Radiotherapy/chemotherapy-induced oral mucositis
Mucite radio ou chemo-induite
1. Systematic Reviews and Meta-Analysis
1.1. Generic Acupuncture
1.1.1. Ji 2025
Ji L, Han L, Sharma A. Efficacy of acupuncture in managing radiotherapy/chemotherapy-induced oral mucositis: a systematic review and meta-analysis. Support Care Cancer. 2025 Sep 23;33(10):873. https://doi.org/10.1007/s00520-025-09931-7
| Objective | To evaluate the preventive and therapeutic efficacy of acupuncture modalities in the management of radiotherapy- and chemotherapy-induced oral mucositis (RIOM/CIOM). |
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| Methods | A systematic search was performed in eight databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP, and SinoMed) for studies published up to July 25, 2025. Randomized controlled trials in English or Chinese investigating acupuncture for RIOM/CIOM were included. Data extraction and risk-of-bias assessment were conducted independently by two reviewers using the Cochrane RoB 2.0 tool. The primary outcome was oral mucositis grading according to WHO, RTOG, or other recognized scales. Evidence quality was assessed using the GRADE methodology. |
| Results | Eleven RCTs involving 865 participants were included. Acupuncture significantly reduced the incidence of moderate-to-severe oral mucositis (RR = 0.58, 95% CI: 0.45–0.76; P < 0.0001), with therapeutic interventions being more effective than preventive approaches (P < 0.0001). Auricular acupuncture showed greater benefit (RR = 0.54) than manual acupuncture (RR = 0.97). Acupuncture also significantly shortened ulcer duration (SMD = −1.13, 95% CI: −1.71 to −0.55; P = 0.0001), reduced pain scores (SMD = −1.89, P = 0.0005), and improved immune-related biomarkers (TGF-β1, IL-6) alongside increased Karnofsky performance scores (MD = 5.83, P = 0.004). No severe adverse events were reported. Overall evidence quality was rated as moderate due to substantial heterogeneity. |
| Conclusion | Acupuncture appears effective for preventing and treating RIOM/CIOM, reducing ulcer severity and duration, alleviating pain, and improving quality of life, with a favorable safety profile. However, the overall certainty of evidence is moderate, and further high-quality randomized controlled trials are required to confirm these findings. |
