Abstract
Objective. To evaluate the effectiveness and safety of acupuncture for cancer-related pain. Methods. A systematic review of literatures published from database inception to February 2015 was conducted in eight databases. RCTs involving acupuncture for treatment of cancer-related pain were identified. Two researchers independently performed article selection, data extraction, and quality assessment of data. Results. 1,639 participants in twenty RCTs were analyzed. All selected RCTs were associated with high risk of bias. Meta-analysis indicated that acupuncture alone did not have superior pain-relieving effects as compared with conventional drug therapy. However, as compared with the drug therapy alone, acupuncture plus drug therapy resulted in increased pain remission rate, shorter onset time of pain relief, longer pain-free duration, and better quality of life without serious adverse effects. However, GRADE analysis revealed that the quality of all outcomes about acupuncture plus drug therapy was very low. Conclusions. Acupuncture plus drug therapy is more effective than conventional drug therapy alone for cancer-related pain. However, multicenter high-quality RCTs with larger sample sizes are needed to provide stronger evidence for the effectiveness of acupuncture in cancer-related pain due to the low data quality of the studies included in the current meta-analysis.
Highlights
Pain is one of the most common symptoms associated with cancer
The inclusion criteria were (1) study design: randomized clinical trials (RCTs) investigating the use of acupuncture for cancer pain relief that contain clinical data, regardless of publication status and language, (2) participants: adult patients diagnosed with any stage of cancer who experienced cancer pain, (3) intervention and control: acupuncture was used as the sole intervention or as an auxiliary therapy for other standard treatments for cancer pain, and a control group received standard treatments or placebo treatment
If acupuncture plus conventional drug therapies was compared with conventional drug therapies alone, the use of analgesic drug must be unchanged during the study period, so as to ensure the effect of acupuncture on cancer pain relief clearly, and (4) outcome measures: the primary outcome was the analgesic effect validated with a pain measurement, such as the Visual Analog Scale for Pain (VAS Pain), the Numeric Rating Scale for Pain (NRS Pain), or the McGill Pain Questionnaire
Summary
Pain is one of the most common symptoms associated with cancer. It may be caused directly by the cancer lesion or by anticancer treatments administered to the patients. It was reported that approximately 25% newly diagnosed cancer patients, 33% patients undergoing anticancer treatments, and 75% patients with advanced cancer suffer from pain [1]. Pain is one of the symptoms cancer patients fear the most. Unrelieved pain causes discomfort in patients and greatly affects their overall quality of life [2]. Mounting evidences show that survival of cancer patients is linked to effective pain management [3]. Studies have shown that at least 20–40% of cancer pain were not adequately relieved by application of the analgesic ladder [4, 5]. The noninvasive Complementary and Alternative Medicine (CAM) is generally considered to be relatively safe and is often used as an auxiliary therapy in addition to other standard pain management techniques [7]
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