Acupuncture for Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis with Trial Sequential Analysis
In brief
Acupuncture raised clinical improvement rates 74% in chemotherapy nerve damage trials
Across 40 randomized trials involving 2,496 people, acupuncture was linked to clinical improvement rates 74% higher than control and benefits on some symptom scores and nerve tests. It did not significantly improve worst pain or sensory testing results, and evidence certainty was very low, leaving the size and reliability of benefit uncertain.
- Journal
- Journal of pain research (Q1)
- Published
- 18 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Zhifeng Pan, Junshang Wu, Yici Xie, Mingzhu Xu, Haifu Huang, Wenhao Liu, et al.
- PMID
- 42780628
- DOI
- 10.2147/JPR.S631984
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (paper of the day, 25 September 2026): Systematic review, acupuncture for chemotherapy neuropathy
Abstract
BACKGROUND: Effective options for managing chemotherapy-induced peripheral neuropathy (CIPN) remain limited. Evidence supporting acupuncture for CIPN continues to accumulate, warranting a comprehensive synthesis to clarify its effects. METHODS: We searched eight databases and extracted study characteristics from the included studies. We assessed risk of bias using the Cochrane RoB 2 tool and graded the certainty of evidence using the GRADE framework. Meta-analyses evaluated CIPN symptoms, clinical effectiveness rate (ER), nerve conduction study (NCS) parameters, and quantitative sensory testing (QST) outcomes. Prespecified subgroup, sensitivity, publication-bias, and trial sequential analyses (TSA) were conducted. RESULTS: The review included 40 RCTs involving 2496 participants. Compared with controls, acupuncture interventions, used alone or with cointerventions, improved several CIPN symptom outcomes, including FACT-Ntx scores (MD = -1.43, 95% CI [-1.91, -0.95]) and increased the ER (RR = 1.74, 95% CI [1.57, 1.93]). Acupuncture also improved nerve conduction velocity and amplitude; however, no significant effects were found for worst pain scores, onset latency, or QST outcomes. GRADE rated the certainty of evidence for FACT-Ntx, EORTC QLQ-CIPN20, and ER as very low. TSA crossed the monitoring boundaries for FACT-Ntx, EORTC QLQ-CIPN20, and ER. Subgroup findings varied by acupuncture type, intervention purpose, and chemotherapy regimen. CONCLUSION: Both manual acupuncture and electroacupuncture were associated with higher ERs, whereas their effects on specific outcomes varied by intervention type, including whether acupuncture was combined with other treatments. LI4 and ST36 were the most frequently used acupoints, and distal hand and foot acupoints were also commonly selected. Future studies should assess how acupuncture modality, intervention purpose, and chemotherapy regimen influence outcomes. Because the certainty of evidence was very low, these findings should be interpreted cautiously.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.