The Efficacy of Acupuncture in Chemotherapy-Induced Peripheral Neuropathy: Systematic Review and Meta-Analysis

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) has no cure, but acupuncture may provide relief through its known neuromodulation or neuroendocrine adjustment. This review aimed to assess the efficacy of acupuncture in treating CIPN. Method: A literature review following the PRISMA Statement was performed, searching 7 databases from inception through August 2019. All studies were clinical trials of the effect of acupuncture on CIPN. The methodological quality of these trials was assessed using Cochrane criteria; meta-analysis software (RevMan 5.2) was used to analyze the data. Data Sources: The databases searched were the following: MEDLINE (Ovid), Embase, Cochrane CENTRAL, Scopus, World Health Organization International Clinical Trials Registry Platform, CNKI (China National Knowledge Infrastructure), and Wanfang Med Online. Results: We examined 386 cancer patients from 6 randomized control trials, which had high quality, based on the modified Jadad scale. Meta-analysis showed that acupuncture led to significant improvements in pain scores (−1.21, 95% confidence interval [CI] = −1.61 to −0.82, P < .00001) and nervous system symptoms based on Functional Assessment of Cancer Therapy/Neurotoxicity questionnaire scores (−2.02, 95% CI = −2.21 to −1.84, P < .00001). No significant change was noted in nerve conduction velocity (1.58, 95% CI = −2.67 to 5.83, P = .47). Conclusion: Acupuncture can effectively relieve CIPN pain and functional limitation. The limited number of subjects warrants a larger scale study.

Effectiveness of Acupuncture Treatment on Chemotherapy-Induced Peripheral Neuropathy: A Pilot, Randomized, Assessor-Blinded, Controlled Trial

“…In addition to the magnitude of improvement, several other factors should also be considered when determining clinical significance, such as patient adherence, safety, and tolerability [ 41 ]. Consistent with our results, several recently published studies showed that acupuncture is safe and well tolerated [ 25 , 26 , 29 , 30 ]. Therefore, after considering these factors in addition to the improvement of the NRS, NCI-CTCAE scores, and NCS, our study provided encouraging results regarding the use of acupuncture for the treatment of CIPN.…”

Peripheral Neuropathy under Oncologic Therapies: A Literature Review on Pathogenetic Mechanisms

“…Antioxidants, vitamins A, B, and E, herbal medicines such as Goshajinkigan, acetyl-l-carnitine, Ca 2+ -Mg 2+ infusions, acupuncture, have been tested for the treatment of TIPN [ 15 , 147 ], but they failed to produce either neuroprotection or alleviation of symptoms [ 57 , 148 ]. Krukowski [ 148 ] showed that IL-10 can attenuate paclitaxel-induced CIPN.…”

“…Epothilones, in particular ixabepilone, are tubulin destabilizers like taxanes, binding preferentially to the beta III tubulin isotype. In the United States, FDA approved ixabepilone for the treatment of breast cancer not responding to other available chemotherapies [ 14 , 147 ], while in Europe this class of drugs didn’t received any approved clinical application. The prevalence of CIPN for ixabepilone has been estimated approximately 67%, with an incidence of severe CIPN from 1% in previously untreated patients to 24% in pretreated patients [ 14 ].…”

Research Trends of Acupuncture Therapy on Cancer Over the Past Two Decades: A Bibliometric Analysis

“… 29 A recent meta-analysis indicated that acupuncture could provide a relief in CIPN pain and functional limitation. 30 Besides, 2 clinical trials showed a reduction in the use of analgesics and improvement in the quality of life. 31 , 32 However, the efficacy and safety of acupuncture for CIPN should be tested by well-designed and high-quality reported randomized controlled study.…”