Mingxiao Yang

Cancer‐related symptoms are detrimental to the quality of life of people with cancer. This review systematically evaluates phase 3 randomized clinical trials (RCTs) assessing the effectiveness and safety of traditional Chinese medicine (TCM) interventions in managing cancer‐related symptoms throughout the cancer care trajectory. A comprehensive literature search was conducted of PubMed, Embase, and the Cochrane Library until April 27, 2025, to further identify eligible RCTs involving patients with cancer or survivors and assessing TCM interventions against valid control arms. Data extraction and quality assessments were conducted in accordance with Cochrane standards and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Nineteen phase 3 RCTs involving 5387 participants (female, 3321; primarily breast, gastrointestinal, and lung cancers) from six countries or regions were included. Nonpharmacological interventions, namely acupuncture and Tai Chi, significantly reduced pain, fatigue, insomnia, radiation‐induced xerostomia, and hormonal therapy–related hot flashes compared to usual care (UC). Their effects on preventing chemotherapy‐ and radiotherapy‐induced nausea and vomiting were mixed, which depended on control arms and outcome measures. Conversely, evidence for pharmacological interventions was limited, with inconclusive results regarding chemotherapy‐induced peripheral neuropathy and hematologic toxicities, although promising outcomes were noted for preventing chemoradiotherapy‐induced mucositis, reducing colorectal adenoma recurrence, and enhancing chemotherapy completion rates compared to placebo or UC. Safety data suggested similar adverse event profiles across groups. These findings show strong evidence for the inclusion of nonpharmacological interventions in oncology practice. However, pharmacological interventions require more high‐quality, multicenter research to fully understand their effectiveness and safety. Implementing rigorous safety assessments and standardized adverse event reporting protocols is crucial to enhance clinical confidence in TCM modalities.

Alice Feng, Mingxiao Yang, Weidong Lu, Wanqing Iris Zhi, Ting Bao. Journal of Acupuncture Research 2025;42:286-94. https://doi.org/10.13045/jar.25.0002

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) worsens the quality of life for people with cancer. Massage therapy involves neuromuscular modulations and can potentially reduce CIPN symptoms. We examined the immediate improvements in CIPN-related pain and neuropathy following massage therapy among patients with CIPN. Methods: In a retrospective cohort, we assessed patients who received 1 massage therapy session for CIPN symptom relief during or after chemotherapy at a National Cancer Institute-Designated Comprehensive Cancer Center from October 2017 to September 2022. We measured the severity of pain and neuropathy before and after massage therapy with a 4-item verbal rating scale (VRS) or a 0 to 10 numerical rating scale (NRS). We converted NRS to VRS scores and examined the pre-post differences in symptom severity using the Wilcoxon rank test. Results: Among 23 patients (median [range] age 64 [4-85] years, female 74%, White 70%), one session of massage therapy decreased the percentage of patients reporting moderate-to-severe pain from 81% at baseline to 0% (none) post-massage; percentage of patients reporting neuropathy also reduced from 77% at baseline to 12% following treatment. The pre-post differences were statistically significant for both pain (mean: −1.6, 95% confidence interval [CI] −1.9 to −1.2; P = .001) and neuropathy scores (mean: −1.2, 95%CI −1.4 to −0.9; P < .0001). Conclusion: Among cancer patients with CIPN, one session of massage therapy was associated with immediate neuropathy and CIPN pain relief reported by patients following treatment. However, this preliminary finding requires further rigorous verifications in future randomized controlled clinical trials.

Background: Chronic pain negatively affects sleep; it is unclear whether pain relief from acupuncture contributes to sleep quality improvements in cancer survivors. This study aimed to evaluate the effect of acupuncture versus usual care on sleep quality among cancer survivors with comorbid sleep disturbance and chronic musculoskeletal pain.Methods: Sleep outcome data from the Personalized Electroacupuncture Versus Auricular Acupuncture Comparative Effectiveness (PEACE) randomized clinical trial were analyzed. Electroacupuncture or auricular acupuncture was compared with usual care for sleep quality improvement over 10 weeks of treatment among cancer survivors with clinically significant sleep disturbance and chronic musculoskeletal pain at baseline. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) global score.Results: Among 268 participants (mean [standard deviation (SD)] age, 61.4 [12.6] years; 191 women [71.3%]; mean [SD] baseline PSQI global score, 10.3 [3.3] points), electroacupuncture and auricular acupuncture resulted in greater reductions in the PSQI global score from baseline to 10 weeks in comparison with usual care: 1.42 points (95% confidence interval [CI], 0.45–2.38; p = .004) and 1.59 points (95% CI, 0.62–2.55; p = .001), respectively. The improvement in sleep quality for the acupuncture groups was sustained for 24 weeks from randomization. Furthermore, a greater proportion of patients in the electroacupuncture and auricular acupuncture groups had clinically meaningful improvement in sleep quality compared to the usual care group (41.0% and 42.9% vs. 21.4%; p = .044).Conclusions: Among cancer survivors with comorbid sleep disturbance and chronic pain, electroacupuncture and auricular acupuncture produced a clinically relevant and persistent improvement in sleep quality. These findings suggest that acupuncture may be an evidence‐based nonpharmacologic intervention to improve sleep health for cancer survivors with pain.Plain Language Summary: This study analyzed the sleep quality data from a published randomized clinical trial that evaluated the effect of electroacupuncture or auricular acupuncture versus usual care on pain relief among people who survived cancer. This analysis included a prespecified subgroup of 268 participants with co‐occurring sleep disturbance and chronic musculoskeletal pain at baseline and found that patients who used acupuncture for pain relief demonstrated greater improvements in sleep quality compared with patients who received usual care. Sleep quality improvement by acupuncture was sustained after the treatment ended.

Background: Sleep disturbances are common and bothersome among cancer and noncancer populations. Suanzaoren ( Ziziphi Spinosae Semen) is commonly used to improve sleep, yet its efficacy and safety are unclear. Methods: We systematically searched PubMed, Cochrane Library, and EMBASE from inception through October 5, 2021, to identify randomized trials of Suanzaoren. We included randomized trials comparing Suanzaoren to placebo, medications, cognitive behavioral therapy (CBT), or usual care for improving sleep outcomes in cancer and noncancer patients with insomnia or sleep disturbance. We performed a risk of bias analysis following Cochrane guidelines. Depending on heterogeneity, we pooled studies with similar comparators using fixed- and random-effects models. Results: We included participants with insomnia disorder (N = 785) or sleep disturbance (N = 120) from 9 trials. Compared with placebo, Suanzaoren led to significant subjective sleep quality improvements in participants with insomnia and patients with sleep disturbance combined (standard mean difference −0.58, 95% CI −1.04, −0.11; P < .01); Compared with benzodiazepines or CBT, Suanzaoren was associated with a significant decrease in insomnia severity (mean difference −2.68 points, 95% CI −5.50, −0.22; P = .03) at 4 weeks in the general population and cancer patients. The long-term effects of Suanzaoren were mixed among trials. Suanzaoren did not increase the incidence of major adverse events. The placebo-controlled studies had a low risk of bias. Conclusion: Suanzaoren is associated with short-term patient-reported sleep quality improvements among individuals with insomnia or sleep disturbance. Due to the small sample size and variable study quality, the clinical benefits and harms of Suanzaoren, particularly in the long term, should be further assessed in a sufficiently powered randomized trial. Registration: PROSPERO CRD42021281943