Comparison efficacy and safety of acupuncture and moxibustion therapies in breast cancer-related lymphedema: A systematic review and network meta-analysis

PLoS One. 2024 May 14;19(5):e0303513. doi: 10.1371/journal.pone.0303513. eCollection 2024.

Abstract

Objective: Although several acupuncture and moxibustion therapies have been tested in managing breast cancer-related lymphedema (BCRL), there is little consensus regarding the best options for treating this condition. This systematic review and network meta-analysis compared the efficacy of various acupuncture and/or moxibustion therapies for BCRL.

Methods: Seven databases and two clinical registration centers were searched from their inception to December 1st, 2023. The Cochrane Collaboration risk-of-bias assessment tool evaluated the quality of included RCTs. A pairwise meta-analysis was performed in STATA 16.0, while a network meta-analysis was performed in R 4.2.2.

Results: 18 studies were included in this analysis. Our results showed that acupuncture and moxibustion methods had great advantages in improving BCRL of patients with breast cancer. In particular, needle-warming moxibustion (NWM) could be the optimal acupuncture and moxibustion method for improving clinical effectiveness and reducing the degree of swelling of affected limbs.

Conclusion: Our findings suggest that NWM has great potential in treating BCRL. It may reduce arm circumference, lower swelling levels, and improve clinical effectiveness. Nevertheless, more multi-center, high-quality, and large sample RCTs will be needed in the future.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Comparative Study

MeSH terms

  • Acupuncture Therapy* / adverse effects
  • Acupuncture Therapy* / methods
  • Breast Cancer Lymphedema* / therapy
  • Breast Neoplasms / complications
  • Breast Neoplasms / therapy
  • Female
  • Humans
  • Moxibustion* / adverse effects
  • Moxibustion* / methods
  • Network Meta-Analysis
  • Treatment Outcome

Grants and funding

Supported by "The Health Commission of Zhejiang Province [No.2022ZA051]". The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.