28 november 2019: Bron: JAMA

Dat acupunctuur een meerwaarde kan hebben bij het behandelen van kankerpatienten is al langer bekend, zie in gerelateerde artikelen. Nu blijkt uit een meta-analyse van 17 gerandomiseerde studies dat acupunctuur en acupressuur de pijnklachten van kankerpatienten beduidend vermindert in vergelijking met sham behandeling (in feite een placebo want sham betekent dat er geen acupunctuur plaatsvindt met het plaastsen van de naalden). Ook was het gebruik van pijnstillers bij kankerpatienten die acupunctuur gebruikten duidelijk minder. 

Hier een grafiek uit 7 gerandomiseerde studies waarin de pijnvermindering werd vergeleken tussen een echte acupunctuur of acupressuur behandeling en een sham behandeling:

Forest Plot of the Estimated Association of Acupuncture and Acupressure With Cancer Pain Intensity


Het volledige studierapport: Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain. A systematic review and meta-analysis is gratis in te zien. Met gedetailleerde beschrijvingen en heldere grafieken.

Hieronder het abstract van de studie plus referentielijst. 

This study found a moderate level of evidence that acupuncture and/or acupressure was significantly associated with lower pain intensity in patients with cancer compared with a sham control, which suggests a potential for a combination of acupuncture and acupressure to help reduce opioid doses in patients with cancer.

Original Investigation
December 19, 2019

Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer PainA Systematic Review and Meta-Analysis

JAMA Oncol. Published online December 19, 2019. doi:https://doi.org/10.1001/jamaoncol.2019.5233
Key Points

Question  Is the use of acupuncture and acupressure associated with improved cancer pain management compared with sham intervention and/or analgesic therapy alone?

Findings  In this systematic review of 17 randomized clinical trials and meta-analysis of 14 trials in the current English-language and Chinese-language literature, a significant association was found between real (compared with sham) acupuncture and reduced pain, and acupuncture combined with analgesic therapy was associated with decreased analgesic use. However, heterogeneity lowered the level of certainty of the evidence.

Meaning  This study found a moderate level of evidence that acupuncture and/or acupressure was significantly associated with lower pain intensity in patients with cancer compared with a sham control, which suggests a potential for a combination of acupuncture and acupressure to help reduce opioid doses in patients with cancer.


Importance  Research into acupuncture and acupressure and their application for cancer pain has been growing, but the findings have been inconsistent.

Objective  To evaluate the existing randomized clinical trials (RCTs) for evidence of the association of acupuncture and acupressure with reduction in cancer pain.

Data Sources  Three English-language databases (PubMed, Embase, and CINAHL) and 4 Chinese-language biomedical databases (Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were searched for RCTs published from database inception through March 31, 2019.

Study Selection  Randomized clinical trials that compared acupuncture and acupressure with a sham control, analgesic therapy, or usual care for managing cancer pain were included.

Data Extraction and Synthesis  Data were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. Random-effects modeling was used to calculate the effect sizes of included RCTs. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach.

Main Outcomes and Measures  The primary outcome was pain intensity measured by the Brief Pain Inventory, Numerical Rating Scale, Visual Analog Scale, or Verbal Rating Scale.

Results  A total of 17 RCTs (with 1111 patients) were included in the systematic review, and data from 14 RCTs (with 920 patients) were used in the meta-analysis. Seven sham-controlled RCTs (35%) were notable for their high quality, being judged to have a low risk of bias for all of their domains, and showed that real (compared with sham) acupuncture was associated with reduced pain intensity (mean difference , −1.38 points; 95% CI, −2.13 to −0.64 points; I2 = 81%). A favorable association was also seen when acupuncture and acupressure were combined with analgesic therapy in 6 RCTs for reducing pain intensity (MD, −1.44 points; 95% CI, −1.98 to −0.89; I2 = 92%) and in 2 RCTs for reducing opioid dose (MD, −30.00 mg morphine equivalent daily dose; 95% CI, −37.5 mg to −22.5 mg). The evidence grade was moderate because of the substantial heterogeneity among studies.

Conclusions and Relevance  This systematic review and meta-analysis found that acupuncture and/or acupressure was significantly associated with reduced cancer pain and decreased use of analgesics, although the evidence level was moderate. This finding suggests that more rigorous trials are needed to identify the association of acupuncture and acupressure with specific types of cancer pain and to integrate such evidence into clinical care to reduce opioid use.


Neufeld  NJ, Elnahal  SM, Alvarez  RH.  Cancer pain: a review of epidemiology, clinical quality and value impact.  Future Oncol. 2017;13(9):833-841. doi:10.2217/fon-2016-0423PubMedGoogle ScholarCrossref
van den Beuken-van Everdingen  MH, Hochstenbach  LM, Joosten  EA, Tjan-Heijnen  VC, Janssen  DJ.  Update on prevalence of pain in patients with cancer: systematic review and meta-analysis.  J Pain Symptom Manage. 2016;51(6):1070-1090.e9. doi:10.1016/j.jpainsymman.2015.12.340PubMedGoogle ScholarCrossref
Carlson  CL.  Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review.  J Pain Res. 2016;9:515-534. doi:10.2147/JPR.S97759PubMedGoogle ScholarCrossref
Simone  CB  II, Vapiwala  N, Hampshire  MK, Metz  JM.  Cancer patient attitudes toward analgesic usage and pain intervention.  Clin J Pain. 2012;28(2):157-162. doi:10.1097/AJP.0b013e318223be30PubMedGoogle ScholarCrossref
Kim  YC, Ahn  JS, Calimag  MM,  et al; ACHEON Working Group.  Current practices in cancer pain management in Asia: a survey of patients and physicians across 10 countries.  Cancer Med. 2015;4(8):1196-1204. doi:10.1002/cam4.471PubMedGoogle ScholarCrossref
Kwon  JH.  Overcoming barriers in cancer pain management.  J Clin Oncol. 2014;32(16):1727-1733. doi:10.1200/JCO.2013.52.4827PubMedGoogle ScholarCrossref
Pachman  DR, Barton  DL, Swetz  KM, Loprinzi  CL.  Troublesome symptoms in cancer survivors: fatigue, insomnia, neuropathy, and pain.  J Clin Oncol. 2012;30(30):3687-3696. doi:10.1200/JCO.2012.41.7238PubMedGoogle ScholarCrossref
Vowles  KE, McEntee  ML, Julnes  PS, Frohe  T, Ney  JP, van der Goes  DN.  Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis.  Pain. 2015;156(4):569-576. doi:10.1097/01.j.pain.0000460357.01998.f1PubMedGoogle ScholarCrossref
Miller  M, Barber  CW, Leatherman  S,  et al.  Prescription opioid duration of action and the risk of unintentional overdose among patients receiving opioid therapy.  JAMA Intern Med. 2015;175(4):608-615. doi:10.1001/jamainternmed.2014.8071
ArticlePubMedGoogle ScholarCrossref
Sharfstein  JM, Olsen  Y.  Lessons learned from the opioid epidemic  [published online August 5, 2019].  JAMA. 2019;322(9):809-810. doi:10.1001/jama.2019.9794
ArticlePubMedGoogle ScholarCrossref
Chua  IS, Leiter  RE, Brizzi  KT,  et al.  US national trends in opioid-related hospitalizations among patients with cancer.  JAMA Oncol. 2019;5(5):734-735. doi:10.1001/jamaoncol.2019.0042
ArticlePubMedGoogle ScholarCrossref
Tick  H, Nielsen  A, Pelletier  KR,  et al; Pain Task Force of the Academic Consortium for Integrative Medicine and Health.  Evidence-based nonpharmacologic strategies for comprehensive pain care: the Consortium Pain Task Force white paper.  Explore (NY). 2018;14(3):177-211. doi:10.1016/j.explore.2018.02.001PubMedGoogle ScholarCrossref
Clark  SD, Bauer  BA, Vitek  S, Cutshall  SM.  Effect of integrative medicine services on pain for hospitalized patients at an academic health center.  Explore (NY). 2019;15(1):61-64. doi:10.1016/j.explore.2018.07.006PubMedGoogle ScholarCrossref
Miller  KR, Patel  JN, Symanowski  JT, Edelen  CA, Walsh  D.  Acupuncture for cancer pain and symptom management in a palliative medicine clinic.  Am J Hosp Palliat Care. 2019;36(4):326-332. doi:10.1177/1049909118804464PubMedGoogle ScholarCrossref
Swarm  R, Anghelescu  DL, Benedetti  C,  et al; National Comprehensive Cancer Network (NCCN).  Adult cancer pain.  J Natl Compr Canc Netw. 2007;5(8):726-751.PubMedGoogle Scholar
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Adult Cancer Pain. Version 1. https://www.nccn.org/professionals/default.aspx. Published January 22, 2018. Accessed June 10, 2018.
Zia  FZ, Olaku  O, Bao  T,  et al.  The National Cancer Institute’s Conference on Acupuncture for Symptom Management in Oncology: state of the science, evidence, and research gaps.  J Natl Cancer Inst Monogr. 2017;2017(52):lgx005. doi:10.1093/jncimonographs/lgx005PubMedGoogle Scholar
Bae  K, Yoo  HS, Lamoury  G, Boyle  F, Rosenthal  DS, Oh  B.  Acupuncture for aromatase inhibitor-induced arthralgia: a systematic review.  Integr Cancer Ther. 2015;14(6):496-502. doi:10.1177/1534735415596573PubMedGoogle ScholarCrossref
Bardia  A, Barton  DL, Prokop  LJ, Bauer  BA, Moynihan  TJ.  Efficacy of complementary and alternative medicine therapies in relieving cancer pain: a systematic review.  J Clin Oncol. 2006;24(34):5457-5464. doi:10.1200/JCO.2006.08.3725PubMedGoogle ScholarCrossref
Chao  LF, Zhang  AL, Liu  HE, Cheng  MH, Lam  HB, Lo  SK.  The efficacy of acupoint stimulation for the management of therapy-related adverse events in patients with breast cancer: a systematic review.  Breast Cancer Res Treat. 2009;118(2):255-267. doi:10.1007/s10549-009-0533-8PubMedGoogle ScholarCrossref
Chen  L, Lin  CC, Huang  TW,  et al.  Effect of acupuncture on aromatase inhibitor-induced arthralgia in patients with breast cancer: a meta-analysis of randomized controlled trials.  Breast. 2017;33:132-138. doi:10.1016/j.breast.2017.03.015PubMedGoogle ScholarCrossref
Chien  TJ, Liu  CY, Chang  YF, Fang  CJ, Hsu  CH.  Acupuncture for treating aromatase inhibitor-related arthralgia in breast cancer: a systematic review and meta-analysis.  J Altern Complement Med. 2015;21(5):251-260. doi:10.1089/acm.2014.0083PubMedGoogle ScholarCrossref
Chiu  HY, Hsieh  YJ, Tsai  PS.  Systematic review and meta-analysis of acupuncture to reduce cancer-related pain.  Eur J Cancer Care (Engl). 2017;26(2):e12457. doi:10.1111/ecc.12457PubMedGoogle Scholar
Choi  TY, Lee  MS, Kim  TH, Zaslawski  C, Ernst  E.  Acupuncture for the treatment of cancer pain: a systematic review of randomised clinical trials.  Support Care Cancer. 2012;20(6):1147-1158. doi:10.1007/s00520-012-1432-9PubMedGoogle ScholarCrossref
Dos Santos  S, Hill  N, Morgan  A, Smith  J, Thai  C, Cheifetz  O.  Acupuncture for treating common side effects associated with breast cancer treatment: a systematic review.  Med Acupunct. 2010;22(2):81-97. doi:10.1089/acu.2009.0730Google ScholarCrossref
Garcia  MK, McQuade  J, Haddad  R,  et al.  Systematic review of acupuncture in cancer care: a synthesis of the evidence.  J Clin Oncol. 2013;31(7):952-960. doi:10.1200/JCO.2012.43.5818PubMedGoogle ScholarCrossref
Hu  C, Zhang  H, Wu  W,  et al.  Acupuncture for pain management in cancer: a systematic review and meta-analysis.  Evid Based Complement Alternat Med. 2016;2016:1720239. doi:10.1155/2016/1720239PubMedGoogle Scholar
Lau  CH, Wu  X, Chung  VC,  et al.  Acupuncture and related therapies for symptom management in palliative cancer care: systematic review and meta-analysis.  Medicine (Baltimore). 2016;95(9):e2901. doi:10.1097/MD.0000000000002901PubMedGoogle Scholar
Lee  H, Schmidt  K, Ernst  E.  Acupuncture for the relief of cancer-related pain—a systematic review.  Eur J Pain. 2005;9(4):437-444. doi:10.1016/j.ejpain.2004.10.004PubMedGoogle ScholarCrossref
Lee  PL, Tam  KW, Yeh  ML, Wu  WW.  Acupoint stimulation, massage therapy and expressive writing for breast cancer: a systematic review and meta-analysis of randomized controlled trials.  Complement Ther Med. 2016;27:87-101. doi:10.1016/j.ctim.2016.06.003PubMedGoogle ScholarCrossref
Li  H.  A Systematic Review of Randomized Controlled Trials of Acupuncture Treatment for Cancer Pain [master's thesis]. Harbin, China: Heilongjiang University Of Chinese Medicine; 2016.
Lian  WL, Pan  MQ, Zhou  DH, Zhang  ZJ.  Effectiveness of acupuncture for palliative care in cancer patients: a systematic review.  Chin J Integr Med. 2014;20(2):136-147. doi:10.1007/s11655-013-1439-1PubMedGoogle ScholarCrossref
Paley  CA, Johnson  MI, Tashani  OA, Bagnall  AM.  Acupuncture for cancer pain in adults.  Cochrane Database Syst Rev. 2015;(10):CD007753. doi:10.1002/14651858.7753.pub3PubMedGoogle Scholar
Pan  CX, Morrison  RS, Ness  J, Fugh-Berman  A, Leipzig  RM.  Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life: a systematic review.  J Pain Symptom Manage. 2000;20(5):374-387. doi:10.1016/S0885-3924(00)00190-1PubMedGoogle ScholarCrossref
Peng  H, Peng  HD, Xu  L, Lao  LX.  Efficacy of acupuncture in treatment of cancer pain: a systematic review  [in Chinese].  Zhong Xi Yi Jie He Xue Bao. 2010;8(6):501-509. doi:10.3736/jcim20100601PubMedGoogle ScholarCrossref
Robb  KA, Bennett  MI, Johnson  MI, Simpson  KJ, Oxberry  SG.  Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.  Cochrane Database Syst Rev. 2008;(3):CD006276. doi:10.1002/14651858.CD006276.pub2PubMedGoogle Scholar
Tao  WW, Jiang  H, Tao  XM, Jiang  P, Sha  LY, Sun  XC.  Effects of acupuncture, tuina, tai chi, qigong, and traditional Chinese medicine five-element music therapy on symptom management and quality of life for cancer patients: a meta-analysis.  J Pain Symptom Manage. 2016;51(4):728-747. doi:10.1016/j.jpainsymman.2015.11.027PubMedGoogle ScholarCrossref
Yang  GS, Kim  HJ, Griffith  KA, Zhu  S, Dorsey  SG, Renn  CL.  Interventions for the treatment of aromatase inhibitor-associated arthralgia in breast cancer survivors: a systematic review and meta-analysis.  Cancer Nurs. 2017;40(4):E26-E41. doi:10.1097/NCC.0000000000000409PubMedGoogle ScholarCrossref
Zheng  Y, Yu  YH, Fang  FF.  Meta-analysis on wrist-ankle acupuncture of cancerous pain  [in Chinese].  Liaoning Zhongyiyao Daxue Xuebao. 2014;16:152-155.Google Scholar
Zhou  J, Liang  Y, Chen  Q, Fang  JQ.  Meta-analysis on randomized controlled clinical trials of auricular acupuncture on cancer pain [in Chinese].  Zhonghua Zhongyiyao Xuekan. 2014;10:2326-2330.Google Scholar
Hershman  DL, Unger  JM, Greenlee  H,  et al.  Effect of acupuncture vs sham acupuncture or waitlist control on joint pain related to aromatase inhibitors among women with early-stage breast cancer: a randomized clinical trial.  JAMA. 2018;320(2):167-176. doi:10.1001/jama.2018.8907
ArticlePubMedGoogle ScholarCrossref
Mao  JJ, Farrar  JT.  Acupuncture for aromatase inhibitor–related joint pain among breast cancer patients.  JAMA. 2018;320(21):2269-2270. doi:10.1001/jama.2018.16736
ArticlePubMedGoogle ScholarCrossref
He  Y, Liu  Y, May  BH,  et al.  Effectiveness of acupuncture for cancer pain: protocol for an umbrella review and meta-analyses of controlled trials.  BMJ Open. 2017;7(12):e018494. doi:10.1136/bmjopen-2017-018494PubMedGoogle Scholar
Higgins  JPT, Altman  DG. Assessing risk of bias in included studies. In: Higgins  JPT, Green  S, eds.  Cochrane Handbook for Systematic Reviews of Interventions. Chichester, UK: John Wiley & Sons; 2008:chap 8. doi:10.1002/9780470712184.ch8
Fainsinger  RL, Fairchild  A, Nekolaichuk  C, Lawlor  P, Lowe  S, Hanson  J.  Is pain intensity a predictor of the complexity of cancer pain management?  J Clin Oncol. 2009;27(4):585-590. doi:10.1200/JCO.2008.17.1660PubMedGoogle ScholarCrossref
Hjermstad  MJ, Fayers  PM, Haugen  DF,  et al; European Palliative Care Research Collaborative (EPCRC).  Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review.  J Pain Symptom Manage. 2011;41(6):1073-1093. doi:10.1016/j.jpainsymman.2010.08.016PubMedGoogle ScholarCrossref
Ruela  LO, Iunes  DH, Nogueira  DA, Stefanello  J, Gradim  CVC.  Effectiveness of auricular acupuncture in the treatment of cancer pain: randomized clinical trial  [article in English, Portuguese, Spanish; abstract available in Portuguese and Spanish from the publisher].  Rev Esc Enferm USP. 2018;52:e03402.doi:10.1590/S1980-220X2017040503402PubMedGoogle Scholar
Kim  K, Lee  S.  Intradermal acupuncture along with analgesics for pain control in advanced cancer cases: a pilot, randomized, patient-assessor-blinded, controlled trial.  Integr Cancer Ther. 2018;17(4):1137-1143. doi:10.1177/1534735418786797PubMedGoogle ScholarCrossref
Wang  Y, Wang  XY, Wang  H, Zhang  Y, Fang  H.  Clinical study of electro-acupuncture combined with hydroxycodone sustained-release tablets for cancer pain in advanced non-small cell lung cancer.  Zhejiang J Tradit Chin Med. 2017;9:684-685. doi:10.13633/j.cnki.zjtcm.2017.09.039Google Scholar
Shen  LF, Chen  WY, Luv  XD,  et al.  Effects of electro-acupuncture on improving sleep quality for patients with lung cancer pain.  J Med Res. 2016;(06):87-90. doi:10.11969/j.issn.1673-548X.2016.06.022Google Scholar
Wang  J, Lu  DR, Bi  R, Shu  XN.  Clinical observation on 30 cases of moderate and severe cancer pain of bone metastasis treated by auricular acupressure.  Yunnan J Tradit Chin Med Materia Medica. 2015;02:43-45.Google Scholar
Guo  ZB, Guo  GH, Yang  JP, Shao  Y.  Effects of acupuncture on pain and quality of life for patients with advanced gastric cancer. International journal of traditional.  Int J Chin Med. 2015;37(4):371-373. doi:10.3760/cma.j.issn.1673-4246.2015.04.023Google Scholar
Mao  JJ, Xie  SX, Farrar  JT,  et al.  A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use.  Eur J Cancer. 2014;50(2):267-276. doi:10.1016/j.ejca.2013.09.022PubMedGoogle ScholarCrossref
Zhu  LN, Wang  RL, Zong  H, Fan  QX.  Effects of auricular acupressure combined with oxycontin for malignant neuropathic pain.  Chin J Physic Med Rehabil.2013;35(7):579-581. doi:10.3760/cma.j.issn.0254-1424.2013.07.020Google Scholar
Oh  B, Kimble  B, Costa  DS,  et al.  Acupuncture for treatment of arthralgia secondary to aromatase inhibitor therapy in women with early breast cancer: pilot study.  Acupunct Med. 2013;31(3):264-271. doi:10.1136/acupmed-2012-010309PubMedGoogle ScholarCrossref
Chen  H, Liu  TY, Kuai  L, Zhu  J, Wu  CJ, Liu  LM.  Electroacupuncture treatment for pancreatic cancer pain: a randomized controlled trial.  Pancreatology. 2013;13(6):594-597. doi:10.1016/j.pan.2013.10.007PubMedGoogle ScholarCrossref
Bao  T, Cai  L, Giles  JT,  et al.  A dual-center randomized controlled double blind trial assessing the effect of acupuncture in reducing musculoskeletal symptoms in breast cancer patients taking aromatase inhibitors.  Breast Cancer Res Treat. 2013;138(1):167-174. doi:10.1007/s10549-013-2427-zPubMedGoogle ScholarCrossref
Jiang  KR.  Clinical Research on Acupuncture on Siguan Points Combined with Auricular Acupressure for Cancer Pain [doctoral thesis]. Guangzhou, China: Guangzhou University of Chinese Medicine; 2011.
Pfister  DG, Cassileth  BR, Deng  GE,  et al.  Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial.  J Clin Oncol. 2010;28(15):2565-2570. doi:10.1200/JCO.2009.26.9860PubMedGoogle ScholarCrossref
Crew  KD, Capodice  JL, Greenlee  H,  et al.  Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer.  J Clin Oncol. 2010;28(7):1154-1160. doi:10.1200/JCO.2009.23.4708PubMedGoogle ScholarCrossref
Crew  KD, Capodice  JL, Greenlee  H,  et al.  Pilot study of acupuncture for the treatment of joint symptoms related to adjuvant aromatase inhibitor therapy in postmenopausal breast cancer patients.  J Cancer Surviv. 2007;1(4):283-291. doi:10.1007/s11764-007-0034-xPubMedGoogle ScholarCrossref
Alimi  D, Rubino  C, Pichard-Léandri  E, Fermand-Brulé  S, Dubreuil-Lemaire  ML, Hill  C.  Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial.  J Clin Oncol. 2003;21(22):4120-4126. doi:10.1200/JCO.2003.09.011PubMedGoogle ScholarCrossref
MacPherson  H, Thomas  K, Walters  S, Fitter  M.  The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists.  BMJ. 2001;323(7311):486-487. doi:10.1136/bmj.323.7311.486PubMedGoogle ScholarCrossref
Chan  MWC, Wu  XY, Wu  JCY, Wong  SYS, Chung  VCH.  Safety of acupuncture: overview of systematic reviews.  Sci Rep. 2017;7(1):3369. doi:10.1038/s41598-017-03272-0PubMedGoogle ScholarCrossref
Briggs  JP, Shurtleff  D.  Acupuncture and the complex connections between the mind and the body.  JAMA. 2017;317(24):2489-2490. doi:10.1001/jama.2017.7214
ArticlePubMedGoogle ScholarCrossref
Sox  HC, Lewis  RJ.  Pragmatic trials: practical answers to “real world” questions.  JAMA. 2016;316(11):1205-1206. doi:10.1001/jama.2016.11409
ArticlePubMedGoogle ScholarCrossref
Ford  I, Norrie  J.  Pragmatic trials.  N Engl J Med. 2016;375(5):454-463. doi:10.1056/NEJMra1510059PubMedGoogle ScholarCrossref
Chalkidou  K, Tunis  S, Whicher  D, Fowler  R, Zwarenstein  M.  The role for pragmatic randomized controlled trials (pRCTs) in comparative effectiveness research.  Clin Trials. 2012;9(4):436-446. doi:10.1177/1740774512450097PubMedGoogle ScholarCrossref
Kaptchuk  TJ, Chen  KJ, Song  J.  Recent clinical trials of acupuncture in the West: responses from the practitioners.  Chin J Integr Med. 2010;16(3):197-203. doi:10.1007/s11655-010-0197-xPubMedGoogle ScholarCrossref
Vickers  AJ, Linde  K.  Acupuncture for chronic pain.  JAMA. 2014;311(9):955-956. doi:10.1001/jama.2013.285478
ArticlePubMedGoogle ScholarCrossref
Fan  AY, Miller  DW, Bolash  B,  et al.  Acupuncture’s role in solving the opioid epidemic: evidence, cost-effectiveness, and care availability for acupuncture as a primary, non-pharmacologic method for pain relief and management—white paper 2017.  J Integr Med. 2017;15(6):411-425. doi:10.1016/S2095-4964(17)60378-9PubMedGoogle ScholarCrossref
Tedesco  D, Gori  D, Desai  KR,  et al.  Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.  JAMA Surg. 2017;152(10):e172872. doi:10.1001/jamasurg.2017.2872
ArticlePubMedGoogle Scholar
Franco  C, Bernardini  S, Ferreri  R.  Acupuncture in palliative care.  OBM Integrative Complementary Med. 2019;4(1):1. doi:10.21926/obm.icm.1901006Google ScholarCrossref
Portenoy  RK.  Treatment of cancer pain.  Lancet. 2011;377(9784):2236-2247. doi:10.1016/S0140-6736(11)60236-5PubMedGoogle ScholarCrossref
Krajnik  M, Zylicz  Z. Pain assessment, recognising clinical patterns, and cancer pain syndromes. In: Hanna  M, Zylicz  ZB, eds.  Cancer Pain. London, UK: Springer London; 2013:95-108. doi:10.1007/978-0-85729-230-8_7
MacLeod  J, Wolff  E, McAllister  A, Mao  JJ, Garland  SN.  Including the patient voice in patient-centered outcomes research in integrative oncology.  J Natl Cancer Inst Monogr. 2017;2017(52):46-47. doi:10.1093/jncimonographs/lgx008PubMedGoogle Scholar
Hui  D, Park  M, Shamieh  O,  et al.  Personalized symptom goals and response in patients with advanced cancer.  Cancer. 2016;122(11):1774-1781. doi:10.1002/cncr.29970PubMedGoogle ScholarCrossref
Ben-Arye  E, Samuels  N.  Patient-centered care in lung cancer: exploring the next milestones.  Transl Lung Cancer Res. 2015;4(5):630-634. doi:10.3978/j.issn.2218-6751.2015.03.07PubMedGoogle Scholar
Elsayem  AF, Elzubeir  HE, Brock  PA, Todd  KH.  Integrating palliative care in oncologic emergency departments: challenges and opportunities.  World J Clin Oncol. 2016;7(2):227-233. doi:10.5306/wjco.v7.i2.227PubMedGoogle ScholarCrossref
Yun  H, Sun  L, Mao  JJ.  Growth of integrative medicine at leading cancer centers between 2009 and 2016: a systematic analysis of NCI-designated comprehensive cancer center websites.  J Natl Cancer Inst Monogr. 2017;2017(52):29-32. doi:10.1093/jncimonographs/lgx004PubMedGoogle ScholarCrossref
Liou  KT, Hung  TKW, Meghani  SH,  et al.  What if acupuncture were covered by insurance for pain management? a cross-sectional study of cancer patients at one academic center and 11 community hospitals.  Pain Med. 2019;20(10):2060-2068. doi:10.1093/pm/pnz087PubMedGoogle ScholarCrossref

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