Effectiveness of Acupuncture and Moxibustion for Non-Small Cell Lung Cancer (NSCLC) Patients Undergoing Standard Treatment: A Systematic Review and Meta-Analysis.

BACKGROUND

Lung cancer is the leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for 80% to 85% of cases. While surgery and chemotherapy are primary treatments, their side effects-such as nausea, vomiting, and immunosuppression-significantly impact quality of life (QoL). Acupuncture and moxibustion, commonly used in Traditional Asian Medicine (TAM), are proposed to alleviate these effects, though their efficacy in NSCLC remains uncertain. This systematic review and meta-analysis evaluated their impact on QoL, chemotherapy-induced nausea and vomiting (CINV), and immune function in NSCLC patients.

METHODS

Nine databases (PubMed, Embase, Cochrane Library, CNKI, OASIS, ScienceON, KISS, KMBASE, and RISS) were searched for randomized controlled trials (RCTs) published until April 2025. RCTs comparing acupuncture or moxibustion with standard care in NSCLC patients were included. Primary outcomes were QoL (QLQ-C30, KPS); secondary outcomes included CINV and immune markers (CD3, CD4, CD8, CD4/CD8 ratio, TNF-α). Data were analyzed using Review Manager 5.4, and risk of bias was assessed using the Cochrane RoB tool.

RESULTS

Thirty-nine RCTs (N = 3610) were included. Acupuncture and moxibustion significantly improved QoL (QLQ-C30 MD = 12.39; KPS MD = 8.22; both P < .00001), reduced CINV incidence (RR = 0.32, P < .00001), and enhanced symptom relief (RR = 1.16, P < .00001). Immune function markers, including CD3 (MD = 7.20, P = .0002), CD4 (MD = 4.89, P = .0003), and the CD4/CD8 ratio (MD = 0.22, P < .00001), were significantly increased, while TNF-α levels decreased (MD = -11.05, P = .04).

CONCLUSION

Acupuncture and moxibustion improve QoL, reduce CINV, and modulate immune function in NSCLC, supporting their complementary role.