Tai Chi for treating cancer-related fatigue: A meta-analysis of randomized controlled trials

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 I 2 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.