Objective:

2

To investigate the effect of acupuncture on advanced cancer patients by meta-analysis.

Methods:

2

Nine databases (the Cochrane Central Register of Controlled Trials

MEDLINE

Web of Science

Embase

China National Knowledge Infrastructure

the Cumulative Index to Nursing and Allied Health Literature

Chinese Biomedical Literature Database

China Science and Technology Journal Database

and WanFang Data) were searched for randomized controlled trials (RCTs) on acupuncture in advanced cancer patients published from inception to February 13

2023 and updated to June 1

2023. Primary outcomes were quality of life (QOL)

while secondary outcomes were pain

fatigue

and adverse events (side effects). Data synthesis was performed using RevMan V.5.3 to calculate pooled effect sizes. RoB-2 was used for the risk of bias

and the quality of evidence was assessed using the Grading of Recommendations

Assessment

Development

and Evaluation (GRADE) tool.

Results:

2

Totally 17 RCTs involving 1

178 participants were included

15 of which were pooled for meta-analysis. Most studies demonstrated some concern for the overall risk of bias. The pooled data indicated that acupuncture was associated with improved QOL [mean difference (MD)=6.67

95% confidence interval (CI): 5.09 to 8.26]

pain (MD=–1.18

95% CI –2.28 to –0.08)

and adverse events (risk ratio=0.30

95% CI: 0.26 to 0.57) compared with control groups. Fatigue outcome was not included. Heterogeneity was substantial

and GRADE evidence was very low for both QOL and pain.

Conclusions:

2

Acupuncture could benefit patients with advanced cancer and is considered safe compared with usual care. However

the evidence regarding QOL and pain outcomes requires further validation. It is crucial to encourage the development of high-quality studies to strengthen this evidence. (Registry No. CRD42023423539)