Acupuncture for Pain Management in Cancer: A Systematic Review and Meta-Analysis

Table 1

Characteristics of the included studies.

Study; (year)	Type of cancer	Sample sizes		Interventions		Acupuncture point; selection	Frequency; Session duration	Main outcomes; Assessment tool of pain	value of main outcome
		T	C	T	C
Chen et al. [18]; (2013)	Pancreas	30	30	EA + drug	Placebo + drug (three-step analgesic ladder)	Jiaji (Ex-B2) points from; T8 to T12 bilaterally	30 min qd; 3 days	Pain in score; NRS
Mi et al. [19]; (2010)	Stomach	32	30	Fire needle + C	Drug (three-step analgesic ladder)	Fire needle point: BL17, BL18, BL21; Manual acupoint: CV12, ST25, and ST36	30 min qod; 4 weeks	Reduction of pain level; VRS
Hu et al. [20]; (2005)	Liver	20; 16; 18	20; 20; 20	A: wrist-ankle AT; B: wrist-ankle AT; C: AT + MS Contin	Codeine 30 mg tid; MS Contin; MS Contin	Ashi point, primary lesion	10–12 h; 10 days	Response rate (reduction of pain more than 1/2); NRS plus VRS
Hu et al. [21]; (2004)	Liver	36	50	Wrist-ankle AT	Drug (three-step analgesic ladder)	Ashi point, primary lesion	9–12 h, qd or qod; 10 days	Response rate; NRS
Wang et al. [22]; (2014)	Miscellaneous	38	38	EA + C	Drug (three-step analgesic ladder)	Jiaji points from T2 to T6; Chest pain: BL13, BL43; Limbs pain: LI11, SJ5, GB30, and GB34; Headache: GB20; Low-back pain: BL23; Abdominal pain: SP6, ST36	15 min, qod; 30 days	() Response rate; () KPS; NRS plus VRS
Liu [23]; (2011)	Liver	30	30	AT + tramadol hc	Tramadol hc; 100 mg q12 h	SP4, PC6, GB40, SJ5, SI3, BL62, LU7, KI6, LR3, and LR14	30 min qd; 4 weeks	() Reduction of pain level; () QOL; NRS
Shen et al. [24]; (2013)	Liver	30	30	EA	Duragesic	DU20, LI11, PC6, SP6, SP10, ST36, LR3, KI3, and GB41	20 min qd; 14 days	Pain in score; (100 mm VAS)
Sun and Yu [25]; (2000)	Liver	80	40	AT	Morphine 30 mg qn	Ashi point	12 h qn; n.r.	Response rate (duration of pain relief more than 3 h)
Han and Chen [26]; (2012)	Liver	25	25	Wrist-ankle AT	Drug (three-step analgesic ladder)	Ashi point	10–12 h qd; 10 days	Response rate; NRS
Dan et al. [27]; (1998)	Miscellaneous	37; 42	34; 34	A: AT; B: AT + C	Drug (three-step analgesic ladder); Drug (three-step analgesic ladder)	LI4, SJ6, and PC6; Chest pain: ST40, HT8; Pain in ribs: GB40, LR3; Abdominal pain: SP6, ST36	0.5–1.5 h qd or bid; 10 days	Reduction of pain level; VRS
Qiao et al. [28]; (2008)	Miscellaneous	34	32	AT + C	Drug (three-step analgesic ladder)	Back-shu points, Ashi point, ST36	30 min/qd; 14 days	Reduction of pain level; NRS plus VRS
Zhang et al. [29]; (2000)	Miscellaneous	22	22	AT	Drug (three-step analgesic ladder)	LI4, PC6, Ashi point, and Back-shu points	0.5–1 h bid; 20 days	Reduction of pain level; VRS
Cui [30]; (2013)	Miscellaneous	20	20	AT	Morphine	LI4, PC6, and Ashi point	35 min bid; 15 days	Response rate (degree of pain relief more than 60%)
Tan et al. [31]; (2012)	Miscellaneous	37; 38; 31	32; 36; 33	Mild: AT + C; Moderate: AT + C; Severe: AT + C	Drug (three-step analgesic ladder); Drug (three-step analgesic ladder); Drug (three-step analgesic ladder)	LI4, PC6, Ashi point, and Back-shu points; Lung cancer: LI4, PC6, and LU6; Liver cancer: LI4, PC6, GB34, and LR6; Colon cancer: LI4, PC6, RN12, ST36, and SJ6	0.5–1 h qd; 3 weeks	Reduction of pain level; VRS
Peng [32]; (2009)	Miscellaneous	11	11	EA + AA	Sham EA + sham AA	Based on syndrome differentiation, disease differentiation	30 min qd; 21 days	() Pain in score (100 mm; VAS); () QLQ-C30
Dang and Yang [33]; (1995)	Stomach	16	16	AT	Drug (three-step analgesic ladder)	ST36, SP6, ST34, PC6, LI11, LI4, and Ashi points; Chest pain: CV17, SP21, TE6, and GB34; Low-back pain: GV12, SI11, SI3, and GB39; Selecting 4~5 mean points and 2~4 auxiliary points each time, right and left were alternately treated	20 min qd-tid; 2 months	() Response rate; () QOL; VRS
Peng et al. [34]; (2012)	Miscellaneous	23	24	EA + C	Drug (three-step analgesic ladder)	LI4, PC6, ST36, and SP6; Back-shu points, front-mu points, and xi-cleft points related to pathological viscera	30 min qd; 7 days	Response rate (degree of pain relief more than 31%); NRS
Huang and Zhang [35]; (2012)	Miscellaneous	43	42	AT + C	Drug (three-step analgesic ladder)	ST36, Ashi point, Back-shu points, and Jiaji points according to symptoms	40 min qd; 2 weeks	() Reduction of pain level; () KPS; VRS
Bian [36]; (1999)	Miscellaneous	32; 38	33; 33	A: EA; B: EA + C	Drug (three-step analgesic ladder); Drug (three-step analgesic ladder)	ST36, PC6, and SJ8; Chest pain: BL13; Gastric pain: BL20, BL21; Abdominal pain: SP6; Low-back pain: BL23	30 min bid	Response rate (duration of pain relief more than 12 h)
Zhang [37]; (2014)	Miscellaneous	30	30	AT + C	Drug (three-step analgesic ladder)	Lung cancer: LI4, PC6, LU6, and ST36; Liver cancer: LI4, GB34, LR6, ST36, and LR3; Colon cancer: LI4, PC6, RN12, ST36, and SJ6	30 min qd; 7 days	() Reduction of pain level; () QOL; NRS
Alimi et al. [38]; (2003)	Miscellaneous	29	30	AA	Sham AA (auricular seeds at nonacupoint)	Ear points based on potential difference	Once a month; 2 months	Pain in score; (100 mm VAS)

T: treatment group, C: control group, AA: auricular-acupuncture, AT: acupuncture, EA: electroacupuncture, n.r.: not reported, NRS: numerical rating scale, VAS: visual analogue scale, and VRS: verbal rating scale.