Rédacteurs : Johan Nguyen, Henri Truong
Liver Cancer
Cancer du foie
1.1. Generic acupuncture
1.1.1. He 2024
He Y, Xiang S, Zhang D, Chen M. Acupuncture treatment for liver cancer pain: A meta-analysis. J Surg Oncol. 2024 Jul;130(1):83-92. https://doi.org/10.1002/jso.27691
| Acupuncture treatment is a common intervention for the clinical relief of primary liver cancer (PLC) pain, but there is variability in its efficacy. This review systematically assessed the efficacy and safety of acupuncture treatment for PLC pain by meta-analysis. A total of 17 randomized controlled trial studies involving 1162 patients met the inclusion criteria. This study identified the acupuncture method, treatment duration, and patient age were the main factors affecting the efficacy of acupuncture treatment. |
1.1.2. Zhang 2022 (pain)
Zhang, Xiao-Wen. and Gu, Yun-Jia. and Wu, Huan-Gan. and Li, Kun-Shan. and Zhong, Rui. and Qi, Qin. and Wu, Pin. and Ji, Jun. and Liu, Hui-Rong. and Huang, Yan. and Son, Chang-Gue. and Wu, Lu-Yi. Systematic review and meta-analysis of acupuncture for pain caused by liver cancer. World Journal of Traditional Chinese Medicine. 2002;8(3):402-12. https://www.wjtcm.net/tocd.asp?2022/8/3/402/351510/1
| Objective | The objective of this study is to systematically review and analyze the efficacy of acupuncture for pain caused by primary liver cancer (PLC). |
| Materials and Methods | We searched databases, including PubMed, Medline, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Science and Technology Periodicals Database (VIP), Wanfang, and SinoMed/Chinese Biomedical Database (CBM), and retrieved randomized controlled trials (RCTs) that used acupuncture as the primary intervention to treat pain caused by PLC. Two investigators then screened the articles, extracted and pooled data, and evaluated the risk of bias of the included articles according to the Cochrane Handbook. RevMan5.3 was used for the meta-analysis of eligible RCTs. |
| Results | A total of 145 articles were retrieved; after screening, 8 RCTs involving 496 patients were eventually included in this meta-analysis. The results showed that acupuncture effectively improved cancer pain and was superior to Western medicine. Moreover, acupuncture was fast-acting for pain relief, prolonged the relief, and prevented relapse. Its adverse reaction rate was also significantly lower than that of Western medicine. No significant difference was observed in Visual Analog Scale score between acupuncture and Western medicine. |
| Conclusion | Acupuncture relieves pain caused by liver cancer and can be used as an adjunct and alternative therapy for drug treatment. The existing research evidence is not yet objective or comprehensive, and more rigorous clinical trials are needed to validate the results. |
2. Clinical Practice Guidelines
⊕ positive recommendation (regardless of the level of evidence reported)
Ø negative recommendation (or lack of evidence) |
2.1. Shanghai Association of Chinese Integrative Medicine (Chine) 2018 ⊕
Ling CQ, Fan J, Lin HS, Shen F, Xu ZY, Lin LZ, Qin SK, Zhou WP, Zhai XF, Li B, Zhou QH; Chinese Integrative Therapy of Primary Liver Cancer Working Group.. Clinical practice guidelines for the treatment of primary liver cancer with integrative traditional Chinese and Western medicine. J Integr Med. 2018;16(4):236-48. [175875].
| 2.7.1. Recommendation I : For cancer pain in patients with PLC, acupuncture therapy (including wrist-ankle acupuncture and electroacupuncture) can be used to relieve pain. Attention should be given to subcutaneous hemorrhage. Wrist-ankle acupuncture plus analgesics is another option, but adverse drug reactions require attention. Acupuncture therapy may be effective for gastrointestinal reactions such as vomiting caused by TACE or other treatments ( 2C). |
| 2.7.2. Recommendation II : As a conventional symptomatic supportive therapy, moxibustion treatment may be beneficial for relieving clinical symptoms such as fatigue and acupuncture therapy can relieve cancer pain to some extent in postoperative PLC patients or in patients with advanced PLC ( 2C). |
