The Impact of Acupuncture on Nausea and Vomiting in Cancer Patients: A Systematic Review and Meta-Analysis

Background Nausea and vomiting (NV) are among the most common adverse effects experienced by patients with cancer undergoing treatment worldwide. Because pharmacotherapy is often complicated by medication interactions and causes unwanted side effects, acupuncture may be an optimal candidate for these patients. The objective of this systematic review and meta-analysis was to assess the effectiveness and safety of acupuncture for treating NV in patients with cancer. Methods Three electronic databases and two clinical registry platforms were searched from inception to October 11th, 2023. Methodological quality was assessed using the Cochrane risk of bias (ROB). Results Fifteen randomized controlled trials (RCTs) were included in the qualitative review, whereas eight RCTs were analyzed for subsequent quantitative meta-analysis. Meta-analysis demonstrated that acupuncture had a significant effect on cancer patients with delayed vomiting (risk ratio (RR): 0.75; 95% confidence intervals (CI): 0.58 to 0.97; p  = 0.03; I ²  = 51%; n = 139). A subgroup analysis con-firmed no significant effect until day 3; however, it became significant on day 5 (RR: 0.56; 95% CI: 0.39 to 0.81; p  = 0.002; I ²  = 0%; n = 92). The most frequently used points were PC6, ST36, CV12, LI4, LR3, and ST25. Conclusions In this review, acupuncture showed significant effects on delayed vomiting in cancer patients undergoing various emetogenic cancer-related therapies. These results suggest that clinicians could expect substantial effectiveness with at least five days of acupuncture therapy, with acupuncture points PC6, ST36, CV12, LI4, LR3, and ST25. Systematic review registration: the PROSPERO database (registration number: CRD42022333811)