• 
  

Systematic Review of Acupuncture in Cancer Care: A Synthesis of the Evidence

1. M. Kay Garcia,
2. Jennifer McQuade,
3. Robin Haddad,
4. Sonya Patel,
5. Richard Lee,
6. Peiying Yang,
7. J. Lynn Palmer and
8. Lorenzo Cohen⇓

+ Author Affiliations

1. M. Kay Garcia, Robin Haddad, Richard Lee, Peiying Yang, J. Lynn Palmer, Lorenzo Cohen, The University of Texas MD Anderson Cancer Center; M. Kay Garcia, American College of Acupuncture and Oriental Medicine; M. Kay Garcia, Sonya Patel, MHealth Multidisciplinary Pain Management Program, Houston, TX; Jennifer McQuade, Hospital of the University of Pennsylvania, Philadelphia, PA.

1. Corresponding author: Lorenzo Cohen, PhD, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 0462, Houston, TX 77030; e-mail: lcohen@mdanderson.org.

© 2013 by American Society of Clinical Oncology

Abstract

Purpose Many cancer centers offer acupuncture services. To date, a comprehensive systematic review of acupuncture in cancer care has not been conducted. The purpose of this review was to evaluate the efficacy of acupuncture for symptom management in patients with cancer.

Methods Medline, Embase, CINAHL, Cochrane (all databases), Scopus, and PubMed were searched from inception through December 2011 for prospective randomized clinical trials (RCT) evaluating acupuncture for symptom management in cancer care. Only studies involving needle insertion into acupuncture points were included. No language limitations were applied. Studies were assessed for risk of bias (ROB) according to Cochrane criteria. Outcomes by symptom were designated as positive, negative, or unclear.

Results A total of 2,151 publications were screened. Of those, 41 RCTs involving eight symptoms (pain, nausea, hot flashes, fatigue, radiation-induced xerostomia, prolonged postoperative ileus, anxiety/mood disorders, and sleep disturbance) met all inclusion criteria. One positive trial of acupuncture for chemotherapy-induced nausea and vomiting had low ROB. Of the remaining studies, eight had unclear ROB (four positive, three negative, and one with unclear outcomes). Thirty-three studies had high ROB (19 positive, 11 negative, and three with both positive and negative outcomes depending on the symptom). 

Conclusion Acupuncture is an appropriate adjunctive treatment for chemotherapy-induced nausea/vomiting, but additional studies are needed. For other symptoms, efficacy remains undetermined owing to high ROB among studies. Future research should focus on standardizing comparison groups and treatment methods, be at least single-blinded, assess biologic mechanisms, have adequate statistical power, and involve multiple acupuncturists.