Li Y, Hong E, Ye W, et al. Moxibustion as an Adjuvant Therapy for Cancer Pain: A Systematic Review and Meta-Analysis. J Pain Res. 2023 Feb 17;16:515-525. doi: 10.2147/JPR.S396696. eCollection 2023. (Systematic review)

PURPOSE: Pain is one of the most common and feared symptoms among cancer patients. Unrelieved pain denies patients comfort and greatly affects their overall quality of life. Moxibustion is commonly used to manage chronic pain. However, its efficacy on cancer pain remains inconclusive. This study aimed to evaluate the efficacy of moxibustion for cancer pain.

METHODS: We searched seven databases to obtain articles about moxibustion combined with pharmacotherapy for cancer pain published before November 2022. All data extraction was carried out independently by two investigators. RevMan 5.4 software was used for data analysis.

RESULTS: A total of ten trials involving 999 cases were included. The results of the meta-analysis revealed that moxibustion combined with pharmacotherapy was significantly better than drug therapy alone in improving pain relief rate (RR =1.16, 95% CI = [1.04, 1.30], P = 0.01), reducing pain scores (SMD = -1.43, 95% CI = [-2.09, -0.77], P < 0.0001), Shortening the onset of analgesia (MD = -12.07, 95% CI = [-12.91, -11.22], P < 0.00001), prolonging the duration of analgesia (MD = 3.69, 95% CI = [3.21, 4.18], P < 0.00001), and improving quality of life (SMD = 2.48, 95% CI = [0.67, 4.29], P = 0.007). In addition, moxibustion combined with pharmacotherapy can effectively reduce adverse reactions of drugs (RR =0.35, 95% CI = [0.21, 0.57], P < 0.0001).

CONCLUSION: The evidence in this review supports moxibustion as an effective adjuvant therapy for cancer pain management. However, high-quality RCTs are needed to further confirm these findings.


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Physician 5 / 7
Comments from MORE raters

Physician rater

Moxibustion is a traditional Chinese medicine therapy that consists of burning dried mugwort on particular points on the body. It is not a medicine therapy I had heard of (nor do I know whether it is available by my complimentary clinicians nor its cost). Given this meta-analysis, however, I would be interested in investigating its applicability for my palliative care patients.

Physician rater

This was challenging to evaluate as I had never heard of moxibustion before (and had to look it up to learn more). I do think it highlights the importance of non-pharm options...whether those are acupuncture, massage, moxibustion, or other therapies like Reiki, osteopathic care, etc. What is very hard to assess in THIS meta-analysis, though, is the critical role that essentially none of the participants were blinded. How much of the effect then was knowing they had the therapy? Overall, this highlights that non-pharm approaches matter in chronic pain and need exploring.
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