Comparison efficacy and safety of acupuncture and moxibustion therapies in breast cancer-related lymphedema: A systematic review and network meta-analysis

• Published in: PloS one Vol. 19; no. 5; p. e0303513
• Main Authors: Xu, Yawen, Yu, Jiangxuan, Shen, Rui, Shan, Xueqi, Zhou, Wenlu, Wang, Junjie
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.05.2024; Public Library of Science (PLoS)
• Subjects: Acupuncture; Acupuncture Therapy - adverse effects; Acupuncture Therapy - methods; Arm circumference; Biology and Life Sciences; Breast cancer; Breast Cancer Lymphedema - therapy; Breast Neoplasms - complications; Breast Neoplasms - therapy; Cancer; Cancer therapies; Care and treatment; Chemotherapy; Clinical medicine; Comparative analysis; Edema; Effectiveness; Female; Health aspects; Humans; Lymphedema; Medical research; Medicine and Health Sciences; Meta-analysis; Moxibustion - adverse effects; Moxibustion - methods; Needles; Network Meta-Analysis; Patients; Physical Sciences; Physical therapy; Research and Analysis Methods; Software; Surgery; Swelling; Systematic review; Treatment Outcome; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0303513

Although several acupuncture and moxibustion therapies have been tested in managing breast cancer-related lymphedema (BCRL), there is little consensus regarding the best options for treating this condition. This systematic review and network meta-analysis compared the efficacy of various acupuncture and/or moxibustion therapies for BCRL. Seven databases and two clinical registration centers were searched from their inception to December 1st, 2023. The Cochrane Collaboration risk-of-bias assessment tool evaluated the quality of included RCTs. A pairwise meta-analysis was performed in STATA 16.0, while a network meta-analysis was performed in R 4.2.2. 18 studies were included in this analysis. Our results showed that acupuncture and moxibustion methods had great advantages in improving BCRL of patients with breast cancer. In particular, needle-warming moxibustion (NWM) could be the optimal acupuncture and moxibustion method for improving clinical effectiveness and reducing the degree of swelling of affected limbs. Our findings suggest that NWM has great potential in treating BCRL. It may reduce arm circumference, lower swelling levels, and improve clinical effectiveness. Nevertheless, more multi-center, high-quality, and large sample RCTs will be needed in the future.