This study was designed to critically evaluate the effect of acupuncture on cancer-related fatigue (CRF).
Seven databases (Cochrane Library, Embase, Medline, Web of Science, CBM, Wanfang, and CNKI) were systematically reviewed from inception to November 2016 for randomized controlled trials (RCTs). Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed form. All analyses were performed with Review Manager 5.
Ten RCTs, including 1327 patients (acupuncture, 733; control, 594), meeting the inclusion criteria for the meta-analysis were identified. Acupuncture had a marked effect on fatigue in cancer patients, regardless of concurrent anti-cancer treatment, particularly among breast cancer patients. The meta-analysis also indicated that acupuncture could significantly mitigate CRF compared with sham acupuncture or usual care. Acupuncture for 20–30 min/session three times/week for two or three weeks, twice weekly for two weeks and weekly for six weeks, and weekly for six weeks had substantial effects on CRF. Six RCTs reported the occurrence of adverse events, whereas five reported none. The remaining study reported some manageable events, including spot bleeding and bruising.
Acupuncture is effective for CRF management and should be recommended as a beneficial alternative therapy for CRF patients, particularly for breast cancer patients and those currently undergoing anti-cancer treatment.
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Tian L, Lin L, Li HL, Chen KJ, Zhang XJ, Qian SJ, Hu Y (2016) Prevalence and associated factors of cancer-related fatigue among cancer patients in eastern China. Oncologist. https://doi.org/10.1634/the oncologist. 2015-0537
Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12:4–10. https://doi.org/10.1634/theoncologist.12-S1-4
Scott JA, Lasch KE, Barsevick AM, Piault-Louis E (2011) Patients’ experiences with cancer-related fatigue: a review and synthesis of qualitative research. Oncol Nurs Forum 38:E191–E203. https://doi.org/10.1188/11.onf.e191-e203
Lehmann H (2013) Acupuncture in ancient China: how important was it really? J Integr Med 11:45–53. https://doi.org/10.3736/jintegrmed2013008
Ma Z (2010) Analysis of syndrome and associated factors of CRF in breast cancer patients. Beijing University of Chinese Medicine, Beijing
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
Furlan AD, Pennick V, Bombardier C, van Tulder M, Editorial Board, Cochrane Back Review Group (2009) 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine (Phila Pa 1976) 34:1929–1941. https://doi.org/10.1097/BRS.0b013e3181b1c99f
Lian WL (2015) Research on TCM differentiation and acupuncture therapy on cancer-related fatigue. Guangzhou University of Chinese Medicine, Guangzhou
Guo LY, Liu SL, Peng Y, Yu H, Li Q, Wang DP (2014) Effect of acupuncture therapy on cancer-related fatigue of patients with gynecologic malignant tumor after chemotherapy. Clin J Tradit Chin Med 30:67–70
Mao JJ, Farrar JT, Bruner D, Zee J, Bowman M, Seluzicki C, DeMichele A, Xie SX (2014) Electroacupuncture for fatigue, sleep, and psychological distress in breast cancer patients with aromatase inhibitor-related arthralgia: a randomized trial. Cancer 120:3744–3751. https://doi.org/10.1002/cncr.28917
Smith C, Carmady B, Thornton C, Perz J, Ussher JM (2013) The effect of acupuncture on post-cancer fatigue and well-being for women recovering from breast cancer: a pilot randomised controlled trial. Acupunct Med 31:9–15. https://doi.org/10.1136/acupmed-2012-010228
Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, Ryder WD, Filshie J, Ream E, Eaton D, Richardson A (2013) A randomized, controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture. Ann Oncol 24:1645–1652. https://doi.org/10.1093/annonc/mdt034
Deng G, Chan Y, Sjoberg D, Vickers A, Yeung KS, Kris M, Straus D, Cassileth B (2013) Acupuncture for the treatment of post-chemotherapy chronic fatigue: a randomized, blinded, sham-controlled trial. Support Care Cancer 21:1735–1741. https://doi.org/10.1007/s00520-013-1720-z
Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, Ryder DW, Filshie J, Ream E, Richardson A (2012) Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial. J Clin Oncol 30:4470–4476. https://doi.org/10.1200/jco.2012.41.6222
Johnston MF, Hays RD, Subramanian SK, Elashoff RM, Axe EK, Li JJ, Kim I, Vargas RB, Lee J, Yang L, Hui KK (2011) Patient education integrated with acupuncture for relief of cancer-related fatigue randomized controlled feasibility study. BMC Complement Altern Med 11:49. https://doi.org/10.1186/1472-6882-11-49
Lim JTW, Wong ET, Aung SKH (2011) Is there a role for acupuncture in the symptom management of patients receiving palliative care for cancer? A pilot study of 20 patients comparing acupuncture with nurse-led supportive care. Acupunct Med 29:173–179. https://doi.org/10.1136/aim.2011.004044
Balk J, Day R, Rosenzweig M, Beriwal S (2009) Pilot, randomized, modified, double-blind, placebo-controlled trial of acupuncture for cancer-related fatigue. J Soc Integr Oncol 7:4–11
Molassiotis A, Sylt P, Diggins H (2007) The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure: a randomised controlled trial. Complement Ther Med 15:228–237. https://doi.org/10.1016/j.ctim.2006.09.009
Cheng XN (2009) Chinese acupuncture and moxibustion, 3rd edn. Foreign Language Press, Beijing
Chen XQ, Jiang ZX, Xu ZP (2013) Effect of Yongquan moxibustion on 38 patients with chronic fatigue syndrome and sleep disorders. Chin Acupunct Mox 33:450
Zeng Y, Luo T, Finnegan-John J, Cheng AS (2014) Meta-analysis of randomized controlled trials of acupuncture for cancer-related fatigue. Integr Cancer Ther 13:193–200. https://doi.org/10.1177/1534735413510024
He XR, Wang Q, Li PP (2013) Acupuncture and moxibustion for cancer-related fatigue: a systematic review and meta-analysis. Asian Pac J Cancer Prev 14:3067–3074. https://doi.org/10.7314/APJCP.2013.14.5.3067
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Conflict of interest
The authors declare that they have no conflicts of interest.
This study was supported by the Suzhou Science and Technology Development Project (SYS 201526).
The authors have full control of all primary data and agree to allow the journal to review the data if requested.
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Zhang, Y., Lin, L., Li, H. et al. Effects of acupuncture on cancer-related fatigue: a meta-analysis. Support Care Cancer 26, 415–425 (2018). https://doi.org/10.1007/s00520-017-3955-6
- Cancer-related fatigue