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. 2020 Sep 30:28:e3377.
doi: 10.1590/1518-8345.4213.3377. eCollection 2020.

Efficacy of the complementary therapies in the management of cancer pain in palliative care: A systematic review

Luís Carlos Lopes-Júnior, Gabriela Sylvestre Rosa, Raphael Manhães Pessanha, Sara Isabel Pimentel de Carvalho Schuab, Karolini Zuqui Nunes, Maria Helena Costa Amorim

Efficacy of the complementary therapies in the management of cancer pain in palliative care: A systematic review

Luís Carlos Lopes-Júnior et al. Rev Lat Am Enfermagem. .

Abstract
in English, Portuguese, Spanish

Objective: to synthesize the knowledge and to critically evaluate the evidences arising from randomized controlled trials on the efficacy of the complementary therapies in the management of cancer pain in adult patients with cancer in palliative care.

Method: a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search for articles in the MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane, and PsycINFO databases, as well as the manual search, selection of studies, data extraction, and methodological assessment using the Cochrane Bias Risk tool were performed independently by two reviewers.

Results: eight hundred and fifteen (815) studies were identified, six of them being selected and analyzed, of which three used massage therapy, one study used a combination of progressive muscle relaxation and guided imaging, and another two studies used acupuncture. Most of the studies had an uncertain risk of bias (n=4; 67%).

Conclusion: while the evidence from the studies evaluating the use of massage therapy or the use of progressive muscle relaxation and guided imaging for the management of cancer pain in these patients demonstrated significant benefits, the other two studies that evaluated the use of acupuncture as a complementary therapy showed contradictory results, therefore, needing more research studies to elucidate such findings.

Objetivo:: sintetizar o conhecimento e avaliar criticamente as evidências provenientes de ensaios clínicos controlados randomizados sobre a eficácia das terapias complementares no manejo da dor oncológica em pacientes adultos com câncer em cuidados paliativos.

Método:: revisão sistemática guiada pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A busca dos artigos nas bases de dados MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane e PsycINFO, bem como a busca manual, seleção dos estudos, extração dos dados e avaliação metodológica pela ferramenta do Risco de Viés da Cochrane foram realizadas por dois revisores de forma independente.

Resultados:: foram identificados 815 estudos, sendo seis selecionados e analisados, dos quais três utilizaram a massagem terapêutica, um estudo usou uma combinação de relaxamento muscular progressivo e imagem guiada, e outros dois estudos a acupuntura. A maioria dos estudos apresentou risco de viés incerto (n=4; 67%).

Conclusão:: enquanto as evidências dos estudos que avaliaram o uso da massagem terapêutica ou o uso de relaxamento muscular progressivo e imagem guiada para manejo da dor oncológica nesses pacientes mostraram benefícios significativos, os outros dois estudos que avaliaram o uso da acupuntura como terapia complementar exibiram resultados divergentes, necessitando, portanto, de mais pesquisas para elucidar tais achados.

Objetivo:: sintetizar conocimiento y realizar el análisis crítico de las evidencias procedentes de ensayos clínicos controlados aleatorios sobre la eficacia de las terapias complementarias en el manejo del dolor oncológico en pacientes adultos con cáncer en cuidados paliativos.

Método:: revisión sistemática guiada por el Preferred Reporting Items for Systematic Reviews and Meta-Analyses. La búsqueda de artículos en las bases de datos MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane y PsycINFO, así como la búsqueda manual, selección de estudios, extracción de datos y evaluación metodológica con la utilización de la herramienta Riesgo de Sesgo de Cochrane se realizaron por dos revisores de forma independiente.

Resultados:: se identificaron 815 estudios, de los cuales, seis fueron seleccionados y analizados, siendo que tres utilizaron masaje terapéutico, un estudio utilizó una combinación de relajación muscular progresiva e imagen guiada, y otros dos estudios la acupuntura. La mayor parte de los estudios presentaron riesgo de sesgo incierto (n=4; 67%)

Conclusión:: mientras las evidencias de los estudios que evalúan el uso de la del masaje terapéutico o el uso de la relajación muscular progresiva y las imágenes guiadas para el manejo del dolor oncológico en estos pacientes demostraron beneficios significativos, los otros dos estudios que evaluaron el uso de la acupuntura como terapia complementaria mostraron resultados divergentes, razón por la cual se requiere de más investigación para dilucidar tales hallazgos.

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Figures

Figure 2
Figure 2. PRISMA flow chart( 34 ) for selecting the studies. Vitória, ES, Brazil. 2019
Figure 4
Figure 4. Risk for bias of the six studies included and evaluated by the Cochrane Collaboration tool( 32 ). Vitória, ES, Brazil, 2019
*Evaluation of the internal validity and of the risk of bias of the randomized controlled trials (RCTs) included in the study according to the Cochrane Collaboration Tool to assess the risk of bias in Randomized Controlled Trials; †Percentage of risk of bias among the RCTs by domains of the Cochrane Collaboration Tool to assess the risk of bias in Randomized Controlled Trials. The plus symbol (+) indicates low risk for bias; the minus symbol (-) indicates high risk for bias; the question mark (?) indicates uncertain risk for bias
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020 Jan 22;69(1):7–34. doi: 10.3322/caac.21590. - DOI - PubMed
    1. World Health Organization . Cancer - World Health Organization. 2020. [Abr 15, 2020]. [Internet] Available from: https://www.who.int/cancer/en/
    1. Instituto Nacional de Câncer José Alencar Gomes da Silva. Coordenação de Prevenção e Vigilância . Estimativa 2020: incidência de câncer no Brasil. 2019. [Apr 24, 2020]. [Internet] Available from: https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/es....
    1. Garcia TR. Classificação Internacional para a Prática de Enfermagem - CIPE(r) Versão 2017. Porto Alegre: Artmed; 2018.

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