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acupuncture:evaluation:oncologie:03. douleur en oncologie [11 Dec 2020 09:35]
Nguyen Johan Replacement automatique de '===== Revues systématiques et méta-analyses =====' par '===== Systematic Reviews and Meta-Analysis =====' 		acupuncture:evaluation:oncologie:03. douleur en oncologie [28 Aug 2025 18:57] (Version actuelle)
Nguyen Johan [1.1.1. Li 2025]
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-====== Cancer pain: effectiveness of acupuncture ​======+/​*English:​Cancer Pain*/ 
 + 
 +====== Cancer pain ======
  
  
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 ===== Systematic Reviews and Meta-Analysis ===== ===== Systematic Reviews and Meta-Analysis =====
  
-| ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture | +
-| ☆☆ | Evidence for effectiveness of acupuncture | +
-| ☆ |Limited evidence for effectiveness of acupuncture | +
-| Ø |No evidence or insufficient evidence |+
  
 ==== Generic Acupuncture ==== ==== Generic Acupuncture ====
 +
 +
 +=== Li 2025 ===
 +
 +Li Y, Li B, Cui Y, Yang X, Wang S, Wang X, Li M, Tu Y, Jing A, Zhou Y, Luo M. Acupuncture for chronic cancer pain: a systematic review and meta-analysis. Eur J Integr Med. 2025;​77:​102493. https://​doi.org/​10.1016/​j.eujim.2025.102493
 +^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. |
 +
 +
 +=== Yan 2025 ===
 +
 +Yan S, Yan F, Liangyu P, Fei X. Assessment of non-pharmacological nursing strategies for pain management in tumor patients: a systematic review and meta-analysis. Front Pain Res (Lausanne). 2025 Apr 15;​6:​1447075. ​ https://​doi.org/​10.3389/​fpain.2025.1447075
 +^Summary background|Cancer is a multifactorial disease associated with intense pain and fatigue. Pain is the main discomfort experienced during cancer treatment, particularly as a major side effect of chemotherapy.|
 +^Objective| This study has aimed to investigate the effectiveness of non-pharmacological nursing strategies, including reflexology,​ aromatherapy,​ acupressure,​ massage therapy and acupuncture,​ in the management of cancer-associated pain. Moreover, it provides evidence-based recommendations for integrating these interventions into standard pain management protocols.|
 +^Search methodology| We gathered data from three major online databases; PubMed, the Cochrane Library and Embase. For the analysis, we exclusively targeted randomized controlled trials (RCTs) assessing the effectiveness of non-pharmacological interventions in managing cancer-related pain. No language restrictions were applied, and pain was considered the primary outcome measure.|
 +^Results| Seventeen RCTs (n = 1,070) were included in this meta-analysis from 166 eligible studies. The pooled effect size demonstrated that all evaluated non-pharmacological nursing strategies, including aromatherapy,​ massage, reflexology,​ **acupressure and acupuncture** significantly reduced cancer-related pain compared to usual care (p < 0.001). Moreover, the reflexology and massage showed negligible heterogeneity among other interventions.|
 +^Conclusion| This meta-analysis found the significant effectiveness of non-pharmacological nursing strategies, particularly reflexology and massage in reducing cancer-related pain. The findings support their integration into clinical practice, providing evidence-based recommendations for enhancing standard pain management protocols.|
 +
 +=== Faria 2024 ===
 +
 +
 +Faria M, Teixeira M, Pinto MJ, Sargento P. Efficacy of acupuncture on cancer pain: A systematic review and meta-analysis. J Integr Med. 2024 May;​22(3):​235-244. ​ https://​doi.org/​10.1016/​j.joim.2024.03.002
 +^Backgound| Pain associated with cancer is one of the greatest causes of reduced quality of life in patients. Acupuncture is one of the treatments used to address this issue, with the great advantage of having little or no side effects, especially when compared with pharmacological pain-killers.|
 +^Objective| The aim of this systematic review and meta-analysis was to evaluate the current evidence regarding the efficacy of acupuncture for cancer pain.|
 +^Methods|Search strategy: Six electronic databases (PubMed, EBSCO, Cochrane Library, Scielo, b-On and Scopus) were searched for relevant articles about pain relief in cancer patients from their beginning until 2022 using MeSH terms such as "​acupuncture,"​ "​electroacupuncture,"​ "ear acupuncture,"​ "​acupuncture analgesia,"​ ''​oncological pain," and "​cancer pain." Inclusion criteria: Studies included were randomized controlled trials (RCTs) where acupuncture was compared with no treatment, placebo acupuncture or usual care. Data extraction and analysis: Three independent reviewers participated in data extraction and evaluation of risk of bias, and a meta-analysis was conducted. The primary outcome was pain intensity, measured with the visual analog scale, numeric rating scale, or brief pain inventory. Secondary outcomes also assessed were quality of life, functionality,​ xerostomia, pain interference,​ and analgesic consumption. Results were expressed as standardized mean difference (SMD) with 95% confidence interval (CI).|
 +^Results| **Sixteen RCTs with a total of 1124 participants** were included in the meta-analysis,​ with the majority of the studies presenting a low or unclear risk of bias. Acupuncture was more effective in reducing pain than no treatment (SMD = -0.90, 95 % CI [-1.68, -0.12]), sham acupuncture (SMD = -1.10, 95 % CI [-1.59, -0.61]) or usual care (SMD = -1.16, 95 % CI [-1.38, -0.93]).|
 +^Conclusion| The results of this study suggest that acupuncture may be an effective intervention to reduce pain associated with cancer. Despite some limitations due to the low quality and small sample size of some included studies, as well as the different types and stages of cancer, acupuncture might provide an effective and safe treatment to reduce cancer pain. |
 +
 +=== Abe 2022 ===
 +
 +
 +Abe H, Inoue R, Tsuchida R, Ando M, Saita K, Konishi M, Edamura T, Ogawa A, Matsuoka Y, Sumitani M. Efficacy of treatments for pain and numbness in cancer survivors: a systematic review and meta-analysis. Ann Palliat Med. 2022 Dec;​11(12):​3674-3696. ​ https://​doi.org/​10.21037/​apm-22-420
 +
 +^Background|Pain and numbness in cancer survivors frequently have negative impacts on quality of life (QoL). This meta-analysis aimed to identify the current treatment options for pain and numbness in cancer survivors and to evaluate their effects.|
 +^Methods|Cancer survivors were defined as patients diagnosed with cancer who had completed active cancer treatment, whose conditions were stable, and who had no evidence of recurrent or progressive disease. A systematic search through the PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, PsycInfo, and CINAHL databases was conducted, which targeted randomized controlled trials (RCTs) published until April 2022 that evaluated any type of treatment for pain or numbness in cancer survivors. A meta-analysis was conducted using the random-effects model to obtain the effect sizes of 7 types of treatments: opioid therapy, nonopioid pharmacotherapy,​ interventional therapy, acupuncture,​ education/​cognitive behavioral therapy (CBT), physical exercise, and alternative medicine.|
 +^Results|A total of 36 studies involving 2,870 cancer survivors were included. Among them, 35 (n=2,813) were included in the meta-analysis for pain. The analysis suggested that physical exercise [n=761; 13 studies; standardized mean difference (SMD) -0.84; 95% confidence interval (CI): -1.14 to -0.55], **acupuncture (n=409; 3 studies; SMD -0.80; 95% CI: -1.04 to -0.56)**, and alternative medicine (n=206; 6 studies; SMD -0.44; 95% CI: -0.71 to -0.16) could significantly reduce pain. Nonopioid pharmacotherapy and education/​CBT did not demonstrate significant effects. No studies were identified that investigated the effects of opioid therapy or interventional therapy on pain. Regarding numbness, 5 studies (n=566) were included in the meta-analysis. Acupuncture (n=99; 2 studies) did not demonstrate significant effects on numbness, and the effects of nonopioid pharmacotherapy,​ education/​CBT,​ and physical exercise could not be determined due to the small number of included studies. No studies were identified that investigated the effects of opioid therapy, interventional therapy, or alternative medicine on numbness.|
 +^Conclusions|This meta-analysis suggested that physical exercise, acupuncture,​ and alternative medicine may reduce pain in cancer survivors, with a very small to moderate amount of evidence. The effect of treatments for numbness could not be determined due to the limited number of included studies. Further studies are needed, particularly on widely used pharmacotherapy.|
 +
 +=== Yan 2022 (Bone Pain) ===
 +
 +
 +
 +Yan Z, MuRong Z, Huo B, Zhong H, Yi C, Liu M, Liu M. Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis. Front Pain Res (Lausanne). 2022 Aug 1;​3:​925013. ​ https://​doi.org/​10.3389/​fpain.2022.925013. ​
 +^Background| Cancer-induced bone pain (CIBP) is a special type of cancer pain and lacks safe and effective treatments. Acupuncture is a potentially valuable treatment for CIBP, studies evaluating the effect of acupuncture on CIBP have increased significantly,​ but the safety and efficacy of acupuncture to control CIBP remains controversial.|
 +^Objective| To provide the first meta-analysis to evaluate the safety and efficacy of acupuncture in CIBP management.|
 +^Methods|Data sources: CNKI, CBM, Wanfang, VIP Database, PubMed, Embase, and Cochrane Library were searched from their inception until 1 June 2022. Study selection: RCTs with primary bone tumor patients or other types of primary cancer companied by bone metastases as the research subjects and to evaluate the efficacy of acupuncture treatment alone or combined with the control treatment were included. Meanwhile, RCTs should choose the pain score as the primary outcome and pain relief rate, frequency of breakthrough pain, analgesic onset time, analgesia duration, quality of life, and adverse events as reference outcomes. Data collection and analysis: We designed a data-extraction form that was used to extract key information from the articles. Data extraction study evaluation was conducted independently by two reviewers, and a third reviewer would resolve any disagreements. The risk of bias was assessed by the Cochrane Collaboration'​s tool for assessing the risk bias. The quality of the evidence for main outcomes was evaluated by the GRADE system. Mean differences (MD), relative risk (RR), and 95% confidence intervals (CIs) were calculated. The forest plots were performed using the Review Manager Software (5.3 version). Subgroup analysis was used to investigate the possible sources of potential heterogeneity. Descriptive analysis was performed in case of unacceptable clinical heterogeneity.|
 +^Results| **Thirteen RCTs (with 1,069 patients)** were included, and all studies were at high risk of bias owing to lack of blinding or other bias. Eleven studies evaluated the effectiveness of acupuncture as a complementary therapy, and showed that acupuncture plus control treatment (compared with control treatment) was connected with reduced pain intensity (MD = -1.34, 95% CI -1.74 to -0.94; Q < 0.1; I 2 = 98%, P < 0.01). Subgroup analyses based on acupoints type partly explain the potential heterogeneity. The results also showed that acupuncture plus control treatment (compared with control treatment) was connected with relieving pain intensity, increasing the pain relief rate, reducing the frequency of breakthrough pain, shortening analgesic onset time, extending the analgesic duration, and improving the quality of life. We have no sufficient evidence to prove the effectiveness of acupuncture alone. Four RCTs reported only adverse events related to opioids'​ side effects. Evidence was qualified as "very low" because of low methodological quality, considerable heterogeneity,​ or a low number of included studies.|
 +^Conclusion| Acupuncture has a certain effect as a complementary therapy on pain management of CIBP, which not only mitigates the pain intensity but also improves the quality of life and reduces the incidence of opioids'​ side effects, although the evidence level was very low. In future, a larger sample size and rigorously designed RCTs are needed to provide sufficient evidence to identify the efficacy and safety of acupuncture as a treatment for CIBP.|
 +
 +=== Li 2021 (Combined with Three-Step Analgesic Drug) ===
 + 
 +Li DH, Su YF, Fan HF, Guo N, Sun CX. Acupuncture Combined with Three-Step Analgesic Drug Therapy for Treatment of Cancer Pain: A Systematic Review and Meta-Analysis of Randomised Clinical Trials. Evid Based Complement Alternat Med. 2021.   ​[220504]. [[https://​doi.org/​10.1155/​2021/​5558590|doi]]  ​
 +
 +^Objective|The purpose of this study was to systematically evaluate the efficacy and safety of acupuncture combined with the WHO three-step analgesic drug ladder for cancer pain. |
 +^Methods|The Cochrane Library, PubMed, and CNKI Database of Systematic Reviews were searched. Using the Cochrane Register for Randomized Controlled Trials, the quality of the included literature was evaluated, and the meta-analysis was carried out with RevMan 5.3 software.|
 +^ Results| Compared with three-step analgesia alone, acupuncture combined with three-step analgesia for cancer pain increased pain relief response rates (RR = 1.12, 95% CI: 1.08∼1.17,​ P < 0.00001), reduced NRS score (SMD = -1.10, 95% CI: -1.86∼-0.35,​ P=0.004), reduced the rate of side effects (RR = 0.45, 95% CI: 0.38∼0.53,​ P < 0.00001), including nausea (P < 0.00001), vomiting (P=0.008), constipation (P < 0.00001), and dizziness (P=0.010), reduced the burst pain rate (SMD = -1.38; 95% CI: -2.44∼-0.32,​ P=0.01), shortened analgesia effect onset time (P=0.004), and extended the duration of response ​ (P < 0.0001). |
 +^Conclusion| For the treatment of cancer pain, acupuncture combined with three-step analgesic drugs is better than using only three-step analgesic drugs.|
  
  
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 ==== Special Clinical Forms ==== ==== Special Clinical Forms ====
  
-=== Cancer ​du sein ===+ 
 +=== Aromatase inhibitor-induced arthralgia === 
 + 
 +|see [[acupuncture:​evaluation:​oncologie:​04. arthralgies sous anti-aromatases|corresponding item]] | 
 +=== Breast ​Cancer ===
  
 == Behzadmehr 2020 == == Behzadmehr 2020 ==
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 Behzadmehr R, Dastyar N, Moghadam MP, Abavisani M, Moradi M. Effect of complementary and alternative medicine interventions on cancer related pain among breast cancer patients: A systematic review. Complement Ther Med. 2020.   ​{{:​medias securises:​acupuncture:​evaluation:​oncologie:​behzadmehr-205771.pdf|[205771]}}. [[https://​linkinghub.elsevier.com/​retrieve/​pii/​S0965-2299(19)31908-9|doi]] Behzadmehr R, Dastyar N, Moghadam MP, Abavisani M, Moradi M. Effect of complementary and alternative medicine interventions on cancer related pain among breast cancer patients: A systematic review. Complement Ther Med. 2020.   ​{{:​medias securises:​acupuncture:​evaluation:​oncologie:​behzadmehr-205771.pdf|[205771]}}. [[https://​linkinghub.elsevier.com/​retrieve/​pii/​S0965-2299(19)31908-9|doi]]
  
-^Objective| This systematic review aimed to evaluate the efficacy of CAM interventions for cancer-related pain in breast cancer patients. |+^Objective|This systematic review aimed to evaluate the efficacy of CAM interventions for cancer-related pain in breast cancer patients. |
 ^Methods|Databases (PubMed, Scopus, Web of Science, and EMBASE) were searched from January 1, 2000, up to April 31, 2019, using the keywords: Complementary and alternative medicine therapies and cancer related pain. Standard tools were used to evaluate the quality of the studies included. | ^Methods|Databases (PubMed, Scopus, Web of Science, and EMBASE) were searched from January 1, 2000, up to April 31, 2019, using the keywords: Complementary and alternative medicine therapies and cancer related pain. Standard tools were used to evaluate the quality of the studies included. |
 ^Results|Of the 3742 articles found, 46 articles comprising 3685 participants entered the final phase. Our results indicate that interventions including **acupuncture/​acupressure**,​ tai chi/qi gong, hypnosis, meditation, music therapy, yoga, massage, reflexology,​ and Reiki improve cancer-related pain in breast cancer patients. However, aromatherapy had no effect on the same. | ^Results|Of the 3742 articles found, 46 articles comprising 3685 participants entered the final phase. Our results indicate that interventions including **acupuncture/​acupressure**,​ tai chi/qi gong, hypnosis, meditation, music therapy, yoga, massage, reflexology,​ and Reiki improve cancer-related pain in breast cancer patients. However, aromatherapy had no effect on the same. |
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-=== Cancer ​du poumon ​===+=== Liver cancer === 
 + 
 +== Zhang 2022 == 
 + 
 + 
 + 
 +Zhang Xiao-Wen, Gu Yun-Jia, Wu Huan-Gan, Li Kun-Shan, Zhong Rui, Qi Qin, Wu Pin, Ji Jun, Liu Hui-Rong, Huang Yan, Son Chang-Gue, Wu Lu-Yi. Systematic review and meta-analysis of acupuncture for pain caused by liver cancer. World Journal of Traditional Chinese Medicine. 2002;​8(3):​402-12. https://​www.wjtcm.net/​tocd.asp?​2022/​8/​3/​402/​351510/​1 
 +^Objective|The objective of this study is to systematically review and analyze the efficacy of acupuncture for pain caused by primary liver cancer (PLC). | 
 +^Materials and Methods|We searched databases, including PubMed, Medline, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure,​ Chinese Science and Technology Periodicals Database (VIP), Wanfang, and SinoMed/​Chinese Biomedical Database (CBM), and retrieved randomized controlled trials (RCTs) that used acupuncture as the primary intervention to treat pain caused by PLC. Two investigators then screened the articles, extracted and pooled data, and evaluated the risk of bias of the included articles according to the Cochrane Handbook. RevMan5.3 was used for the meta-analysis of eligible RCTs. | 
 +^Results|A total of 145 articles were retrieved; after screening, **8 RCTs involving 496 patients** were eventually included in this meta-analysis. The results showed that acupuncture effectively improved cancer pain and was superior to Western medicine. Moreover, acupuncture was fast-acting for pain relief, prolonged the relief, and prevented relapse. Its adverse reaction rate was also significantly lower than that of Western medicine. No significant difference was observed in Visual Analog Scale score between acupuncture and Western medicine. | 
 +^Conclusion|Acupuncture relieves pain caused by liver cancer and can be used as an adjunct and alternative therapy for drug treatment. The existing research evidence is not yet objective or comprehensive,​ and more rigorous clinical trials are needed to validate the results.| 
 + 
 +=== Lung Cancer === 
 + 
 +== Jia 2024 == 
 + 
 +Jia L, Wang K, Chen S. Acupuncture combined with opioid for treatment of lung cancer-related pain: A systematic review and meta-analysis. Medicine (Baltimore). 2024 Oct 18;​103(42):​e40158. ​ https://​doi.org/​10.1097/​MD.0000000000040158.  
 +^Backgound| Many individuals diagnosed with lung cancer suffer from tremendous pain, and it is crucial to implement more effective measures to assist these patients in alleviating their pain. The present study utilizes a meta-analysis to evaluate the safety and efficacy of acupuncture combined with opioids for treating lung cancer-related pain in patients.| 
 +^Methods| We have searched 8 electronic databases: The Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure,​ China Science and Technology Journal Database, Wanfang Database, and SinoMed. We included all randomized controlled trials of acupuncture combined with opioids for lung cancer-related pain in adults. We observed the main outcome indicators, including pain relief rates, numeric rating scale scores, and adverse events. Two researchers independently conducted literature screening, literature data extraction, and assessment of bias risk in the literature quality. Any disagreements were resolved through discussions between the 2 researchers or consultations with a third researcher. The risk of bias in the included studies was assessed using the revised risk of bias assessment tool. The overall quality of evidence for each outcome was evaluated using Grading of Recommendations,​ Assessment, Development and Evaluations.| 
 +^Results| We retrieved **812 lung cancer patients from 11 trials**. The study showed that compared to opioids alone, the combination of acupuncture and opioids significantly reduced numeric rating scale scores, increased pain relief rates, and decreased the occurrence of side effects.| 
 +^Conclusion| The current evidence indicates that combining acupuncture with opioid analgesics is superior to using opioid analgesics alone for managing lung cancer-related pain. Additionally,​ this combination therapy has fewer adverse reactions.|
  
 == Bian 2020 == == Bian 2020 ==
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 ^Method| The clinical randomized controlled study of acupuncture combined with three-step analgesics in the treatment of lung cancer pain was retrieved by computer from China Journal Full-text Database (CNKI), VIP Journal Database (VIP), Wanfang Data Resources, PubMed, and Cochrane Library Database (since beginning to May 2018), and the meta-analysis was performed with Revman 5. 3 software. | ^Method| The clinical randomized controlled study of acupuncture combined with three-step analgesics in the treatment of lung cancer pain was retrieved by computer from China Journal Full-text Database (CNKI), VIP Journal Database (VIP), Wanfang Data Resources, PubMed, and Cochrane Library Database (since beginning to May 2018), and the meta-analysis was performed with Revman 5. 3 software. |
 ^Results| **9 articles including 531 patients** were included. Meta-analysis showed that acupuncture combined with three-step analgesics was more effective in analgesia than single-step analgesics alone, the degree of pain improvement was greater. It can also reduce the incidence of nausea and vomiting, reduce the occurrence of constipation reaction. | ^Results| **9 articles including 531 patients** were included. Meta-analysis showed that acupuncture combined with three-step analgesics was more effective in analgesia than single-step analgesics alone, the degree of pain improvement was greater. It can also reduce the incidence of nausea and vomiting, reduce the occurrence of constipation reaction. |
-^ Conclusion|Acupuncture combined with three-step analgesic is effective and safe in the treatment of lung cancer pain, but it still needs more and higher quality literature to verificate and support. |+^Conclusion|Acupuncture combined with three-step analgesic is effective and safe in the treatment of lung cancer pain, but it still needs more and higher quality literature to verificate and support. | 
 + 
 +=== Palliative Care === 
 + 
 + 
 +== Yang 2021 == 
 + 
 + 
 +Yang J, Wahner-Roedler DL, Zhou X, Johnson LA, Do A, Pachman DR, Chon TY, Salinas M, Millstine D, Bauer BA. Acupuncture for palliative cancer pain management: systematic review. BMJ Support Palliat Care. 2021;​11(3):​264-270. ​  ​[221319]. [[https://​doi.org/​10.1136/​bmjspcare-2020-002638]] 
 +^ Background| Pain is one of the most common and problematic symptoms encountered by patients with cancer. Due to the multifactorial aetiology, pain management of these patients frequently requires multidisciplinary interventions including conventional support and specialty palliative care. Acupuncture has been identified as a possible adjunctive therapy for symptom management in cancer pain, and there is currently no systematic review focused solely on the evidence of acupuncture on cancer pain in palliative care.  | 
 +^Objective| To critically analyse currently available publications regarding the use of acupuncture for pain management among patients with cancer in palliative care settings.| 
 +^ Methods| Multiple academic databases were searched from inception to 29 October 2020. Randomised controlled trials involving acupuncture in palliative care for treatment of cancer-related pain were synthesised. Data were extracted by two independent reviewers, and methodological quality of each included study was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence. | 
 +^Results|**Five studies (n=189)** were included in this systematic review. Results indicated a favourable effect of acupuncture on pain relief in palliative care for patients with cancer. According to OCEBM 2011 Levels of Evidence, they were level 2 in one case (20%), level 3 in two cases (40%) and level 4 in the remaining (40%). Low-level evidence adversely affects the reliability of findings. | 
 +^Conclusions|Acupuncture may be an effective and safe treatment associated with pain reduction in the palliative care of patients with cancer. Further high-quality,​ adequately powered studies are needed in the future.| 
 + 
 + 
 +=== Stomach cancer === 
 + 
 +== Zhou 2024 == 
 + 
 + 
 +Zhou X, Zhang J, Jiang L, Zhang S, Gu Y, Tang J, Pu T, Quan X, Chi H, Huang S. Therapeutic efficacy of acupuncture point stimulation for stomach cancer pain: a systematic review and meta-analysis. Front Neurol. 2024 Apr 4;​15:​1334657. ​ https://​doi.org/​10.3389/​fneur.2024.1334657 
 +^Purpose|In recent years, traditional Chinese medicine has received widespread attention in the field of cancer pain treatment. This meta-analysis is the first to evaluate the effectiveness and safety of acupuncture point stimulation in the treatment of stomach cancer pain.| 
 +^Methods| For this systematic review and meta-analysis,​ we searched PubMed, Web of Science, Cochrane Library, Embase, WANFANG, China National Knowledge Infrastructure (CNKI), and Chinese Journal of Science and Technology (VIP) databases as well as forward and backward citations to studies published between database creation to July 27, 2023. All randomized controlled trials (RCTs) on acupuncture point stimulation for the treatment of patients with stomach cancer pain were included without language restrictions. We assessed all outcome indicators of the included trials. The evidence from the randomized controlled trials was synthesized as the standardized mean difference (SMD) of symptom change. The quality of the evidence was assessed using the Cochrane Risk of Bias tool. This study is registered on PROSPERO under the number CRD42023457341.| 
 +^Results| **Eleven RCTs** were included. The study included 768 patients, split into 2 groups: acupuncture point stimulation treatment group (n = 406), medication control group (n = 372). The results showed that treatment was more effective in the acupuncture point stimulation treatment group than in the medication control group (efficacy rate, RR = 1.63, 95% CI 1.37 to 1.94, p < 0.00001), decreasing in NRS score was greater in acupuncture point stimulation treatment group than in the medication control group (SMD = -1.30, 95% CI -1.96 to -0.63, p < 0.001).|
  
  
 ==== Special Acupuncture Techniques ==== ==== Special Acupuncture Techniques ====
-=== Acupuncture ​auriculaire ​===+ 
 +=== Comparison of Acupuncture techniques === 
 + 
 + 
 + 
 +== Xie 2025 == 
 + 
 +Xie T, Liu C, Wu Y, Li X, Yang Q, Tan J. Efficacy and Safety of Different Acupuncture Treatments for Cancer-Related Pain: A Systematic Review and Network Meta-Analysis. Integr Cancer Ther. 2025 Jan-Dec;​24:​15347354251314500. ​ https://​doi.org/​10.1177/​15347354251314500 
 +^Backgound| Cancer pain is a prevalent and persistent issue, and while there have been some observations of the possible benefits of acupuncture in managing cancer pain, there is still debate regarding its safety and effectiveness. This study aims to compare the efficacy and safety of different acupuncture modalities in the treatment of cancer pain through a network meta-analysis.| 
 +^Methods| Between the time each database was created and June 3, 2024, eight databases were queried: PubMed, Cochrane, Embase, Web of Science, CNKI, Wanfang, VIP, and China Biomedicine. Randomized controlled trials investigating the use of various acupuncture and moxibustion techniques in the treatment of cancer pain were identified. Publication bias and quality of randomized controlled trials were assessed using the Cochrane Risk of Bias tool and the Jadad scale, and network meta-analyses were performed using Stata 15 and R 4.3.2.| 
 +^Results| We incorporated **111 studies encompassing 9549 individuals** diagnosed with cancer, examining 29 distinct therapies. Network meta-analysis showed that, compared to Usual Medicine, Acupuncture + Usual Medicine + Traditional Chinese medicine (MD = -1.83, 95% CI: -2.86 to -0.80) could reduce NRS scores, Acupuncture + Traditional Chinese medicine (OR = 30.86, 95% CI: 3.75-254.20) could improve cancer pain relief, Moxibustion + Usual Medicine (MD = 2.12, 95% CI: 0.43-3.80) could effectively improve KPS score, Acupuncture + Application of Chinese medicine (OR = 0.16, 95% CI: 0.04-0.66) is associated with a lower incidence of constipation,​ Electro-Acupuncture + Usual Medicine (OR = 0.11, 95% CI: 0.03-0.45) shows a lower incidence of nausea and vomiting, Acupuncture + Moxibustion + Usual Medicine (OR = 0.29, 95% CI: 0.09-0.90) is associated with a lower incidence of dizziness.| 
 +^Conclusion| Acupuncture + Traditional Chinese medicine is the best intervention for different acupuncture methods in the treatment of cancer pain, and Moxibustion + Usual Medicine is the best intervention to improve the quality of life of patients.| 
 + 
 +== Jin 2024 == 
 + 
 + 
 +Jin H, Liang J, Zhang S, Ma S, Qin H, Zhang D, Pang X, Zhang M. External treatment of traditional Chinese medicine for cancer pain: A systematic review and network meta-analysis. Medicine (Baltimore). 2024 Feb 23;​103(8):​e37024. ​ https://​doi.org/​10.1097/​MD.0000000000037024. PMID: 38394488. 
 + 
 +^Backgound| Cancer pain is one of the most intolerable and frightening symptoms of cancer patients. However, the clinical effect of the three-step analgesic ladder method (TSAL) is not satisfactory. The combination of external treatment of traditional Chinese medicine (TCM) can improve the clinical effect.| 
 +^Objective| This study used network meta-analysis to compare the effects of different external treatment methods of TCM combined with TSAL on cancer pain.| 
 +^Methods| Databases searched by our team included Google Scholar, Web of Science, Scopus, Embase, PubMed, and Cochrane Library. Randomized controlled trials related to the external treatment of TCM combined with TSAL for cancer pain were screened from the establishment of the database till now. The above literature extracted clinical efficacy, NRS score, KPS score, analgesic onset time, and duration as the main results after the screening. The 95% confidence interval (95% CI) of OR value and SMD value was used as the effect index to compare the difference in efficacy of different interventions,​ and the ranking was conducted. STATA 17.0 software was used for the statistical analysis of the above data.| 
 +^Results| A total of 78 studies were included, including 8 interventions and 5742 participants. Based on ranking probability,​ the clinical effective rate of manual acupuncture combined with TSAL was the best when the intervention time was set at 4 weeks [OR = 5.42, 95% CI (1.99,​14.81)],​ and the improvement effect on KPS score was also the best [SMD = 0.97, 95% CI (0.61, 1.33)]. Acupoint external application was the best intervention in reducing NRS score [SMD = -1.14, 95% CI (-1.90, -0.93)]. Acupoint moxibustion combined with TSAL was considered to be the most effective intervention to prolong the duration of analgesia [SMD = 1.69, 95% CI (0.84, 2.54)] and shortening the onset time of analgesia [SMD = -3.00, 95% CI (-4.54, -1.47)].| 
 +^Conclusions| TSAL combined with manual acupuncture is the best in terms of clinical efficacy and improvement of patients'​ functional activity status. With the extension of treatment time, the intervention of this kind of treatment on the clinical effect is more pronounced. Acupoint external application also has a unique advantage in reducing the pain level of patients. From the point of view of analgesic duration and duration of analgesia, combined acupoint moxibustion has the best effect.| 
 + 
 + 
 + 
 +== Zhang 2023 == 
 + 
 + 
 + 
 +Zhang Q, Yuan Y, Zhang M, Qiao B, Cui Y, Wang Y, Feng L. Efficacy and safety of acupuncture-point stimulation combined with opioids for the treatment of moderate to severe cancer pain: a network meta-analysis of randomized controlled trials. Front Oncol. 2023 Jun 2;​13:​1166580. ​ https://​doi.org/​10.3389/​fonc.2023.1166580 
 +^Background| Pain is one of the most common and troublesome symptoms of cancer. Although potential positive effects of acupuncture-point stimulation (APS) on cancer pain have been observed, knowledge regarding the selection of the optimal APS remains unclear because of a lack of evidence from head-to-head randomized controlled trials (RCTs).| 
 +^Objective| This study aimed to carry out a network meta-analysis to compare the efficacy and safety of different APS combined with opioids in treating moderate to severe cancer pain and rank these methods for practical consideration.| 
 +^Methods| A comprehensive search of eight electronic databases was conducted to obtain RCTs involving different APS combined with opioids for moderate to severe cancer pain. Data were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk-of-bias tool. The primary outcome was the total pain relief rate. Secondary outcomes were the total incidence of adverse reactions, the incidence of nausea and vomiting, and the incidence of constipation. We applied a frequentist,​ fixed-effect network meta-analysis model to pool effect sizes across trials using rate ratios (RR) with their 95% confidence intervals (CI). Network meta-analysis was performed using Stata/SE 16.0.| 
 +^Results| We included **48 RCTs, which consisted of 4,026 patients**, and investigated nine interventions. A network meta-analysis showed that a combination of APS and opioids was superior in relieving moderate to severe cancer pain and reducing the incidence of adverse reactions such as nausea, vomiting, and constipation compared to opioids alone. The ranking of total pain relief rates was as follows: fire needle (surface under the cumulative ranking curve (SUCRA) = 91.1%), body acupuncture (SUCRA = 85.0%), point embedding (SUCRA = 67.7%), auricular acupuncture (SUCRA = 53.8%), moxibustion (SUCRA = 41.9%), transcutaneous electrical acupoint stimulation (TEAS) (SUCRA = 39.0%), electroacupuncture (SUCRA = 37.4%), and wrist-ankle acupuncture (SUCRA = 34.1%). The ranking of total incidence of adverse reactions was as follows: auricular acupuncture (SUCRA = 23.3%), electroacupuncture (SUCRA = 25.1%), fire needle (SUCRA = 27.2%), point embedding (SUCRA = 42.6%), moxibustion (SUCRA = 48.2%), body acupuncture (SUCRA = 49.8%), wrist-ankle acupuncture (SUCRA = 57.8%), TEAS (SUCRA = 76.3%), and opioids alone (SUCRA = 99.7%).| 
 +^Conclusions| APS seemed to be effective in relieving cancer pain and reducing opioid-related adverse reactions. Fire needle combined with opioids may be a promising intervention to reduce moderate to severe cancer pain as well as reduce opioid-related adverse reactions. However, the evidence was not conclusive. More high-quality trials investigating the stability of evidence levels of different interventions on cancer pain must be conducted. | 
 + 
 +=== Sham acupuncture === 
 + 
 +== Lee 2023 == 
 + 
 + 
 +Lee B, Kwon CY, Lee HW, Nielsen A, Wieland LS, Kim TH, Birch S, Alraek T, Lee MS. Different Outcomes According to Needling Point Location Used in Sham Acupuncture for Cancer-Related Pain: A Systematic Review and Network Meta-Analysis. Cancers (Basel). 2023 Dec 17;​15(24):​5875. ​ https://​doi.org/​10.3390/​cancers15245875 
 +^Backgound| Numerous acupuncture studies have been conducted on cancer-related pain; however, its efficacy compared to sham acupuncture remains controversial. We confirmed whether the outcome of acupuncture differs according to the needling points of sham acupuncture for cancer-related pain. | 
 +^Methods| We searched 10 databases on 23 May 2023 to screen acupuncture trials using sham acupuncture or waiting list as controls for cancer-related pain. Sham acupuncture was classified into two types, depending on whether the needling was applied at the same locations as verum acupuncture (SATV) or not (SATS). A network meta-analysis (NMA) was performed on the basis of a frequentist approach to assess pain severity. | 
 +^Results|Eight studies (n = 574 participants) were included in the review, seven of which (n = 527 participants) were included in the NMA. The pain severity was not significantly different between SATV and verum acupuncture,​ but verum acupuncture significantly improved pain severity compared to SATS. The risk of bias affecting the comparisons between the verum and sham acupuncture was generally low. Previous acupuncture trials for cancer-related pain showed differing outcomes of sham and verum acupuncture,​ depending on the needling points of sham acupuncture. | 
 +^Conclusions| The application of SATV cannot be considered a true placebo, which leads to an underestimation of the efficacy of verum acupuncture.| 
 + 
 +=== Moxibustion === 
 +== Li 2023 == 
 + 
 + 
 +Li Y, Hong E, Ye W, You J. Moxibustion as an Adjuvant Therapy for Cancer Pain: A Systematic Review and Meta-Analysis. J Pain Res. 2023 Feb 17;​16:​515-525. ​ https://​doi.org/​10.2147/​JPR.S396696 
 +^Purpose| Pain is one of the most common and feared symptoms among cancer patients. Unrelieved pain denies patients comfort and greatly affects their overall quality of life. Moxibustion is commonly used to manage chronic pain. However, its efficacy on cancer pain remains inconclusive. This study aimed to evaluate the efficacy of moxibustion for cancer pain.| 
 +^Methods| We searched seven databases to obtain articles about moxibustion combined with pharmacotherapy for cancer pain published before November 2022. All data extraction was carried out independently by two investigators. RevMan 5.4 software was used for data analysis.| 
 +^Results| A total of **ten trials involving 999 cases** were included. The results of the meta-analysis revealed that moxibustion combined with pharmacotherapy was significantly better than drug therapy alone in improving pain relief rate (RR =1.16, 95% CI = [1.04, 1.30], P = 0.01), reducing pain scores (SMD = -1.43, 95% CI = [-2.09, -0.77], P < 0.0001), Shortening the onset of analgesia (MD = -12.07, 95% CI = [-12.91, -11.22], P < 0.00001), prolonging the duration of analgesia (MD = 3.69, 95% CI = [3.21, 4.18], P < 0.00001), and improving quality of life (SMD = 2.48, 95% CI = [0.67, 4.29], P = 0.007). In addition, moxibustion combined with pharmacotherapy can effectively reduce adverse reactions of drugs (RR =0.35, 95% CI = [0.21, 0.57], P < 0.0001).| 
 +^Conclusion| The evidence in this review supports moxibustion as an effective adjuvant therapy for cancer pain management. However, high-quality RCTs are needed to further confirm these findings.| 
 + 
 + 
 + 
 + 
 +=== Auricular ​Acupuncture ===
  
 == Yang 2020 == == Yang 2020 ==
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-=== Acupuncture ​des poignets et chevilles ​===+=== Wrist-Ankle ​Acupuncture === 
 +== Dong 2021 ☆☆ == 
 + 
 + 
 +Dong B, Lin L, Chen Q, Qi Y, Wang F, Qian K, Tian L. Wrist-ankle acupuncture has a positive effect on cancer pain: a meta-analysis. BMC Complement Med Ther. 2021;​21(1):​24. ​  ​{{:​medias securises:​acupuncture:​evaluation:​oncologie:​dong-216259.pdf|[216259]}}. [[https://​doi.org/​10.1186/​s12906-020-03193-y|doi]] 
 + 
 +^Background|Wrist-ankle acupuncture (WAA) as a kind of micro acupuncture therapy has been used to management cancer pain, however, the effects of WAA on cancer pain were controversial in the current studies. Therefore, the purpose of this meta-analysis was to critically evaluate the effect of wrist-ankle acupuncture (WAA) on cancer pain. | 
 +^Methods| Seven digital databases were searched from the inception of databases to July 2020, including CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed and Embase. Randomized controlled trials conforming to the inclusion and exclusion criteria were screened and extracted; the risk of bias was evaluated using the Cochrane Collaboration criteria. The primary outcome indicators included pain relief rate and pain score, and the secondary outcome was adverse reaction incidence. All analyses were performed with Review Manager 5.3. | 
 +^Results|A total of **13 studies** with **1005 cancer patients** (intervention group: 568, control group: 437) were included in this meta-analysis. The results demonstrated that the pain relief rate of experimental group (WAA / WAA + drug intervention) was better than that of control group (analgesic drug intervention),​ and the difference was statistically significant [RR = 1.31, 95%CI: 1.15 ~ 1.49, P < 0.01]. | 
 +^Conclusions|WAA has certain effect on cancer pain, and the effect of WAA combined with pharmacological intervention is better than that of drug therapy alone. | 
 + 
 + 
 + 
 == Zheng 2014 Ø== == Zheng 2014 Ø==
  
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 ^ Conclusions ​ | The results of this systematic review are **inconclusive due to a lack of suitable RCTs**. Large multi-centre RCTs are required to assess the value of TENS in the management of cancer-related pain in adults ​ | ^ Conclusions ​ | The results of this systematic review are **inconclusive due to a lack of suitable RCTs**. Large multi-centre RCTs are required to assess the value of TENS in the management of cancer-related pain in adults ​ |
  
-===== Overview ​of Systematic Reviews =====+===== Overviews ​of Systematic Reviews =====
  
  
-==== Sasaki 2019 (cancer du sein) ====+==== Zhang D 2023 ==== 
 + 
 +Zhang D, Ji Y, Lv L, Zhou Q, Liu Z, Zhang C, Chen S. An Overview of Systematic Reviews and Meta-Analyses of Clinical Studies of Acupuncture for Cancer Pain. Integr Cancer Ther. 2023 Jan-Dec;​22:​15347354231210288. ​ https://​doi.org/​10.1177/​15347354231210288 
 +^Background| Systematic reviews (SRs) and meta-analyses (MAs) for the use of acupuncture for cancer pain have been increasing, but the evidence has not been systematically and comprehensively assessed. We aimed to perform an overview of the evidence quality of SRs/MAs of acupuncture for improving cancer pain.| 
 +^Methods| 8 databases were systematically searched to identify SRs/MAs of acupuncture for improving cancer pain. The A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Grades of Recommendations,​ Assessment, Development,​ and Evaluation (GRADE), respectively,​ were applied by 2 independent reviewers to evaluate the methodological quality, risk of bias, reporting quality, and evidence quality.| 
 +^Results| A total of **14 SRs/Mas** were included in the present study. By AMSTAR-2, two reviews were rated as having high methodological quality, while 12 were given a critically low rating. All SRs/MAs in Phase 1, Domain 1, and Domain 4, according to ROBIS, were at low risk. Furthermore,​ 4 reviews in Domain 2, twelve reviews in Domain 3, and ten SRs/MAs in Phase 3, were rated as having low risk of bias. With reporting quality, some reporting flaws were identified in the topic of protocol and registration,​ additional analyses, and search strategy. According to GRADE, the level of evidence quality was "​critically low" to "​moderate,"​ and risk of bias was the most common downgraded factor.| 
 +^Conclusion| Acupuncture may be beneficial in improving cancer pain. However, due to the identified limitations and inconsistent findings, we recommend further rigorous, and more standardized SRs/MAs to provide strong evidence for definitive conclusions.| 
 + 
 +==== Zhang Y 2023 ==== 
 + 
 +Zhang Y, Zhang Y, Liu S, Li B, Song Z, Han Q, Wang C, Wang Y, Yu Y, Xia H, Wang C, Li J. Acupuncture for cancer pain: a scoping review of systematic reviews and meta-analyses. Front Oncol. 2023 May 15;​13:​1169458. ​ https://​doi.org/​10.3389/​fonc.2023.1169458 
 + 
 +^Background| Due to the effectiveness and safety, acupuncture,​ one of the traditional therapies of Chinese medicine, has been widely used in clinical practice globally. A few systematic review or meta-analyses have proved its effectiveness and safety towards patients with cancer pain, while there are no syntheses among those evidence. The aim of this scoping review is to summarize the evidence from systematic reviews of acupuncture for the treatment of cancer pain and evaluate the breadth and methodological quality of these evidence as well.| 
 +^Methods| The scoping review process was guided by the methodology framework of Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA ScR) and "​Arkseyand O'​Malley six-stage framework"​. Electronic searches were carried out in several online databases from inception to Jan 2022. Systematic reviews and meta-analyses that involve any type of acupuncture for patients with cancer pain will be included. A pair of reviewers independently screened full texts. Moreover, review characteristics were extracted, and methodological quality was assessed using the AMSTAR 2 tool.| 
 +^Results| **Twenty-five systematic reviews and meta-analyses** were included. Manual acupuncture is the most frequently included types of test group intervention (48%), followed by acupuncture + medicine (28%), and auricular acupuncture (12%). All the reviews have declared that acupuncture is an effective method for cancer pain treatment. Eleven reviews (44%) aiming at evaluating the safety also have confirmed that acupuncture is safe for treating cancer pain. However, most included studies were conducted in China. With certain geographical limitations,​ the findings were not representative within the region. The results of our review may owe to the synthesis of all kinds of cancer pain, and only 2 reviews described the type of cancer pain in detail.| 
 +^Conclusions| This scoping review synthesizes and evaluates existing evidence of acupuncture for cancer pain. From this scoping review of systematic reviews and meta-analyses,​ there are clear recommendations for future studies: expanding the region of research in the world and trying to conduct the study of different types of cancer pain in details as much as possible. Evidences of acupuncture for cancer pain can inform clinical decision-making. | 
 + 
 +==== Sasaki 2019 (Breast Cancer) ====
  
  
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 ===== Clinical Practice Guidelines ===== ===== Clinical Practice Guidelines =====
 | ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) | | ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) |
 +
 +==== American Society of Clinical Oncology / Society for Integrative Oncology (ASCO/SIO, USA 2022) ⊕ ====
 +
 +Mao JJ, Ismaila N, Bao T, Barton D, Ben-Arye E, Garland EL, Greenlee H, Leblanc T, Lee RT, Lopez AM, Loprinzi C, Lyman GH, MacLeod J, Master VA, Ramchandran K, Wagner LI, Walker EM, Bruner DW, Witt CM, Bruera E. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol. 2022 Sep 19:​JCO2201357. ​ https://​doi.org/​10.1200/​JCO.22.01357
 +|**Aromatase inhibitor–related joint pain**.\\ //​Recommendation//​ 1.1. Acupuncture should be offered to patients experiencing AI-related joint pain in breast cancer (Type: Evidence based, benefits outweigh harms; Evidence quality: Intermediate;​ Strength of recommendation:​ Moderate).\\ **General cancer pain or musculoskeletal pain**.\\ //​Recommendation//​ 1.3. Acupuncture may be offered to patients experiencing general pain or musculoskeletal pain from cancer (Type: Evidence based, benefits outweigh harms; Evidence quality: Intermediate;​ Strength of recommendations:​ Moderate).\\ //​Recommendation//​ 1.4.Reflexology or acupressure may be offered to patients experiencing pain during systemic therapy for cancer treatment (Type: Evidence based, benefits outweigh harms; Evidence quality: Intermediate;​ Strength of recommendation:​ Moderate).\\ **Chemotherapy-induced peripheral neuropath**.\\ //​Recommendation//​ 1.8. Acupuncture may be offered to patients experiencing chemotherapy-induced peripheral neuropathy from cancer treatment (Type: Evidence based-informal consensus, benefits outweigh harms; Evidence quality: Low; Strength of recommendation:​ Weak).\\ //​Recommendation//​ 1.9.Reflexology or acupressure may be offered to patients experiencing chemotherapy-induced peripheral neuropathy from cancer treatment (Type: Evidence based, benefits outweigh harms; Evidence quality: Low; Strength of recommendation:​ Weak).\\ **Procedural or surgical pain**.\\ //​Recommendation//​ 1.11. Acupuncture or acupressure may be offered to patients undergoing cancer surgery or other cancer-related procedures such as bone marrow biopsy (Type: Evidence based-informal consensus, benefits outweigh harms; Evidence quality of: Low; Strength of recommendation:​ Weak).|
 +
 +
 +
 +
 +
 +==== International Trustworthy traditional Chinese Medicine Recommendations (TCM Recs) Working Group (2022) ⊕ ====
 +
 +
 +Ge L, Wang Q, He Y, Wu D, Zhou Q, Xu N, Yang K, Chen Y, Zhang AL, Hua H, Huang J, Hui KK, Liang F, Wang L, Xu B, Yang Y, Zhang W, Zhao B, Zhu B, Guo X, Xue CC, Zhang H. Acupuncture for cancer pain: an evidence-based clinical practice guideline. Chin Med. 2022;​17(1):​8. ​  ​[219467]. [[https://​doi.org/​10.1186/​s13020-021-00558-4|doi]]
 +
 +| Recommendation 1. We recommend the treatment of acupuncture rather than no treatment to relieve pain in patients with moderate to severe cancer pain (strong recommendation,​ moderate certainty evidence). \\ Recommendation 2. We suggest a combination treatment with acupuncture acupressure to reduce pain intensity, decrease opioid dose, and alleviate opioid-related side effects in moderate to severe cancer pain patients who are using analgesics (weak recommendation,​ low certainty evidence). \\ Recommendation 3. We recommend the treatment of acupuncture rather than no treatment to relieve pain in breast cancer patients with aromatase inhibitor-induced arthralgia (strong recommendation,​ low certainty evidence).|
 +
 +
 +==== National Cancer Comprehensive Network (NCCN, USA) 2022 ⊕ ====
 +
 +  * NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Adult Cancer Pain Version 1.2022. National Cancer Comprehensive Network. 2022. 104P.   ​[223543]. https://​www.nccn.org/​professionals/​physician_gls/​pdf/​pain.pdf
 +
 +|//Adult Cancer Pain:// acupuncture,​ electro-acupuncture or acupressure|
 +
 +
 +  * NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Survivorship Version 1.2022. National Cancer Comprehensive Network. 2022. 285P. [170072]. https://​www.nccn.org/​professionals/​physician_gls/​pdf/​survivorship.pdf
 +
 +|//​Myalgias,​ arthralgias//:​ acupuncture (category 1 for AI-induced arthralgia).\\ //​Neuropathic pain//: Paresthesias (tingling or prickling), Shooting, "​electrical",​ Numbnes, ​ Allodynia (pain with non-painful stimulus) : acupuncture.\\ //​Myofascial pain//: acupuncture or acupressure.|
 +
 +
 +
 +==== Association of the Scientific Medical Societies, German Cancer Society, German Cancer Aid, (AWMF, DKG, DK, Germany) 2021 ⊕ ====
 +S3-Leitlinie Komplementärmedizin in der Behandlung von onkologischen PatientInnen. September 2021. 
 +https://​www.leitlinienprogramm-onkologie.de/​leitlinien/​komplementaermedizin/​
 +
 +|11.3.1.10. //Pain//. \\ **Acupuncture**. Recommendation strength: Should. Patient context: Breast cancer ​ Patients. Note:  (Joint pain from aromatase inhibitors. \\ **Acupuncture**. Recommendation strength: Should. Patient context: Oncological ​ Patients. Note:  (tumor) pain. \\ **Acupressure**. Recommendation strength: Can. Patient context: ​ Patients with cancer pain. Note:  (Tumor) pain intervention:​ ear acupressure. \\ **Acupuncture**. Recommendation strength: Can. Patient context: ​ Patients with chemotherapy-induced peripheral neuropathic pain. Note:  Neuropathic pain. \\ **Acupuncture**. Recommendation strength: Can. Patient context: ​ Patients who have undergone a prostatectomy. Note:  Postoperative pain intervention:​ electroacupuncture. \\ **Acupuncture**. Recommendation strength: Can. Patient context: ​ Patients during brain tumor surgery. Note:  Postoperative pain intervention:​ electroacupuncture. |
 +
 +
 +==== National Cancer Comprehensive Network (NCCN, USA) 2020 ⊕====
 +
 +
 +NCCN Guidelines for Supportive Care :  Adult Cancer Pain. National Cancer Comprehensive Network. Version 1.2020.99P. [[https://​www.nccn.org/​professionals/​physician_gls/​default.aspx#​supportive/​|doi]]
 +
 +|//Pain likely to be relieved or function improved by cognitive, physical, or interventional modalities: //Physical interventions include, but aren't limited to, therapeutic or conditioning exercise, physical or occupational therapy, massage, use of heat and/or cold, **acupuncture,​ and acupressure.**|
 +
 +
 ==== Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Germany) 2018 ⊕ ==== ==== Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Germany) 2018 ⊕ ====
  
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 Palliative Care for the Patient with Incurable Cancer or Advanced Disease Part 2: Pain and Symptom Management . Clinical Practice Guidelines and Protocols in British Columbia. 2017:​47P. ​ {{:medias securises:​acupuncture:​evaluation:​oncologie:​bcca-197157.pdf| [197157]}}. ​ Palliative Care for the Patient with Incurable Cancer or Advanced Disease Part 2: Pain and Symptom Management . Clinical Practice Guidelines and Protocols in British Columbia. 2017:​47P. ​ {{:medias securises:​acupuncture:​evaluation:​oncologie:​bcca-197157.pdf| [197157]}}. ​
 |//Cancer pain management://​ consider non-pharmacological therapies (e,g, massages, relaxation, **acupuncture**,​ TENS),| |//Cancer pain management://​ consider non-pharmacological therapies (e,g, massages, relaxation, **acupuncture**,​ TENS),|
 +
 +B.C. Inter-Professional Palliative Symptom Management Guidelines. BC Centre for Palliative Care. 2017:​304P. ​  ​[219379]. [[https://​bc-cpc.ca/​wp-content/​uploads/​2018/​09/​SMGs-interactive-final-Nov-30-compressed.pdf|URL]]
 + 
 +|Pain: Interventions requiring additional equipment or transfer to acute care Transcutaneous Electrical Nerve Stimulation (TENS), acupuncture,​ acupressure.|
 +
 +
 ==== American Society of Clinical Oncology (ASCO, USA) 2016 ⊕ ==== ==== American Society of Clinical Oncology (ASCO, USA) 2016 ⊕ ====
  
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 |There is inconclusive evidence that acupuncture is more effective than placebo for chronic pain. though there may be some benefit in cancer related pain.| |There is inconclusive evidence that acupuncture is more effective than placebo for chronic pain. though there may be some benefit in cancer related pain.|
 +
 +
 +
 +==== Malaysia Health Technology Assessment Section (MaHTAS, Malaysia) 2010 ⊕ ====
 +
 +
 +Malaysia Health Technology Assessment Section (MaHTAS). Management of cancer pain. Ministry of Health (MoH). 2010:​89P. ​  ​{{:​medias securises:​acupuncture:​evaluation:​oncologie:​mahtas-172207.pdf|[172207]}}. [[http://​www.acadmed.org.my/​view_file.cfm?​fileid=342|doi]]
 +
 +| Physical and complementary treatment [acupuncture] can be used as an adjunctive therapy for patients with cancer pain. (Grade A)| 
 +
 +
  
 ==== American College of Chest Physicians (ACCP, USA) 2007 ⊕ ==== ==== American College of Chest Physicians (ACCP, USA) 2007 ⊕ ====
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-===== Essais contrôlés randomisés ​=====+===== Randomized Controlled Trials ​=====
  
  
Ligne 403: Ligne 663:
   - **Paley 2015**: Paley CA, Johnson MI, Tashani OA, Bagnall AM. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. 2015. [184147]. (n=5)   - **Paley 2015**: Paley CA, Johnson MI, Tashani OA, Bagnall AM. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. 2015. [184147]. (n=5)
  
-==== Liste ====+==== List  ​====