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Acupuncture-Point Stimulation for Chemotherapy-Induced Nausea and Vomiting

Authors: Shen, J; Shivnan, JC; Streitberger, K; Treish, I; Zhang, G; Pearl, M; Roscoe, J; +8 Authors

Acupuncture-Point Stimulation for Chemotherapy-Induced Nausea and Vomiting

Abstract

Purpose Assess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients. Materials and Methods Randomized trials of acupuncture-point stimulation by needles, electrical stimulation, magnets, or acupressure were retrieved. Data were provided by investigators of the original trials and pooled using a fixed-effects model. Results Eleven trials (N = 1,247) were pooled. Overall, acupuncture-point stimulation reduced the proportion of acute vomiting (relative risks [RR] = 0.82; 95% CI, 0.69 to 0.99; P = .04), but not the mean number of acute emetic episodes or acute or delayed nausea severity compared with controls. By modality, stimulation with needles reduced the proportion of acute vomiting (RR = 0.74; 95% CI, 0.58 to 0.94; P = .01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95% CI, 0.60 to 0.97; P = .02), but manual acupuncture did not; delayed symptoms were not reported. Acupressure reduced mean acute nausea severity (standardized mean difference = −0.19; 95% CI, −0.38 to −0.01; P = .03) and most severe acute nausea, but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics. Conclusion This review complements data on postoperative nausea and vomiting, suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies with state-of-the-art antiemetics as well as studies for refractory symptoms are needed to determine clinical relevance. Acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies did not involve a placebo control. Noninvasive electrostimulation seems unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologic antiemetic therapy.

Keywords

Vomiting, 610, Antineoplastic Agents, Electric Stimulation Therapy, Nausea, Anticipatory - Etiology - Therapy, Randomized Controlled Trials As Topic, Electroacupuncture, Treatment Outcome, Antineoplastic Agents - Adverse Effects, Antiemetics - Therapeutic Use, Neoplasms, Acute Disease, Antiemetics, Humans, Nausea - Chemically Induced - Therapy, Vomiting, Anticipatory, Vomiting - Chemically Induced - Therapy, Acupuncture Points, Neoplasms - Drug Therapy, Vomiting, Anticipatory - Etiology - Therapy, Randomized Controlled Trials as Topic

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
366
Top 1%
Top 1%
Top 1%
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