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acupuncture:evaluation:oncologie:04. leucopenie induite par chimiotherapie ou radiotherapie [03 May 2023 06:07] Nguyen Johan [1.2. Special Acupuncture Techniques] |
acupuncture:evaluation:oncologie:04. leucopenie induite par chimiotherapie ou radiotherapie [28 Aug 2025 18:46] (Version actuelle) Nguyen Johan [1.2.2. Moxibustion] |
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| - | ====== Leucopénie induite par chimiothérapie ou radiothérapie : évaluation de l'acupuncture ====== | + | ====== Leucopénie induite par chimiothérapie ou radiothérapie ====== |
| | //Articles connexes//: - [[pharmacopee:evaluation:oncologie:04. myelosupression des chimiotherapies|évaluation de la pharmacopée chinoise]] - conduites thérapeutiques - pathologie - acupuncture expérimentale - qigong - | | | //Articles connexes//: - [[pharmacopee:evaluation:oncologie:04. myelosupression des chimiotherapies|évaluation de la pharmacopée chinoise]] - conduites thérapeutiques - pathologie - acupuncture expérimentale - qigong - | | ||
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| ===== Systematic Reviews and Meta-Analysis ===== | ===== Systematic Reviews and Meta-Analysis ===== | ||
| ==== Generic Acupuncture ==== | ==== Generic Acupuncture ==== | ||
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| + | === Deng 2024 === | ||
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| + | Deng Y, Zhang H, Wei T, He G, Zhu Z, Zhang S, Liu M, Xue J, Zhang W, Yang X. Efficacy and safety of acupuncture therapy for leukopenia after chemotherapy or radiotherapy: A systematic review and meta-analysis. Eur J Integr Med. 2024 Jun;68:102373. https://doi.org/10.1016/j.eujim.2024.102355 | ||
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| + | ^ Introduction | Acupuncture-Moxibustion Therapy (AMT) has been used to treat leukopenia associated with cancer treatment. This systematic review and meta-analysis aimed to assess the clinical efficacy, safety, and degree of evidence of AMT in the treatment of post-chemoradiotherapy leukopenia. | | ||
| + | ^ Methods | Four English databases (The Cochrane Library, PubMed, EMBASE, Web of Science) and four Chinese databases (Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and WanFang Database) were searched from inception to February 6, 2023 for randomized controlled trials (RCTs) regarding post-chemoradiotherapy leukopenia with AMT. Two authors extracted data and assessed the quality of trials through the Cochrane risk of bias tool 2.0 independently. All meta-analysis was performed using Review Manager 5.4.1 and GRADE was usually used to measure the certainty of evidence. | | ||
| + | ^ Results | The analysis included **18 RCTs with 1,377 patients**. The results showed that in treating post-chemoradiotherapy leukopenia, AMT is more effective compared to Chinese herbal medicine (CHM) (e.g., the effective rate: risk ratio (RR)=1.33, 95 % confidence interval (CI) 1.16 to 1.53, 3 RCTs, 349 cases; the white blood cell count (WBC): standardized mean difference (SMD)=1.03, 95 %CI 0.04 to 2.01, 2 RCTs, 148 cases), experimental synthetic drugs (ESDs) (e.g., the effective rate: RR=1.35, 95 %CI 1.13 to 1.61, 3 RCTs, 184 cases; the WBC: SMD=1.43, 95 %CI 1.21 to 1.65, 3 RCTs, 244 cases). AMT in combination with myeloid growth factors (MGFs) significantly improved the effective rate (RR=1.21, 95 %CI 1.09 to 1.35, 3 RCTs, 187 cases) and WBC (SMD=1.86, 95 %CI 1.56 to 2.17, 2 RCTs, 117 cases) compared to MGFs. However, there are no data to support the benefits of AMT or in combination with drugs in terms of Karnofsky performance status scores. The certainty of the overall evidence is very low due to the small sample sizes and poor quality of the included RCTs. | | ||
| + | ^ Conclusions | Very low certainty evidence suggests that AMT may be an effective complementary therapy for post-chemoradiotherapy leukopenia. The present evidence does not support a definitive safety profile for AMT. However, the quality of the current studies are low, and these conclusions need to be further validated by conducting more high quality RCTs. | | ||
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| + | === Shih 2023 === | ||
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| + | Shih YW, Wang MH, Monsen KA, Chang CW, Rias YA, Tsai HT. Effectiveness of Acupuncture for Relieving Chemotherapy-Induced Bone Marrow Suppression: A Systematic Review with a Meta-analysis and Trial Sequential Analysis. J Integr Complement Med. 2023 Oct;29(10):621-636. https://doi.org/10.1089/jicm.2022.0735 | ||
| + | ^Objective| Bone marrow suppression is the most common side effect of chemotherapy that may lead to discontinuation for treatment pertaining to patients during the therapy course. Acupuncture may relieve bone marrow suppression with regulation hematopoietic function during chemotherapy. The purpose of this study is to evaluate the effectiveness of acupuncture in relieving chemotherapy-induced bone marrow suppression and determine the effects of acupuncture on bone marrow function. | | ||
| + | ^Design| PubMed, Embase, Cochrane Library, Medline OVID, CINAHL Plus, Web of Science, and Chinese articles in the Airiti Library and China National Knowledge Infrastructure databases were searched up to February 2023. Publications in both English and Chinese were eligible for inclusion without any limitations on the publication date. Only randomized controlled trials investigating the impact of acupuncture on chemotherapy-induced bone marrow suppression were considered. In addition, a trial sequential analysis was performed to assess the adequacy of the current sample size. | | ||
| + | ^Results| A total of **25 studies** met the inclusion criteria. Acupuncture was found to increase the levels of hematopoietic cytokine granulocyte colony-stimulating factor (G-CSF) (Hedges' g = 0.79, p < 0.001), as well as stimulate the production of white blood cells (Hedges' g = 0.69, p < 0.001), red blood cells (Hedges' g = 0.37, p = 0.01), neutrophils (Hedges' g = 0.66, p < 0.001), absolute neutrophil count (Hedges' g = 0.89, p = 0.01), hemoglobin (Hb) (Hedges' g = 0.37, p = 0.02), platelets (Hedges' g = 0.50, p < 0.001), and natural killer (NK) cells (Hedges' g = 1.30, p = 0.02). Further, the levels of platelets and NK cells were observed to increase cumulatively over time.| | ||
| + | ^Conclusions|Acupuncture may improve chemotherapy-induced bone marrow suppression due to increasing levels of the hematopoietic cytokine, G-CSF and further relieving chemotherapy-induced bone marrow suppression.| | ||
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| === Nian 2022 ★★=== | === Nian 2022 ★★=== | ||
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| - | === Wei 2023 === | + | == Wei 2023 == |
| Wei Y, Zheng Y. Transcutaneous electronic acupoint stimulation improves bone marrow suppression in lung cancer patients following chemotherapy: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2023 Apr 21;102(16):e33571. https://doi.org/10.1097/MD.0000000000033571 | Wei Y, Zheng Y. Transcutaneous electronic acupoint stimulation improves bone marrow suppression in lung cancer patients following chemotherapy: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2023 Apr 21;102(16):e33571. https://doi.org/10.1097/MD.0000000000033571 | ||
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| === Moxibustion === | === Moxibustion === | ||
| + | == Li 2025 == | ||
| + | Li ZY, Chen CL, Li XY, Huo WG, Yang Y, Guo YH, Liu ZD. Comparative efficacy of moxibustion in chemotherapy-induced leukopenia: A Bayesian network meta-analysis. Integr Med Res. 2025 Jun;14(2):101145. https://doi.org/10.1016/j.imr.2025.101145 | ||
| + | ^Backgound| Moxibustion has been applied in various clinical treatments, including chemotherapy-induced leukopenia. Using a Bayesian network meta-analysis, this study assessed a wide range of published data to identify the most efficient and effective method of moxibustion therapy for treating chemotherapy-induced leukopenia.| | ||
| + | ^Methods| PubMed, EMBASE, and eight other databases plus two clinical trial registration platforms were searched from their respective inception date to January 2024. All randomized controlled trials (RCTs) of moxibustion for chemotherapy-induced leukopenia were included. The primary outcome indicator was white blood cell count, and the secondary outcome was the Karnofsky performance status score. Stata (version 17.0) and the gemtc package (version 1.0-0) of R (version 4.3.1) were used to perform the network meta-analysis.| | ||
| + | ^Results| **Thirty RCTs with 2282 total patients** involving 12 types of moxibustion-related therapies were identified. Results of the surface under the cumulative ranking curve revealed the following treatments as most effective for leukopenia: thunder-fire moxibustion combined with medication (95.9 %), grain-sized moxibustion combined with medication (76.2 %), and herb-separated moxibustion (76.0 %). Grain-sized moxibustion combined with medication (76.5 %) ranked first in improving Karnofsky performance status scores.| | ||
| + | ^Conclusion| Thunder-fire moxibustion combined with medication appears to be the most effective treatment for chemotherapy-induced leukopenia.| | ||
