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. 2024 Aug 19;24(1):310.
doi: 10.1186/s12906-024-04603-1.

Acupuncture-related interventions improve chemotherapy-induced peripheral neuropathy: A systematic review and network meta-analysis

Mei-Ling Yeh  1 , Ru-Wen Liao  2 , Pin-Hsuan Yeh  1 , Chuan-Ju Lin #  3 , Yu-Jen Wang #  4
Affiliations

Acupuncture-related interventions improve chemotherapy-induced peripheral neuropathy: A systematic review and network meta-analysis

Mei-Ling Yeh et al. BMC Complement Med Ther. .

Abstract

Background: The previous effects of acupuncture-related interventions in improving chemotherapy-induced peripheral neuropathy (CIPN) symptoms and quality of life (QoL) remain unclear in terms of pairwise comparisons.

Aims: This systematic review and network meta-analysis aimed to determine the hierarchical effects of acupuncture-related interventions on symptoms, pain, and QoL associated with CIPN in cancer patients undergoing chemotherapy.

Methods: Nine electronic databases were searched, including PubMed, Embase, Cochrane Library, EBSCO, Medline Ovid, Airiti Library, China National Knowledge Infrastructure (CNKI), China Journal full-text database (CJFD), and Wanfang. Medical subject heading terms and text words were used to search for eligible randomized controlled trials published from database inception to May 2023.

Results: A total of 33 studies involving 2,027 participants were included. Pairwise meta-analysis revealed that acupuncture-related interventions were superior to usual care, medication, or dietary supplements in improving CIPN symptoms, CIPN pain, and QoL. Furthermore, network meta-analysis indicated that acupuncture plus electrical stimulation (acupuncture-E) had the greatest overall effect among the various interventions. The surface under the cumulative ranking curve (SUCRA) revealed that acupuncture-E ranked the highest in improving CINP symptoms. Acupuncture alone was most effective in reducing CIPN pain, and acupuncture plus moxibustion (acupuncture-M) ranked highest in enhancing QoL.

Conclusion: This finding suggests that acupuncture-related interventions can provide patients with benefits in improving CIPN symptoms, pain, and QoL. In particular, acupuncture-E could be the most effective approach in which the provided evidence offers diverse options for cancer patients and healthcare professionals.

Implication for the profession and/or patient care: These findings provide valuable insights into the potential benefits of acupuncture-related interventions for managing symptoms, pain, and QoL associated with CIPN in patients undergoing chemotherapy. Among the various interventions studied, overall, acupuncture-E had the most significant impact and was effective for a minimum duration of 3 weeks. On the other hand, transcutaneous electrical acupoint/nerve stimulation (TEAS) was identified as a noninvasive and feasible alternative for patients who had concerns about needles or the risk of bleeding. It is recommended that TEAS interventions should be carried out for a longer period, preferably lasting 4 weeks, to achieve optimal outcomes.

Trial registration: The study protocol was registered in the International Prospective Register of Systematic Reviews.

Registration number: CRD42022319871.

Keywords: Acupuncture; Chemotherapy-induced peripheral neuropathy; Electrical stimulation; Moxibustion; Pain; Quality of life.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for systematic review of acupuncture-related treatments. Note, CNKI: China National Knowledge Infrastructure; CJFD: China Journal full-text database
Fig. 2
Fig. 2
The results of the assessment of risk of bias
Fig. 3
Fig. 3
The effect of acupuncture-related interventions on CIPN symptoms improved by blinding classification
Fig. 4
Fig. 4
The effect of acupuncture-related interventions on CIPN pain reduced by blinding classification
Fig. 5
Fig. 5
The effect of acupuncture-related interventions on CIPN QoL improved by blinding classification
Fig. 6
Fig. 6
Network plot for the outcomes of chemotherapy-induced peripheral neuropathy (CIPN) symptoms, pain, and quality of life. Note, the size of the nodes corresponds to the number of participants assigned to each treatment; treatments with direct comparisons are linked with a line; its thickness corresponds to the number of trials evaluating the comparison
Fig. 7
Fig. 7
Surface under the cumulative ranking curves for chemotherapy-induced peripheral neuropathy (CIPN) symptoms, CIPN pain, and quality of life
See this image and copyright information in PMC

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