Reference Citation(s)	Type of Study	Condition Treated	No. of Patients: Enrolled; Treated; Controlb	Strongest Benefit Reportedc	Concurrent Therapy Used (Yes/No/ Unknown)d	Level of Evidence Scoree
[9]	RCT	Stomach cancer pain	48; 16 acupuncture and 16 acupuncture point injection of freeze-dried human transfer factor; 16 conventional analgesics	In long-term treatment, equal or better analgesia than conventional drugsf	No	1iiC
[10]	RCT	Postoperative pain in liver cancer patients	16; 12 Chinese herbs, auricular EA, or epidural morphine given alone or in combination; 4 placebo controls	Combination treatment better than placebo and EA alone, Chinese herbs alone, or epidural morphine aloneg	Yes (Chinese herbs; epidural morphine)	1iC
[15]	RCT	Cancer pain	90; 28 auricular acupuncture; 51 acupuncture at placebo points in ear or auricular seeds fixed at placebo points with adhesive	Pain intensity decreased by 36% at 2 monthsh	Yes (analgesics and co-analgesics, including tricyclic antidepressants and antiepileptics)	1iiC
[11]	Nonconsecutive case series	Cancer pain	20; 20 auricular acupuncture; none	Average pain intensity decreased by 43%, using VAS (0–100 mm)i	Yes (analgesics)	3iiiC
[12]	Nonrandomized controlled trial	Local pain and limitation of arm movement after breast cancer surgery and axillary lymph node dissection	80; 48 acupuncture; 32 no acupuncture	Improved postoperative pain; improved range of arm motionj	Unknown	2C
[13]	Nonconsecutive case series	Cancer-related pain	183; 183 acupuncture; none	95 (52%) “significantly helped”	Yes (analgesics)	3iC
[14]	Nonconsecutive case series	Cancer pain	29; 29 EA; none	Pain reduced; injection of analgesics reduced or no longer required	Yes (analgesics)	3iC
[8]	Best case series	Cancer pain	5; 5 auricular EA; none	Symptoms improved	Unknown	4

EA = electroacupuncture; No. = number; RCT = randomized controlled trial; VAS = Visual Analog Scale.

aSee text and the NCI Dictionary for additional information and definition of terms.

bNumber of patients treated plus number of patients control may not equal number of patients enrolled; number of patients enrolled equals number of patients initially recruited/considered by the researchers who conducted a study; number of patients treated equals number of enrolled patients who were given the treatment being studied AND for whom results were reported.

cStrongest evidence reported that the treatment under study has activity or otherwise improves the well-being of cancer patients.

dConcurrent therapy for symptoms treated (not cancer).

eFor information about levels of evidence analysis and an explanation of the level of evidence scores, see Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.

f P < .05, acupuncture treatment versus conventional analgesics.

g P < .05, combination of traditional Chinese medicine (acupuncture and Chinese herbs) and epidural morphine versus placebo.

h P < .0001, acupuncture versus placebo.

i P < .00001, day 60 after start of acupuncture treatment versus day 0.

j P < .01, acupuncture treatment versus no acupuncture treatment.

References

8. Niemtzow RC: Integration of complementary disciplines into the oncology clinic. Part I. Acupuncture. Curr Probl Cancer 24 (4): 184-93, 2000 Jul-Aug.  [PUBMED Abstract]
   
   
9. Dang W, Yang J: Clinical study on acupuncture treatment of stomach carcinoma pain. J Tradit Chin Med 18 (1): 31-8, 1998.  [PUBMED Abstract]
   
   
10. Li QS, Cao SH, Xie GM, et al.: Combined traditional Chinese medicine and Western medicine. Relieving effects of Chinese herbs, ear-acupuncture and epidural morphine on postoperative pain in liver cancer. Chin Med J (Engl) 107 (4): 289-94, 1994.  [PUBMED Abstract]
    
    
11. Alimi D, Rubino C, Leandri EP, et al.: Analgesic effects of auricular acupuncture for cancer pain. J Pain Symptom Manage 19 (2): 81-2, 2000.  [PUBMED Abstract]
    
    
12. He JP, Friedrich M, Ertan AK, et al.: Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer. Clin Exp Obstet Gynecol 26 (2): 81-4, 1999.  [PUBMED Abstract]
    
    
13. Filshie J, Redman D: Acupuncture and malignant pain problems. Eur J Surg Oncol 11 (4): 389-94, 1985.  [PUBMED Abstract]
    
    
14. Wen HL: Cancer pain treated with acupuncture and electrical stimulation. Mod Med Asia 13 (2): 12-6, 1977. 
    
    
15. Alimi D, Rubino C, Pichard-Léandri E, et al.: Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. J Clin Oncol 21 (22): 4120-6, 2003.  [PUBMED Abstract]