Cheon, S., Zhang, X., Lee, I.S., Cho, S.H., Chae, Y., & Lee, H. (2014). Pharmacopuncture for cancer care: A systematic review. Evidence-Based Complementary and Alternative Medicine, 2014, 804746.
DOI Link
Purpose
STUDY PURPOSE: To determine the efficacy of pharmacopuncture on cancer-related symptoms
TYPE OF STUDY: Meta-analysis (for chemotherapy-induced nausea and vomiting [CINV] only) and systematic review
Search Strategy
DATABASES USED: PubMed, Embase, the Cochrane Central Register of Controlled Trials, CINAHL, Chinese National Knowledge Infrastructure, KoreaMed, KMbase, Riss4U, KISS, OASIS, DBPIA, and trial registries (i.e., ClinicalTrials.gov)
KEYWORDS: Acupuncture (pharmaco-, herbal-, and aqua-), acupoint injection, cancer/tumor, tumor, antineoplastic agents, malignant, meta-analysis, systematic review, review literature, and randomized controlled trial (RCT)
INCLUSION CRITERIA: RCTs and systematic reviews; random allocation of patients; reported clinical symptom improvements
EXCLUSION CRITERIA: Reported only laboratory findings
Literature Evaluated
TOTAL REFERENCES RETRIEVED: 350 (50 full-text articles assessed for eligibility)
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: A data extraction sheet and an assessment of risk of bias (ROB) were completed independently by two authors.
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 22 in qualitative synthesis (six studies of CINV) and five in meta-analysis
- TOTAL PATIENTS INCLUDED IN REVIEW = 2,459
- SAMPLE RANGE ACROSS STUDIES: 51–480 patients
- KEY SAMPLE CHARACTERISTICS: Various cancer types
Phase of Care and Clinical Applications
PHASE OF CARE: Active antitumor treatment (for CINV trials)
Results
All studies favored pharmacopuncture over the control group, but outcome measures varied. Five out of six studies reported response rates as an outcome measure. Two studies calculated response rate using emesis episodes. One study (26) used two outcome measures, the total number of emesis episodes in 21 days and the proportion of emesis-free days in the same period.
Conclusions
The level of evidence was not strong enough to draw any conclusions. There was a careful suggestion that pharmacopuncture may help alleviate cancer-related pain, CINV, and other symptoms such as ileus, hiccups, fever, quality of life, and gastrointestinal disturbances.
Limitations
Participants and assessors were not blinded in the included studies. This could have caused performance or detection bias. Entire studies had high ROB. Studies were clinically heterogeneous, and study participants often had different types and stages of cancer. The causes of symptoms were not specified, the duration of the interventions and follow-up lengths were missing in some studies, and some of the selected control groups did not use the best evidence-based treatment available. As with acupuncture, pharmacopuncture interventions varied greatly across trials.
Nursing Implications
The findings of this meta-analysis should be interpreted with consideration of its limitations. Additional rigorously designed and conducted studies are required.
Legacy ID
5400
