cancer-related fatigue: A meta-analysis of randomized controlled trials
Chang Qiao, Xiao-Hui Zhao, Yue-Chuan Jiao, Hao-Wei Li, Na Guo, Li-Ying Wei, Zheng-Rong Wang, Guo-Lei Li, De-Hui Li
Chang Qiao, Xiao-Hui Zhao, Yue-Chuan Jiao, Hao-Wei Li, Graduate School, Hebei University of Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
Na Guo, Li-Ying Wei, Zheng-Rong Wang, Department of Oncology II, The First Affiliated Hospital of Hebei University of Chinese Medicine (Hebei Province Hospital of Chinese Medicine), Shijiazhuang 050000, Hebei Province, China
Guo-Lei Li, Department of General Surgery, Hebei Provincial Hospital of Chinese Medicine, Shijiazhuang 050011, Hebei Province, China
De-Hui Li, Department of Oncology II, The First Affiliated Hospital of Hebei University of Chinese Medicine (Hebei Province Hospital of Chinese Medicine), Key Laboratory of Integrated Chinese and Western Medicine for Gastroenterology Research, Hebei Industrial Technology Institute for Traditional Chinese Medicine Preparation, Shijiazhuang 050000, Hebei Province, China
Co-first authors: Chang Qiao and Xiao-Hui Zhao.
Co-corresponding authors: Guo-Lei Li and De-Hui Li.
Author contributions: Qiao C and Zhao XH participated in the study design, data collection, and analysis; Jiao YC and Li HW performed the data analysis; Guo N, Wei LY, Wang ZR, Li GL, and Li DH revised the manuscript; Li GL and Li DH played important and indispensable roles in the manuscript preparation as the co-corresponding authors; all authors read and approved the final manuscript.
Supported by 2023 Government-Funded Project of the Outstanding Talents Training Program in Clinical Medicine, No. ZF2023165; Key Research and Development Projects of Hebei Province, No. 18277731D; Natural Science Foundation of Hebei Province, No. H202423105; Hebei Provincial Administration of Traditional Chinese Medicine, Scientific Research Project, No. 2023045 and No. 2024023; Hebei Institute of Traditional Chinese Medicine Pharmaceutical Preparation Industry Technology Special Project, No. YJY2024006; and Scientific Research Project of Health Commission of Hebei Province, No. 20220962 and No. 20240282.
Conflict-of-interest statement: The authors do not have any conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: De-Hui Li, MD, Department of Oncology II, The First Affiliated Hospital of Hebei University of Chinese Medicine (Hebei Province Hospital of Chinese Medicine), Key Laboratory of Integrated Chinese and Western Medicine for Gastroenterology Research, Hebei Industrial Technology Institute for Traditional Chinese Medicine Preparation, No. 389 Zhongshan East Road, Chang'an District, Shijiazhuang 050000, Hebei Province, China.
258289951@qq.com
Received: April 30, 2025
Revised: June 6, 2025
Accepted: September 19, 2025
Published online: March 20, 2026
Processing time: 286 Days and 11 Hours
BACKGROUND
Cancer-related fatigue (CRF) lacks effective pharmacological treatment, with the available options in Western medicine often having limited efficacy and adverse effects. Tai Chi, a traditional Chinese exercise, shows promise in improving CRF.
AIM
To evaluate the clinical efficacy of Tai Chi in alleviating CRF.
METHODS
In this meta-analysis, we reviewed 9 randomized controlled trials (RCTs) retrieved from databases such as PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and the Chinese Biomedical Literature Database, and published before March 31, 2025. The experimental groups received conventional treatment plus Tai Chi, and the control groups received conventional treatment only, with varying durations. Using random-effects models, we calculated standardized mean differences (SMD) and mean differences with 95% confidence intervals (CI) to assess the effects of CRF. Heterogeneity was evaluated through I2 statistics. To assess the robustness of the pooled results, we performed leave-one-out sensitivity analysis by sequentially excluding each study and reconducting the meta-analysis. Publication bias was evaluated through funnel plot inspection, supplemented by quantitative assessments using the trim-and-fill method and Egger’s test.
RESULTS
This study conducted a systematic review and meta-analysis of 9 RCTs (n = 659 cancer patients) and found that Tai Chi significantly improved CRF, enhanced sleep quality, and increased quality of life, with a favorable safety profile. The research provides evidence-based medical support for promoting Tai Chi as an adjunctive therapy for CRF.
CONCLUSION
Results analysis based on the GRADE assessment indicated that Tai Chi significantly alleviated fatigue symptoms in cancer patients (moderate-certainty evidence, SMD = -1.29, 95%CI: -1.72 to -0.85, P < 0.00001), improved sleep quality (moderate-certainty evidence, SMD = -0.45, 95%CI: -0.78 to -0.12, P = 0.007), and enhanced quality of life (low-certainty evidence, SMD = 0.70, 95%CI: 0.23 to 1.16, P = 0.003), suggesting that Tai Chi can serve as an effective adjuvant intervention for CRF.
Core Tip: This meta-analysis offers moderate-certainty evidence indicating that Tai Chi is a safe and effective mind-body intervention for reducing cancer-related fatigue (CRF) and enhancing sleep quality in cancer patients. Potential benefits were also observed regarding quality of life; however, this finding is supported by low-certainty evidence. Overall, these results support the use of Tai Chi as a complementary therapy for alleviating CRF.
