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| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:evaluation:oncologie:04. leucopenie induite par chimiotherapie ou radiotherapie [16 Aug 2024 18:16] Nguyen Johan [1.1.1. Shih 2023] |
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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| 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 | 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 | ||
| - | ^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. | | + | ^ 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. | | + | ^ 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. | | + | ^ 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| | + | ^ 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. | |
| - | 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. | | + | |
| === Shih 2023 === | === Shih 2023 === | ||
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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.| | ||
