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Updated: Sep 26, 2026
Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
Published on: June 21, 2024
Acupuncture for Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis with Trial
Zhifeng Pan1, Junshang Wu2, Yici Xie1
1Department of Rehabilitation, Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong Province, People's Republic of China.
Background:
Effective options for managing chemotherapy-induced peripheral neuropathy (CIPN) remain limited. Evidence supporting acupuncture for CIPN continues to accumulate, warranting a comprehensive synthesis to clarify its effects.
Methods:
We searched eight databases and extracted study characteristics from the included studies. We assessed risk of bias using the Cochrane RoB 2 tool and graded the certainty of evidence using the GRADE framework. Meta-analyses evaluated CIPN symptoms, clinical effectiveness rate (ER), nerve conduction study (NCS) parameters, and quantitative sensory testing (QST) outcomes. Prespecified subgroup, sensitivity, publication-bias, and trial sequential analyses (TSA) were conducted.
Results:
The review included 40 RCTs involving 2496 participants. Compared with controls, acupuncture interventions, used alone or with cointerventions, improved several CIPN symptom outcomes, including FACT-Ntx scores (MD = -1.43, 95% CI [-1.91, -0.95]) and increased the ER (RR = 1.74, 95% CI [1.57, 1.93]). Acupuncture also improved nerve conduction velocity and amplitude; however, no significant effects were found for worst pain scores, onset latency, or QST outcomes. GRADE rated the certainty of evidence for FACT-Ntx, EORTC QLQ-CIPN20, and ER as very low. TSA crossed the monitoring boundaries for FACT-Ntx, EORTC QLQ-CIPN20, and ER. Subgroup findings varied by acupuncture type, intervention purpose, and chemotherapy regimen.
Conclusion:
Both manual acupuncture and electroacupuncture were associated with higher ERs, whereas their effects on specific outcomes varied by intervention type, including whether acupuncture was combined with other treatments. LI4 and ST36 were the most frequently used acupoints, and distal hand and foot acupoints were also commonly selected. Future studies should assess how acupuncture modality, intervention purpose, and chemotherapy regimen influence outcomes. Because the certainty of evidence was very low, these findings should be interpreted cautiously.