Effect of acupuncture at 3 anti-fatigue acupoints in the treatment of cancer-related fatigue in patients with cancer: Protocol for a systematic review and meta-analysis of randomized controlled trials

The Effects of Transcutaneous Acupoint Electrical Stimulation on Cancer-related Fatigue and Negative Emotions in Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Transcutaneous electrical acupoint stimulation (TEAS) is a noninvasive and therapeutic technique that stimulated the acupoint by delivering electricity. Whether TEAS could relieve cancer-related fatigue (CRF), anxiety, and depression and improve the quality of life in cancer patients remains controversial. Thus, we conducted a thorough literature search of electronic Chinese and English databases for randomized controlled trials (RCTs) reporting the effect of CRF, anxiety, depression, and quality of life in cancer patients from inception to July 1st, 2021. The Cochrane Collaboration Risk of Bias criteria were used to assess the risk of bias for each included RCT. Continuous variables were analyzed using standardized mean difference (SMD) and 95% confidence interval (CI). A fixed-effects model was used for the meta-analysis of all outcomes. A total of nine RCTs with 924 cancer patients were included in this analysis, including 460 patients in the interventional group and 464 patients in the control group. We found that TEAS could significantly reduce CRF, depression, and anxiety (SWD = −0.83, 95% CI: −0.99 to −0.66, $P<0.05$ ) and improve the quality of life (SWD = −1.37, 95% CI: −2.34 to −0.40, $P<0.05$ ). The funnel plot analysis revealed no significant publication bias. We conclude that TEAS is beneficial for reducing CRF, depression, and anxiety and improving the quality of life of cancer patients, but additional high-quality evidence in the future is entailed to support this.