Acupuncture for chemotherapy-induced nausea and vomiting: An umbrella review of systematic reviews.
Jiarui Cao, Junfan Wu, Zhitong Bi et al.
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In 30 seconds
This umbrella review assessed invasive acupuncture for chemotherapy-induced nausea and vomiting (CINV), synthesizing existing systematic reviews and meta-analyses and conducting a renewed meta-analysis of primary randomized controlled trials. Eight reviews were included; their methodological quality was generally low, and evidence certainty was low or very low for most outcomes. Across 41 RCTs involving 3843 patients, acupuncture was associated with improved outcomes for delayed CINV, including a higher effective rate (RR = 1.26, 95% CI: 1.17-1.34). The authors conclude that benefit is possible, but the evidence remains limited.
Key findings
- For delayed CINV, the effective rate improved across 18 RCTs (P < 0.001, RR = 1.26, 95% CI: 1.17-1.34, I² = 49%).
- The delayed CINV complete response rate improved across 11 RCTs (P = 0.002, RR = 1.32, 95% CI: 1.10-1.57, I² = 55%).
- KPS and post-chemotherapy FLIE scores improved, while serum 5-HT levels decreased; certainty for most outcomes was low or very low.
Why it matters
CINV can affect patients’ symptoms and functioning during chemotherapy. This synthesis suggests invasive acupuncture may help with delayed CINV and related outcomes, but the low certainty of much of the evidence means the pooled benefits should be interpreted cautiously. The review highlights the need for better-quality trials before the efficacy of acupuncture can be established with confidence.
What to keep in mind
The included reviews were generally methodologically weak, and evidence certainty was low or very low for most outcomes. The authors call for larger, rigorously designed RCTs.