Zeng, Y., Luo, T., Finnegan-John, J., & Cheng, A.S. (2013). Meta-analysis of randomized controlled trials of acupuncture for cancer-related fatigue. Integrative Cancer Therapies, 13, 193–200.

DOI Link

Purpose

STUDY PURPOSE: To examine effects of acupuncture on cancer-related fatigue

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: Medline, CINAHL®, Scopus, Cochrane Library, and CAJ full-text database
 
KEYWORDS: acupuncture, acupuncture therapy, fatigue, cancer-fatigue, cancer, carcinoma, tumour or tumor, malignance
 
INCLUSION CRITERIA: Articles published in English or Chinese, RCTs of acupuncture for the treatment of cancer-related fatigue; initially cancer survivors expanded to patients with cancer undergoing treatment
 
EXCLUSION CRITERIA: Studies of acupuncture that did not involve needle insertion, such as laser acupuncture or electro-acupuncture

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 488 records screened; 349 records excluded; 139 full-text articles assessed for eligibility
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Data extracted by two authors; methodological quality of included studies assessed by two authors independently; risk of bias of methodological quality assessed using the Cochrane Assessment Tool

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 7
  • TOTAL PATIENTS INCLUDED IN REVIEW = 689
  • SAMPLE RANGE ACROSS STUDIES: 12–302
  • KEY SAMPLE CHARACTERISTICS: 568 were female; 121 unknown; primarily diagnosed with breast cancer. No other demographic information provided.

Phase of Care and Clinical Applications

  • PHASE OF CARE: Multiple phases of care
  • APPLICATIONS: Elder care

Results

Three of seven trials had high risk of bias; one trial (combination of acupuncture with educational interventions compared to usual care) showed significant differences but could not parse out if acupuncture or education caused the effects; pooled analysis showed no difference in acupuncture compared to sham acupuncture or usual care in cancer-related fatigue, although forest plots indicate in favor of acupuncture; pooled analysis also showed no significant difference in quality of life and functioning.

Conclusions

The meta-analysis did not provide evidence to support the use of acupuncture in reducing cancer-related fatigue. There was no evidence that acupuncture was harmful.

Limitations

  • Small number of studies
  • Primarily women with breast cancer
  • Methodological bias in many studies

Nursing Implications

No evidence to recommend acupuncture for cancer-related fatigue, although no evidence indicates that it is harmful either. Rigorously designed RCTs are needed.

Legacy ID

4011