Efficacy and Safety of Acupuncture for Pain in Non-Small Cell Lung Cancer: A Meta-Analysis.

BACKGROUND AND

OBJECTIVE

Lung cancer remains the primary cause of cancer-related deaths globally, with non-small cell lung cancer (NSCLC) accounting for most cases. Although acupuncture has been used for cancer pain management, its efficacy remains controversial due to varying results from clinical studies. This study aims to evaluate the efficacy and safety of acupuncture for managing pain in patients with non-small cell lung cancer (NSCLC).

METHODS

A literature search was conducted across eight major databases up to September 3, 2024. Two reviewers independently screened studies, extracted data, and assessed risk of bias following Cochrane guidelines. RevMan software was employed to calculate risk ratios and standardized mean differences (SMD) with 95% confidence intervals (CI), using fixed or random-effects models based on the heterogeneity observed. Subgroup analyses, sensitivity analyses, publication bias assessment (funnel plots and Egger's test), evidence quality rating, and trial sequential analysis (TSA) were performed.

RESULTS

Eleven randomized controlled trials incorporating 745 NSCLC patients were included in the meta-analysis. The primary outcomes assessed included pain intensity and adverse events. The meta-analysis revealed that acupuncture significantly outperformed medical treatments in reducing pain intensity (SMD=-1.33, 95% CI [-2.02, -0.63]) and incidence of adverse events (OR = 0.25, 95% CI [0.14, 0.43]). Compared to medical treatment, acupuncture showed benefits in improving total effective rate (OR=3.30, 95% CI [1.15, 9.46]) and reducing symptoms of anorexia (SMD=-0.40, 95% CI [-0.74, -0.06]), insomnia (SMD=-0.67, 95% CI [-1.03, -0.31]) and fatigue (SMD=-1.18, 95% CI [-2.04, -0.33]) compared to medical treatments. Sensitivity analyses validated result robustness. No significant publication bias was detected via funnel plots and Egger tests. TSA confirmed sufficient sample sizes for pain intensity, fatigue, and insomnia outcomes.

CONCLUSION

Acupuncture has demonstrated positive effects in alleviating cancer pain in patients with NSCLC, contributing to an improved quality of life while maintaining a certain level of safety.