Efficacy of integrating acupuncture to reduce cancer-related pain: a meta-analysis

Abstract

Background: Pain is commonly experienced by cancer patients, compromising quality of life. This study aims to investigate the efficacy of acupuncture and identify the acupoints distribution in alleviating cancer-related pain. Methods: Six established databases were searched from inception through 25 May 2022. Eligible trials were analyzed using Review Manager 5.4.1. Subgroup analysis was conducted to determine whether any mode of acupuncture or cancer-pain had significantly better efficacy than the rest. R-Studio Version 4.1.1 was used to generate relative frequency plot of highly-used acupoints. Results: 21 eligible trials covering 1413 participants were included. Meta-analysis revealed that efficacy of acupuncture analgesia was significantly higher than the control [SMD(Standardized mean difference)=0.85, 95%CI(confidence interval)=(0.58,1.13), p<0.00001]. The four therapies showed significant benefit in reducing cancer-pain, where SMD=1.33,95%CI=(0.13,2.53),p=0.03 for moxibustion; SMD=0.97,95%CI=(0.57,1.38),p<0.00001 for manual acupuncture; SMD=0.65,95%CI=(0.20,1.10),p=0.03 for electroacupuncture and SMD=0.55,95%CI=(0.13,0.97),p=0.01 for acupressure. However, their differences were insignificant (p=0.38). Therapeutic effect was demonstrated within each cancer-pain subtype, but differences among subgroups were insignificant (p=0.09). LI4, auricular Shenmen, LR3, PC6 and ST36 were 5 most commonly used acupoints. Conclusion: Acupuncture is effective in reducing cancer-related pain, though no evidence supported the superiority in any mode of therapy or pain type. Acupoints distribution could guide physicians in relieving cancer-pain.