Acupuncture for chronic cancer pain: a systematic review and meta-analysis

Introduction Pain is highly prevalent among cancer patients. Cancer pain is classified as chronic cancer pain (MG30.10) and chronic post-cancer treatment pain (MG30.11) in the International Classification of Diseases, 11th Revision (ICD-11). This research aims to ascertain the efficacy and safety of acupuncture in treating chronic cancer pain (MG30.10). Methods Eight Chinese and English databases were systematically searched from their inception to December 31, 2024, to identify randomized controlled trials (RCTs) that examined the efficacy of acupuncture in combination with active treatments versus active treatment alone (identical to the treatment group), no treatment, or sham acupuncture for cancer pain management. The risk of bias was assessed using the version 2 of the Cochrane risk-of-bias tool (ROB 2.0), and data analysis was conducted utilizing RevMan 5.4 and Stata 17.0. Additionally, the quality of evidence was evaluated using the grading of recommendations assessment, development, and evaluation (GRADE) approach. Results A total of 21 RCTs were included in the meta-analysis, involving 1432 patients. The meta-analysis revealed that compared to the control group, the treatment group exhibited significantly reduced Numeric Rating Scales (NRS) scores (mean difference (MD) = -0.93, 95 % confidence interval (CI) [-1.21, -0.64], P<0.00001, low certainty), fewer burst pain events (MD = -2.13, 95 % CI [-2.86, -1.39], P < 0.00001, low certainty), reduced analgesic consumption (standard mean difference (SMD) =-0.60, 95 % CI [-0.84, -0.37], P<0.00001, moderate certainty), improved quality of life (MD =6.37, 95 % CI [3.21, 9.54], P<0.0001, low certainty), and diminished side effects of taking analgesics, with no serious adverse effects of acupuncture treatment. Conclusion The integration of acupuncture with analgesic drugs has demonstrated considerable potential to significantly mitigate pain and ameliorate adverse effects of analgesics in patients with chronic cancer pain (MG30.11). However, further high-quality RCTs are required to elucidate the efficacy of acupuncture in cancer pain management and optimize treatment protocols. Registration CRD42024550206