Skip to main content

Advertisement

SpringerLink
Log in

Effects of acupuncture on cancer-related fatigue: a meta-analysis

  • Review Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to critically evaluate the effect of acupuncture on cancer-related fatigue (CRF).

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. 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

  2. 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

    Article  PubMed  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. Lehmann H (2013) Acupuncture in ancient China: how important was it really? J Integr Med 11:45–53. https://doi.org/10.3736/jintegrmed2013008

    Article  PubMed  Google Scholar 

  5. Ma Z (2010) Analysis of syndrome and associated factors of CRF in breast cancer patients. Beijing University of Chinese Medicine, Beijing

    Google Scholar 

  6. 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

    Article  PubMed  Google Scholar 

  7. 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

    Article  Google Scholar 

  8. Lian WL (2015) Research on TCM differentiation and acupuncture therapy on cancer-related fatigue. Guangzhou University of Chinese Medicine, Guangzhou

    Google Scholar 

  9. 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

    CAS  Google Scholar 

  10. 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

    Article  PubMed  PubMed Central  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. 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

    Article  CAS  PubMed  Google Scholar 

  13. 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

    Article  PubMed  PubMed Central  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. 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

    Article  PubMed  PubMed Central  Google Scholar 

  16. 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

    Article  PubMed  Google Scholar 

  17. 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

    PubMed  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. Cheng XN (2009) Chinese acupuncture and moxibustion, 3rd edn. Foreign Language Press, Beijing

    Google Scholar 

  20. 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

    CAS  Google Scholar 

  21. 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

    Article  PubMed  Google Scholar 

  22. 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

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The First Affiliated Hospital of Soochow University, P.O. Box 102, Suzhou, China

    Yan Zhang & Li Tian

  2. School of Nursing, Soochow University, P.O. Box 203, Suzhou, China

    Lu Lin & Huiling Li

  3. School of Nursing, Fudan University, P.O. Box 401, Shanghai, China

    Yan Hu

Authors
  1. Yan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lu Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Huiling Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yan Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Li Tian
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Zhang Y and Tian L performed the meta-analysis and wrote the first draft of the manuscript. Li HL and Hu Y supervised the work. Tian L and Lin L revised the final manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Li Tian.

Ethics declarations

Ethical approval

For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflicts of interest.

Grant

This study was supported by the Suzhou Science and Technology Development Project (SYS 201526).

Additional information

The authors have full control of all primary data and agree to allow the journal to review the data if requested.

Appendix

Appendix

Table 3 A detailed search strategy for Medline
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-017-3955-6

Keywords

Search

Navigation