The efficacy of acupoint stimulation for the management of therapy-related adverse events in patients with breast cancer: a systematic review

Abstract

The aim of the present study was to scrutinize the evidence on the use of acupoint stimulation for managing therapy-related adverse events in breast cancer. A comprehensive search was conducted on eight English and Chinese databases to identify clinical trials designed to examine the efficacy of acupressure, acupuncture, or acupoint stimulation (APS) for the management of adverse events due to treatments of breast cancer. Methodological quality of the trials was assessed using a modified Jadad scale. Using pre-determined keywords, 843 possibly relevant titles were identified. Eventually 26 papers, 18 in English and eight in Chinese, satisfied the inclusion criteria and entered the quality assessment stage. The 26 articles were published between 1999 and 2008. They assessed the application of acupoint stimulation on six disparate conditions related to anticancer therapies including vasomotor syndrome, chemotherapy-induced nausea and vomiting, lymphedema, post-operation pain, aromatase inhibitors-related joint pain and leukopenia. Modalities of acupoint stimulation used included traditional acupuncture, acupressure, electroacupuncture, and the use of magnetic device on acupuncture points. Overall, 23 trials (88%) reported positive outcomes on at least one of the conditions examined. However, only nine trials (35%) were of high quality; they had a modified Jadad score of 3 or above. Three high quality trials revealed that acupoint stimulation on P6 (NeiGuang) was beneficial to chemotherapy-induced nausea and vomiting. For other adverse events, the quality of many of the trials identified was poor; no conclusive remarks can be made. Very few minor adverse events were observed, and only in five trials. APS, in particular acupressure on the P6 acupoint, appears beneficial in the management of chemotherapy-induced nausea and vomiting, especially in the acute phase. More well-designed trials using rigorous methodology are required to evaluate the effectiveness of acupoint stimulation interventions on managing other distress symptoms.

Effectiveness of acupuncture and related therapies for palliative care of cancer: overview of systematic reviews

“…However, no statistical differences were found in the response rates of acupuncture and related therapies and those of conventional analgesic treatment (pooled RR, 1.12; 95% CI, 0.98 to 1.28). No significant difference was seen in the pain score Meta-analysis was not conducted in the other SRs [6][7][8]13,21,27,32 (Tables 5-7 and Appendix 4). Three SRs 8,21,27 (Tables 5 and 7 and Appendix 4) identified one RCT with a low RoB and mentioned that auricular acupuncture provided statistically significant relief on CRP when compared with sham acupuncture.…”

“…Sixteen SRs summarised the evidence on a single outcome, including CRP 8,13,21,22,26,27 , fatigue 9,24,31 , hot flashes 17,18 , chemotherapy-induced nausea and vomiting (CINV) 14,20 , hiccups 29 and irradiation-induced xerostomia 19 . The remaining seven SRs 6,7,12,20,28,30,32 reported evidence on a wide range of outcomes in the palliative care of patients with cancer. The characteristics of these SRs can be found in Tables 1-3.…”

“…Cancer-related pain. Ten SRs [6][7][8]12,13,21,22,26,27,32 synthesised clinical evidence on the use of acupuncture and related therapies in the reduction of CRP, of which only two 22,26 conducted a meta-analysis (Table 7, Appendix 4). Zheng and colleagues 26 included five studies (395 patients) that evaluated the effectiveness of wrist-ankle acupuncture on the symptom improvement rate.…”

“…Five SRs 6,7,17,18,25 summarised evidence on acupuncture and related therapies for the treatment of hot flashes in patients with breast cancer 6,7,17 , prostate cancer 18 , or both 25 ( Tables 5 and 7 First author and year of publication and Appendix 4). Only one study 17 conducted a meta-analysis to compare acupuncture with sham acupuncture (Table 5 and Appendix 4).…”

Integrative Tumor Board: A Case Report and Discussion From East-West Cancer Center

“…31 Xerostomia induced by radiotherapy significantly improved with acupuncture. 32 High satisfaction was observed in reducing both chemotherapy-related nausea 33 and radiation-induced nausea when using acupressure bands.…”