Table 1.
Characteristics of the Included Studies.
| Authors/Year/Country | No. of Patients (Acupuncture Group/Control Group) | Mean Age of Acupuncture Group (years) | Mean Age of Control Group (years) | Status of Cancer | Current Treatment | Hormone Therapy | Duration | Outcome Measures/Results |
|---|---|---|---|---|---|---|---|---|
| Bao et al, 2013,2 United States | 23/24 | 61 (44-82) | 61 (45-85) | 0-III | Hormone replacement therapy, letrozole, anastrozole, exemestane | Letrozole and/or anastrozole, and/or exemestane, ≥1 month | 8 Weeks | Significant improvements in HAQ-DI (P < .03), pain (VAS), significant reduction of IL-17 (P < .009), no significant modulation was seen in estradiol, β-endorphin, or other proinflammatory cytokine (P > .05) |
| Crew et al, 2007,3 United States | 9/9 | 47 ± 1.1 Of 11 patients (52%) who reported taking analgesics (acetaminophen, NSAIDs, or COX-2 inhibitors) at baseline | 43 ± 1.5 | II-III | Medicated with tamoxifen, postoperative radiation and chemotherapy | Letrozole and/or anastrozole, and/or exemestane, 6 months | 6 Weeks | Significant improvements in anxiety (HADS-A; P < .001), depression (HADS-D; P < .001), and PSS in true acupuncture group (P < .001) |
| Crew et al, 2010,4 United States | 20/18 | 58 (44-77) | 57 (37-77) | I-III | Medicated with tamoxifen, chemotherapy, and radiotherapy | Letrozole and/or anastrozole, and/or exemestane, 6 months | 6 Weeks | Significant improvement in pain and physical well-being (BPI, P < .01; WOMAC, P < .01), significant improvement in quality of life (FACT-B and BPI-SF; P < .01) in true acupuncture group |
| Deng et al, 2007,15 United States | 42/30 | 53.5 | 54 | Unclear | Medicated with tamoxifen, postoperative radiation and chemotherapy, SSRIs | Tamoxifen and/or aromatase inhibitors, within 3 weeks | 4 Weeks | No significant improvement in hot flashes/24 in true acupuncture group (P > .05) |
| Nedstrand et al, 2005,27 Sweden | 19/19 | 53 | Unclear | Unclear | Medicated with tamoxifen, postoperative chemotherapy and radiotherapy | Tamoxifen treatments mentioned, no details | 6 Months | Significant reduction in hot flushes (P < .0001) in both groups, significant reduction in KI (P < .0001) in both groups |
| Frisk et al, 2008,23 Sweden | 36 | 56.5 | 53.4 | I - III | Medicated with Tamoxifen, postoperative radiation and chemotherapy | >2 Years sequential estrogen/progestagen combination, >2 years after menopause, given combined estrogen/progestagen | 6 months | Significant reduction in hot flushes (P < .001) in the electroacupuncture group, significant reduction in KI in both groups (P < .05) |
| Hervik and Mjåland, 2009,21 Norway | 30/29 | 53.6 ± 6.4 | 52.3 ± 6.9 | Unclear | Postoperative radiation and chemotherapy | Tamoxifen for at least 3 months, mentioned, no details | 6 Weeks | Significant reduction in hot flashes (P < .001) in both groups; significant reduction in KI in true acupuncture group (P < .0001) and small reduction (P = .06) in the sham acupuncture group |
| Hervik and Mjåland, 2014,22 Norway | 43/45 | 52.5 | 50.2 | Unclear | Postoperative, medicated with tamoxifen | Tamoxifen for 3 months | 10 Weeks | Significant reduction in KI |
| Johnston et al, 2011,5 United States | 5/7 | 55 ± 6.40 | 53 ± 7.2 | Unclear | Medicated with hormone replacement therapy, postoperative radiation, and chemotherapy | Hormone replacement therapy mentioned, no details | 8 Weeks | Significant decline in fatigue (BFI; P < .10) in true acupuncture group, no significant improvement in cognitive dysfunction (FACT-B; P > .05) in true acupuncture group |
| Liljegren et al, 2012,6 Sweden | 38/36 | 58 ± 6.8 | 58 ± 9.3 | I | Medicated with tamoxifen, and chemotherapy | Tamoxifen treatments mentioned, at least 2 months | 6 Weeks | Significant reduction in hot flushes (P < .001), significant improvement in physical well-being (WOMAC; P < .01) |
| Mao et al, 2014,18 United States (I) | 19/21 | 57.5 ± 10.1 | 60.9 ± 6.5 | I-III | Postoperative, medicated with tamoxifen, and chemotherapy | Anastrozole, letrozole, exemestane | 12 Weeks | Significant improvements in pain (BPI; P < .00), stiffness (WOMAC; P < .0.00); no significant improvement on upper PPT (P > .05) |
| Mao et al, 2014,24 United States (II) | 19/21 | 57.5 ± 10.1 | 60.9 ± 6.5 | I-III | Hormone therapy | Anastrozole, letrozole, exemestane | 12 Weeks | Significant improvements in fatigue (BFI; P < .0095), anxiety (HADS; P < .044), depression (HADS; P < .015), and sleep disturbance (PSQI; P < .058) |
| Mao et al, 2015,25 United States | 30/32 | 52.9 ± (8.6) | 52 ± (8.9) | I-III | Hormone replacement therapy | Tamoxifen, aromatase inhibitor mentioned, no details | 8 Weeks | Significant reduction in hot flash composite score (HFCS; P < .001) |
| Molassiotis et al, 2013,16 United Kingdom | 56/49 | 46 | 53 | I-IIIa | Medicated with tamoxifen, postoperative radiation and chemotherapy | Hormone treatments mentioned, no details | 10 Weeks | No significant improvement in fatigue (MFI; P > .05), emotional well-being (HADS; P > .05), and quality of life (FACT-B; P > .05) |
| Nedstrand et al, 2006,7 Sweden | 17/14 | 30-64(53) | Unclear | Unclear | Postoperative radiation and chemotherapy | Tamoxifen treatments mentioned, at least 12 weeks | 6 months | Significant reduction in hot flashes (P < .001), significant reduction in KI (P < .0001), significant reduction in pain (VAS; P < .0001) in both groups, significant improvement in psychological well-being (SCL; P < .0001) in both groups, mood improved significantly (MS; P < .0001) in the electroacupuncture group |
| Smith et al, 2013,17 Australia | 10/10 | 55 ± 8.8 | 53 ± 12.5 | Unclear | Surgical treatment | Hormone treatments mentioned, no details | 6 Weeks | No significant reduction in fatigue (BPI-SF; P > .05), significant improvement in quality of life (MYCaW; P = .006) |
| Yao et al, 2016,26 Korea | 15/15 | 56.2 ± 5.82 | 55.8 ± 5.02 | Chemotherapy, radiation therapy | Not mentioned | 6 Weeks | Lymphedema, significant improvement (P < .0000); shoulder range of motion, significant improvement (P < .0000); quality of life (QLQ-30), significant improvement (P < .05) |
Abbreviations: BFI, Brief Fatigue Inventory; BPI-SF, Brief Pain Inventory–Short Form; COX, cyclo-oxygenase; FACT-B, Functional Assessment of Cancer Therapy; HADS, Hospital Anxiety and Depression Scale; IL, interleukin; KI, Kupperman Index; MFI, Multidimensional Fatigue Inventory; MS, Mood Scale; MYCaW, Measure Yourself Concerns and Wellbeing questionnaire; NSAID, nonsteroidal anti-inflammatory drug; PPT, Physical Performance Test; PSQI, Pittsburgh Sleep Quality Index; PSS, Perceived Stress Scale; SCL, Symptom Checklist; SSRI, selective serotonin reuptake inhibitor; VAS, Visual Analogue Scale; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index; HAQ-DI, Health Assessment Questionnaire Disability Index; HADS-D, Hospital Anxiety and Depression Scale-Subscales of Depression; HADS-A, Hospital Anxiety and Depression Scale-Subscales of Anxiety; HFCS, Hot Flash Composite Score; QLQ, Quality of Life Questionnaire.