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. 2025 Jul 12;16(1):1322.
doi: 10.1007/s12672-025-03120-y.

Efficacy of astragalus polysaccharides (PG2) in alleviating chemotherapy-induced fatigue in gynecologic cancer: a retrospective cohort study

Chia-Ching Chang  1   2 , Yi-Liang Lee  1   2   3 , Chih-Hsiang Yin  1   2 , Cheng-Chang Chang  4   5   6   7 , Yi-Hsin Lin  8   9
Affiliations

Efficacy of astragalus polysaccharides (PG2) in alleviating chemotherapy-induced fatigue in gynecologic cancer: a retrospective cohort study

Chia-Ching Chang et al. Discov Oncol. .

Abstract

Background: Cancer related fatigue (CRF) is a common and debilitating side effect among gynecologic cancer patients undergoing chemotherapy. Astragalus polysaccharides (PG2), an immunomodulatory drug, has shown promise in relieving CRF. This study aimed to evaluate the effectiveness of PG2 in managing CRF in gynecologic cancer patients.

Methods: This retrospective cohort study was performed at the Department of Obstetrics & Gynecology, Tri-Service General Hospital from December 2015 to December 2022. Of 53 patients included, 40 received PG2 with chemotherapy, while 13 received chemotherapy alone. Outcomes included CRF severity and HRQL, assessed via Brief Fatigue Inventory (BFI) and Functional Assessment of Cancer Therapy-General 7 (FACT-G7), plus safety profiles.

Results: PG2-treated patients showed a statistically significant reduction in CRF severity, as reflected by lower BFI (p < 0.001). The PG2 group showed trends toward improved HRQL and reduced appetite loss, though not statistically significant (p > 0.05). PG2's safety profile aligned with the control group, showing no increase in grade 3/4 toxicities.

Conclusion: The study concludes that PG2 shows promise as an adjunct therapy in the management of CRF among patients with gynecologic cancer receiving chemotherapy. However, the findings highlight the need for additional prospective, randomized controlled trials to rule out the risk of bias and ascertain PG2's full therapeutic potential in oncology supportive care.

Keywords: Astragalus polysaccharides; Cancer-related fatigue; Chemotherapy; Gynecologic cancer; PG2; Quality of life.

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Conflict of interest statement

Declarations. Ethics approval: All procedures involving human participants performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study received approval from the Institutional Review Board of Tri-Service General Hospital (IRB No 2-105-05-088). Informed consent: Informed consents (Consent to Participate and Consent to Publish) were obtained from all participants in this study. Competing Interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Linear mixed model analysis of the longitudinal changes in BFI fatigue scores over time. a Fatigue global score. b Fatigue intensity. c Fatigue interference. BFI brief fatigue inventory, β beta regression coefficient for cycle * group. *P value < 0.05 ~ 0.01; **P value < 0.001
Fig. 2
Fig. 2
Linear mixed model analysis of the longitudinal changes in FACT-G7 scores over time. a FACT-G7 total, b physical well-being, c functional well-being, d emotional well-being. β beta regression coefficient for cycle * group
See this image and copyright information in PMC

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