Methods: Systemic searches will perform on online databases (English and Chinese) to identify papers from inception until December 2019 for inclusion into the review. The search strategy will be following PRISMA Scoping Reviews Checklist as a quality assurance step. All records retrieved will be screened by 2 independent reviewers. The preclinical studies and clinical studies that involve in assessing the concurrent use of CHM and PtC will be considered. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used as scoping review framework.

Discussion: This scoping review will explore the compatibility or combination rule of CHM-PtC and assist in understanding HDI in CHM-PtC co-treatment. Identification of active properties in CHM's HDI and understanding pharmacokinetics and pharmacodynamic of the CHM alone or as co-treatment are essential for patients' safety profile. It will provide a new insight for future practice in cancer treatment.

METHODS: Systematic searches were conducted on 6 databases (English and Chinese). Studies published up till May 2017 were considered for inclusion.

RESULTS: A final 14 RCTs (total 994 head and neck cancer patients undergoing radiotherapy) compared Chinese herbs with no herbs, were included in analysis. Very low to moderate quality of evidence found Chinese herbal treatment may relief radiotherapy-induced xerostomia and other related complications (such as oral mucositis and loss of appetite) in head and neck cancer patients.

METHODS: Head and neck cancer patients were recruited from July 2016 till March 2017 at National Cancer Institute, Ministry of Health, Malaysia. All study participants continued their standard oncology surveillance. Treatment group participants additionally received Chinese herbal treatment. The assessments included unstimulated salivary flow rate (USFR), stimulated salivary flow rate (SSFR), and QoL questionnaire.

RESULTS: Of 42 recruited participants, 28 were in the treatment group and 14 were in the control group. Participants were mainly Chinese (71.4%), stage III cancer (40.5%), and had nasopharynx cancer (76.2%). The commonly used single herbs were Wu Mei, San Qi, and Tian Hua Fen. Sha Shen Mai Dong Tang, Liu Wei Di Huang Wan, and Gan Lu Yin were the frequently prescribed herbal formulas. The baseline characteristics, USFR, SSFR, and QoL between control and treatment groups were comparable (p > 0.05). USFR between control and treatment groups were similar throughout the 6-month study period. SSFR for the treatment group significantly improved from 0.15 ± 0.28 ml/min (baseline) to 0.32 ± 0.22 ml/min (p = 0.04; at the 3rd month) and subsequently achieved 0.46 ± 0.23 ml/min (p = 0.001; at the 6th month). The treatment group had better QoL in terms of speech (p = 0.005), eating (p = 0.02), and head and neck pain (p = 0.04) at the 6th month.