title: Acupuncture for the treatment of cancer pain: a systematic review of randomised clinical trials.
abstract: OBJECTIVE
  Controlling cancer-related pain is an important component in the palliative care of cancer patients. The objective of this review was to assess the effectiveness of acupuncture for treating cancer pain.
  
  
  METHODS
  Fourteen databases were searched from their inception through April 2011. Randomised clinical trials (RCTs) were included if acupuncture was used as the sole treatment or as a part of a combination therapy for cancer pain. Studies were included if they were controlled with a placebo or controlled against a drug-therapy or no-treatment group. The Cochrane criteria were used to assess the risk of bias.
  
  
  RESULTS
  A total of 15 RCTs met our inclusion criteria. All of the included RCTs were associated with a high risk of bias. The majority of acupuncture treatments or combination therapies with analgesics exhibited favourable effects compared with conventional treatments in individual studies. However, a meta-analysis suggested that acupuncture did not generate a better effect than drug therapy (n = 886; risk ratio (RR), 1.12; 95% CI 0.98 to 1.28; P = 0.09). The comparison between acupuncture plus drug therapy and drug therapy alone demonstrated a significant difference in favour of the combination therapy (n = 437; RR, 1.36; 95% CI 1.13 to 1.64; P = 0.003). The results of this systematic review provide no strong evidence for the effectiveness of acupuncture in the management of cancer pain.
  
  
  CONCLUSIONS
  The total number of RCTs included in the analysis and their methodological quality were too low to draw firm conclusions. Future rigorous RCTs will be necessary to assess the clinical efficacy of acupuncture in this area.
authors.affiliation: Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, 305-811, South Korea.
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Choi
authors.forename: Myeong Soo
authors.initials: MS
authors.lastname: Lee
authors.forename: Tae-Hun
authors.initials: TH
authors.lastname: Kim
authors.forename: Christopher
authors.initials: C
authors.lastname: Zaslawski
authors.forename: Edzard
authors.initials: E
authors.lastname: Ernst
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D009369:Neoplasms / Q000150:complications; D010146:Pain / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D010166:Palliative Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000700:Analgesics