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Review
. 2022 Jan 5;17(1):8.
doi: 10.1186/s13020-021-00558-4.

Acupuncture for cancer pain: an evidence-based clinical practice guideline

Long Ge #  1   2   3   4 , Qi Wang #  1   2 , Yihan He #  5   6   7 , Darong Wu #  5   6   7 , Qi Zhou #  8 , Nenggui Xu #  9 , Kehu Yang #  2   3   4   10 , Yaolong Chen #  3   4   8   10 , Anthony Lin Zhang #  11 , Haiqing Hua #  12 , Jinchang Huang #  13 , Ka-Kit Hui #  14 , Fanrong Liang #  15 , Linpeng Wang #  16 , Bin Xu #  17 , Yufei Yang #  18 , Weimin Zhang #  19 , Baixiao Zhao #  20 , Bing Zhu #  21 , Xinfeng Guo  22   23   24 , Charlie Changli Xue  25   26   27   28 , Haibo Zhang  29   30   31 ; International Trustworthy traditional Chinese Medicine Recommendations (TCM Recs) Working Group
Collaborators, Affiliations
Review

Acupuncture for cancer pain: an evidence-based clinical practice guideline

Long Ge et al. Chin Med. .

Abstract

Background: This study aims to develop an evidence-based clinical practice guideline of acupuncture in the treatment of patients with moderate and severe cancer pain.

Methods: The development of this guideline was triggered by a systematic review published in JAMA Oncology in 2020. We searched databases and websites for evidence on patient preferences and values, and other resources of using acupuncture for treatment of cancer pain. Recommendations were developed through a Delphi consensus of an international multidisciplinary panel including 13 western medicine oncologists, Chinese medicine/acupuncture clinical practitioners, and two patient representatives. The certainty of evidence, patient preferences and values, resources, and other factors were fully considered in formulating the recommendations. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to rate the certainty of evidence and the strength of recommendations.

Results: The guideline proposed three recommendations: (1) a strong recommendation for the treatment of acupuncture rather than no treatment to relieve pain in patients with moderate to severe cancer pain; (2) a weak recommendation for the combination treatments with acupuncture/acupressure to reduce pain intensity, decrease the opioid dose, and alleviate opioid-related side effects in moderate to severe cancer pain patients who are using analgesics; and (3) a strong recommendation for acupuncture in breast cancer patients to relieve their aromatase inhibitor-induced arthralgia.

Conclusion: This proposed guideline provides recommendations for the management of patients with cancer pain. The small sample sizes of evidence limit the strength of the recommendations and highlights the need for additional research.

Keywords: Acupuncture; Cancer pain; Evidence-based practice; Practice guideline.

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Conflict of interest statement

The guideline development was initiated by the international Trustworthy traditional Chinese Medicine Recommendations (TCM Recs) Working Group. Guangdong Provincial Hospital of Chinese Medicine and Evidence-Based Medicine Centre of Lanzhou University led the guideline development following the universal methodology by reaching the final consensus based on the latest research evidence and multidisciplinary expert opinions. All guideline panel members have completed the TCM Recs interest disclosure form. The TCM Recs judged that no panel member had any financial conflict of interest. Professional and academic interests are minimized as much as possible. Besides, we declare that the guideline will not be disseminated for commercial promotions.

Figures

Fig. 1
Fig. 1
Rapid development process of TCM Recs based on a published systematic review
Fig. 2
Fig. 2
Visual summary of recommendations
See this image and copyright information in PMC

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