The safety and efficacy of using moxibustion and or acupuncture for cancer-related insomnia: a systematic review and meta-analysis of randomised controlled trials

Wang, Carol; Han, Ellen; Jenkins, Mark A.; Hong, Xuepei; Pang, Shuqin; Whitehead, Lisa; Walker, Deborah; Williams, Anne

doi:10.1177/26323524211070569

Cited by 8 publications

(6 citation statements)

References 46 publications

(161 reference statements)

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“…These results offer promise as they underscore a potentially viable approach to managing and treating fatigue and associated symptoms among cancer survivors. These results align well with a growing body of literature demonstrating the ability of acupuncture and moxibustion to help alleviate the fatigue [26,27] and insomnia [28,29] experienced by patients diagnosed with or recovering from cancer. Strikingly, ILM failed to significantly improve fatigue as compared to sham treatment at the end of the treatment interval despite exhibiting significant benefits at later follow-up time points, consistent with the results of another recent moxibustion trial [27].…”

Section: Discussionsupporting

confidence: 86%

Infrared laser moxibustion for cancer-related fatigue in breast cancer survivors: a randomized controlled trial

Mao,

Jin,

Xie

et al. 2024

Breast Cancer Res

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Background Cancer-related fatigue (CRF) is a pervasive, persistent, and distressing symptom experienced by cancer patients, for which few treatments are available. We investigated the efficacy and safety of infrared laser moxibustion (ILM) for improving fatigue in breast cancer survivors. Methods A three-arm, randomized, sham-controlled clinical trial (6-week intervention plus 12-week observational follow-up) was conducted at a tertiary hospital in Shanghai, China. The female breast cancer survivors with moderate to severe fatigue were randomized 2:2:1 to ILM (n = 56) sham ILM (n = 56), and Waitlist control (WLC)(n = 28) groups. Patients in the ILM and sham ILM (SILM) groups received real or sham ILM treatment, 2 sessions per week for 6 weeks, for a total of 12 sessions. The primary outcome was change in the Brief Fatigue Inventory (BFI) score from baseline to week 6 with follow-up until week 18 assessed in the intention-to-treat population. Results Between June 2018 and July 2021, 273 patients were assessed for eligibility, and 140 patients were finally enrolled and included in the intention-to-treat analysis. Compared with WLC, ILM reduced the average BFI score by 0.9 points (95% CI, 0.3 to 1.6, P = .007) from baseline to week 6, with a difference between the groups of 1.1 points (95% CI, 0.4 to 1.8, P = .002) at week 18. Compared with SILM, ILM treatment resulted in a non-significant reduction in the BFI score (0.4; 95% CI, -0.2 to 0.9, P = .206) from baseline to week 6, while the between-group difference was significant at week 18 (0.7; 95% CI, 0.2 to 1.3, P = .014). No serious adverse events were reported. Conclusion While ILM was found to be safe and to significantly reduce fatigue compared with WLC, its promising efficacy against the sham control needs to be verified in future adequately powered trials. Trial registration Clinicaltrials.gov: NCT04144309. Registered 12 June 2018.

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Section: Discussionsupporting

confidence: 86%

Infrared laser moxibustion for cancer-related fatigue in breast cancer survivors: a randomized controlled trial

Mao,

Jin,

Xie

et al. 2024

Breast Cancer Res

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“…Previous studies have shown that auricular acupuncture (AA) ( 9 ), scalp acupuncture (SA) ( 10 ), electro-acupuncture (EA) ( 11 ), and intradermal needling (IN) ( 12 ) might be more advantageous in treating CRI than WM, placebo-sham acupuncture (PSA), or routine care (RC). A systematic review ( 13 ) published in 2022 found that acupuncture and/or moxibustion have an affirmative effect on the treatment of CRI. Such treatment could be considered an adjuvant alternative to current CRI management.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture and moxibustion in patients with cancer-related insomnia: A systematic review and network meta-analysis

Dong

et al. 2023

Front. Psychiatry

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ObjectivesCancer-related insomnia (CRI) is one of the most common and serious symptoms in patients with cancer. Acupuncture and moxibustion have been widely applied in the treatment of CRI. Nevertheless, the comparative efficacy and safety of different acupuncture and moxibustion techniques remain unclear. This study aimed to evaluate and compare the efficacy and safety of different acupuncture and moxibustion techniques in the treatment of CRI.MethodsEight medical databases were comprehensively searched for relevant randomized controlled trials (RCTs) as of June 2022. Two independent reviewers assessed the risk of bias and conducted the research selection, data extraction, and quality assessment of the included RCTs. A network meta-analysis (NMA) was performed using frequency models, combining all available direct and indirect evidence from RCTs. The Pittsburgh Sleep Quality Index (PSQI) was set as the primary outcome, and adverse events and effective rates were set as the secondary outcomes. The efficacy rate was calculated as the ratio of patients with insomnia symptom relief to the total number of patients.ResultsThirty-one RCTs with 3,046 participants were included, including 16 acupuncture- and moxibustion-related therapies. Transcutaneous electrical acupoint stimulation [surface under the cumulative ranking curve (SUCRA) 85.7%] and acupuncture and moxibustion (SUCRA 79.1%) were more effective than Western medicine, routine care, and placebo-sham acupuncture. Furthermore, Western medicine showed significantly better effects than placebo-sham acupuncture. In the NMA, the acupuncture and moxibustion treatments with the best therapeutic effects for CRI were transcutaneous electrical acupoint stimulation (SUCRA 85.7%), acupuncture and moxibustion (SUCRA 79.1%), auricular acupuncture (SUCRA 62.9%), routine care combined with intradermal needling (SUCRA 55.0%), and intradermal needling alone (SUCRA 53.3%). No serious acupuncture- or moxibustion-related adverse events were reported in the included studies.ConclusionAcupuncture and moxibustion are effective and relatively safe in treating CRI. The relatively conservative recommended order of acupuncture- and moxibustion-related therapies for CRI is as follows: transcutaneous electrical acupoint stimulation, acupuncture and moxibustion, and auricular acupuncture. However, the methodological quality of the included studies was generally poor, and further high-quality RCTs are needed to strengthen the evidence base.

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“…Compared with previous meta-analyses (19,20,(24)(25)(26), this study carried out a more comprehensive retrieval, including more recently published trials, successfully updating the evidence. The previous meta-analysis encompassed some studies in which participants were not diagnosed with CRI, PSQI served merely as a secondary outcome, and the experimental groups included other non-pharmaceutical interventions.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of acupuncture therapy on cancer-related insomnia: a systematic review and network meta-analysis

Chen,

Li,

et al. 2024

Front. Neurol.

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ObjectivesCancer-related insomnia (CRI) takes a toll on many cancer survivors, causing distressing symptoms and deteriorating the quality of life. Acupuncture therapy has been used for CRI already. However, it is still uncertain which acupuncture regime is best for CRI. The primary objective of this review is to conduct a comparative evaluation and ranking of the effectiveness of different acupuncture therapies for CRI.MethodsRandomized controlled trials (RCTs) that were published up to July 31, 2023, from 8 databases (PubMed, Embase, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc) were integrated in this study. Trials that met the inclusion criteria were evaluated the risk of bias. Pittsburgh sleep quality index (PSQI) was used to assess the efficacy of different acupuncture therapies as the primary outcome. Then, STATA 15, R, and OpenBUGS were applied to perform the network meta-analysis. PRISMA statements were followed in this network meta-analysis.ResultsA total of 37 studies were included in this review, involving 16 interventions with 3,246 CRI participants. Auriculotherapy + moxibustion [surface under the cumulative ranking curve (SUCRA) 98.98%] and auriculotherapy (SUCRA 77.47%) came out top of the ranking, which were more effective than control, medicine, usual care and sham acupuncture.ConclusionAuriculotherapy + moxibustion and auriculotherapy + acupuncture emerged as the top two acupuncture regimes for CRI and future studies should pay more attention to CRI.Clinical trial registrationhttps://clinicaltrials.gov/, identifier INPLASY202210095.

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The safety and efficacy of using moxibustion and or acupuncture for cancer-related insomnia: a systematic review and meta-analysis of randomised controlled trials

Cited by 8 publications

References 46 publications

Infrared laser moxibustion for cancer-related fatigue in breast cancer survivors: a randomized controlled trial

Infrared laser moxibustion for cancer-related fatigue in breast cancer survivors: a randomized controlled trial

Acupuncture and moxibustion in patients with cancer-related insomnia: A systematic review and network meta-analysis

Efficacy of acupuncture therapy on cancer-related insomnia: a systematic review and network meta-analysis

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