Acupuncture for Breast Cancer: A Systematic Review and Meta-Analysis of Patient-Reported Outcomes

Yuzhu Zhang; Yang Sun; Dongmei Li; Xiaoyuan Liu; Chen Fang; Chunmin Yang; Tianyu Luo; Hai Lu; Huachao Li; Hongyan Zhang; Qianyi Liang; Jiahua Wu; Limei Huang; Rui Xu; Liping Ren; Qianjun Chen

doi:10.3389/fonc.2021.646315

Acupuncture for Breast Cancer: A Systematic Review and Meta-Analysis of Patient-Reported Outcomes

Front Oncol. 2021 Jun 10:11:646315. doi: 10.3389/fonc.2021.646315. eCollection 2021.

Authors

Yuzhu Zhang^{1

2

3}, Yang Sun^{1

2}, Dongmei Li⁴, Xiaoyuan Liu^{1

2}, Chen Fang^{1

2}, Chunmin Yang^{1

2}, Tianyu Luo^{1

2}, Hai Lu^{1

2}, Huachao Li^{1

2}, Hongyan Zhang^{1

2}, Qianyi Liang^{1

2}, Jiahua Wu^{1

2}, Limei Huang^{1

2}, Rui Xu^{1

2}, Liping Ren^{1

2}, Qianjun Chen^{1

2}

Affiliations

¹ Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
² Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
³ National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China.
⁴ Breast Department, Zhuhai Hospital of Guangdong Province Hospital of Chinese Medicine, Zhuhai, China.

Abstract

Abstract: The present systematic review and meta-analysis was undertaken to evaluate the effects of acupuncture in women with breast cancer (BC), focusing on patient-reported outcomes (PROs).

Methods: A comprehensive literature search was carried out for randomized controlled trials (RCTs) reporting PROs in BC patients with treatment-related symptoms after undergoing acupuncture for at least four weeks. Literature screening, data extraction, and risk bias assessment were independently carried out by two researchers.

Results: Out of the 2, 524 identified studies, 29 studies representing 33 articles were included in this meta-analysis. At the end of treatment (EOT), the acupuncture patients' quality of life (QoL) was measured by the QLQ-C30 QoL subscale, the Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES), the Functional Assessment of Cancer Therapy-General/Breast (FACT-G/B), and the Menopause-Specific Quality of Life Questionnaire (MENQOL), which depicted a significant improvement. The use of acupuncture in BC patients lead to a considerable reduction in the scores of all subscales of the Brief Pain Inventory-Short Form (BPI-SF) and Visual Analog Scale (VAS) measuring pain. Moreover, patients treated with acupuncture were more likely to experience improvements in hot flashes scores, fatigue, sleep disturbance, and anxiety compared to those in the control group, while the improvements in depression were comparable across both groups. Long-term follow-up results were similar to the EOT results.

Conclusions: Current evidence suggests that acupuncture might improve BC treatment-related symptoms measured with PROs including QoL, pain, fatigue, hot flashes, sleep disturbance and anxiety. However, a number of included studies report limited amounts of certain subgroup settings, thus more rigorous, well-designed and larger RCTs are needed to confirm our results.

Keywords: acupuncture; breast cancer; meta-analysis; patient-reported outcome; systematic review.

Publication types

Systematic Review