Chiu, H.Y., Hsieh, Y.J., & Tsai, P.S. (2016). Systematic review and meta-analysis of acupuncture to reduce cancer-related pain. European Journal of Cancer Care. Advance online publication. 

DOI Link

Purpose

STUDY PURPOSE: To evaluate the effects of acupuncture in reducing cancer-related pain associated with treatment types

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: EMBASE, PUBMED, PsycINFO, CINAHL, Cochrane CENTRAL, Airiti Library, Taiwan Electronic Periodical Services, Wanfang Data, China Knowledge Integrated Database
 
INCLUSION CRITERIA: Adults, at least 20 participants, prospective randomized, controlled trial comparing acupuncture to control
 
EXCLUSION CRITERIA: Not specified

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 566
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Criteria from Cochrane Handbook for Systematic Review of Interventions

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 36
  • TOTAL PATIENTS INCLUDED IN REVIEW: 2,213
  • SAMPLE RANGE ACROSS STUDIES: 21–215 patients
  • KEY SAMPLE CHARACTERISTICS: Various tumor types

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care
 
APPLICATIONS: Palliative care

Results

Eleven trials focused on radiation-induced pain, and five focused on surgery-induced pain. The majority of trials (17) focused on general cancer-related pain. Overall analysis showed that acupuncture reduced cancer-related pain with a small effect size (-0.45, 95% CI [-0.63, -0.26]). There was high and significant heterogeneity. In the 17 trials regarding cancer-related pain, the weighted mean effect size was -0.71 (95% CI [-0.94, -0.48]), without significant heterogeneity. Among trials examining radiation-related pain, no effect was found. For surgical-related pain, mean effect size for five randomized, controlled trials was -0.4 (95% CI [-0.69, -0.1]) with high heterogeneity. For patients receiving hormonal therapy, no significant effect was seen.

Conclusions

Acupuncture may be helpful in reducing chronic cancer pain and pain associated with surgical procedures.

Limitations

  • Mostly low quality/high risk of bias studies
  • Low sample sizes
  • Various types of acupuncture were used, including auricular as well as other acupoint locations.
  • Various measures were used, and some studies measured pain outcomes only in terms of patient response as to whether or not they felt better, or practitioner evaluations of the responses.
  • No information regarding other interventions or medications used for patients with chronic and acute pain

Nursing Implications

Evidence regarding efficacy of acupuncture for pain is limited; however, findings from this meta-analysis suggest that it may be helpful for chronic and acute pain in patients with cancer. Effect sizes were small.

Legacy ID

5837