Posadzki, P., Moon, T. W., Choi, T. Y., Park, T. Y., Lee, M. S., & Ernst, E. (2013). Acupuncture for cancer-related fatigue: a systematic review of randomized clinical trials. Supportive Care in Cancer, 21, 2067–2073.

To review the evidence regarding acupuncture for cancer-related fatigue (CRF).

Databases searched were PRISMA, AMED, CINAHL, EMBASE, MEDLINE, PsycINFO, Cochrane Collaboration, one Chinese, three Japanese, and four Korean databases.

Search keywords were acupuncture therapy or electroacupuncture, cancer, and fatigue. A full listing of search terms used was provided.

Studies were included in the review if they were randomized, controlled trials (RCTs) investigating the effect of acupuncture treatments on CRF.

The exclusion criteria were not specified.

In total, 2,419 references were retrieved. The Cochrane tool was used to assess research method quality.

• The final number of studies included was seven RCTs (548 patients).
• The sample range across studies was not provided.

Of the seven RCTs found for inclusion, four favored acupuncture and three showed no effect. Most studies had serious limitations and methodological flaws. Of the two studies that were of relatively high quality, one showed no benefit over sham acupuncture and one favored the intervention over sham and wait-list control. Three of the four studies that controlled for placebo effect showed no benefit of acupuncture.

The evidence for acupuncture in the management of CRF is ambiguous, conflicting, and inconclusive.

• The review included a small number of studies.
• The included studies were of low quality. 
• Heterogeneity among studies precluded meta-analysis.

Findings showed that evidence is lacking in support of acupuncture for the management of CRF.