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Group 1: Pain
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C1: Yeh CH, et al; 2017 (17) . Auricular point acupressure to manage aromatase inhibitor-induced arthralgia in postmenopausal breast cancer survivors: a pilot study. |
QES a
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To assess the viability of punctual ear acupressure in the management of aromatase inhibitor-induced arthralgia . |
20 women survivors of breast cancer with aromatase inhibitor-induced arthralgia. |
Bilateral ear therapy with seeds once a week for 4 weeks. Auricular points: corresponding to the location of pain and three points to relieve stress and pain (shenmen, subcortex and sympathetic). |
Brief Pain Inventory - Short form (BPISF) for assessing the severity of pain, the impact of pain on daily function, the location of pain and use of analgesics; also blood samples (inflammatory cytokines and chemokines). |
The mean of the worst pain observed score decreased by 27% (p = 0.05) after the first day of the intervention and reached the greatest reduction of 63% (p<0.0001) on day 28. Pro-inflammatory cytokines and chemokines showed an average percentage reduction trend. Ear acupressure is feasible and may be effective in controlling arthralgia in breast cancer survivors. |
Chinese |
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C6: Yeh CH, et al; 2015 (5) . Pilot randomized controlled trial of auricular point acupressure to manage symptom clusters of pain, fatigue, and disturbed sleep in breast cancer patients. |
RCT b
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To assess the viability and tolerability of ear acupressure intervention to control pain, fatigue and sleep disorders in patients with breast cancer. |
31 women with breast cancer were randomized to an intervention group (n = 16) or a placebo control group (n = 15). |
Auriculotherapy with seeds once a week for 4 weeks. Auricular points: shenmen, sympathetic, occipital, sucortex and anxiety associated with pain-related points in different locations (8 to 12 points). |
M. D. Anderson Symptom Inventory (MDASI) scale assessment of the severity of symptoms and interference with daily activities, in addition to a quality of life questionnaire (WHOQOL-BREF). |
Participants in active auriculotherapy treatment reported a 71% reduction in pain (p = 0.0217), 44% in fatigue (p = 0.2351), 31% in sleep disorder (p = 0.0642) and 61% in the interference in daily activities (p = 0.2792). Thus, auriculotherapy can provide an inexpensive and effective complementary approach to managing groups of symptoms for breast cancer patients. |
Chinese |
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C7: Yeh CH, et al; 2015 (22) . Auricular point acupressure as an adjunct analgesic treatment for cancer patients: a feasibility study. |
QES a
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To examine the feasibility of an auriculotherapy protocol in terms of recruitment for evaluating and managing pain in cancer patients. |
50 participants diagnosed with cancer with intensity > or = to 3 points on a 11-point numerical pain scale at the time of recruitment. |
Auriculotherapy with seeds for 7 days. Auricular points: two fixed points (subcortex and sympathetic) and the corresponding pain points (total of 5 to 9 points). Collection was performed daily for 7 days on pain intensity and medication use. |
The Brief Pain Inventory (BPI) form was used to assess the severity and impact of pain on daily functions in the past 24 hours. This assessment included pain intensity and interference, medication used and pain relief by medication. |
Auriculotherapy reduced pain intensity by more than 55% for “worse pain” (p<0.0001) and about 57% for “average pain” (p<0.0001) and “pain intensity” (p<0.0001). One of the main results of this study is a decrease in medication use (78%) for pain, which can have a positive effect in decreasing the risk of potential problems related to the use of analgesics in cancer patients. Auriculotherapy therapy can be implemented in clinical practice as a non-invasive and effective intervention for managing cancer-related pain. |
Chinese |
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Group 2: Constipation
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C2: Shin J, et al; 2018 (18) . Effects of auricular acupressure on constipation in patients with breast cancer receiving chemotherapy: a randomized control trial. |
RCT b
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To examine the effects of ear acupressure to relieve constipation in breast cancer patients undergoing chemotherapy. |
52 breast cancer participants receiving chemotherapy were randomized to an intervention group (n = 26) or a control group (n = 26). |
Auricular acupressure with seeds once a week for 6 consecutive weeks. Auricular points: intestine, rectum, San Jiao, spleen, lung, sympathetic and subcortex. The control group received normal care. |
Constipation Assessment Scale (CAS), stool form - Bristol Stool Form (BSF), and the effect of constipation on daily life - Patient Assessment of Constipation -Quality of Life (PAC-QOL). |
Participants in the intervention group had reduced scores on the constipation assessment (p<0.001), increased scores on the stool form (p = 0.003) and reduced scores on the effect of constipation on daily life (p<0.001) compared to the control group. Ear acupressure was considered a safe, acceptable and effective nursing intervention in relieving constipation in breast cancer patients undergoing chemotherapy. |
Chinese |
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C10: Li Y, et al; 2017 (25) . Effect of auricular points treatment combined with acupoints application in patients with constipation after lung cancer surgery. |
RCT b
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To evaluate the effect of treating ear points combined with applying acupuncture points on a patient with constipation after lung cancer surgery. |
341 lung cancer patients between 50 and 70 years after pulmonary lobectomy were randomized into the experimental group (n = 174) or the control group (n=167). |
Auriculotherapy with seeds* for 1 week combined with acupuncture, in addition to routine nursing care (psychological support, guidance on diet and on postoperative activities). The control group received only routine nursing care. |
The Bristol Stool Scale was used to assess the stool form. Postoperative constipation was considered after 3 days of absence of postoperative evacuation . |
Compared to the two constipation groups, the constipation incidence in the control group was higher than in the experimental group (p<0.001) and the stool characteristics of the experimental group were better than in the control group (p = 0.047). Routine measures to prevent constipation after lung cancer surgery, plus ear fixation points combined with acupuncture points can effectively decrease the incidence of postoperative constipation. |
Chinese |
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Group 3: Nausea and vomiting
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C3: Eghbali M, et al; 2016 (19) . The effect of auricular acupressure on nausea and vomiting caused by chemotherapy among breast cancer patients. |
RCT b
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To determine the effect of ear acupressure on the relief of nausea and vomiting among women who received chemotherapy. |
48 women undergoing chemotherapy with drugs such as cisplatin and anthracycline were randomized to experimental and control groups. |
Auriculotherapy in 1 cycle of chemotherapy with seeds was maintained for 5 days. Auricular points: zero, stomach, brain stem, shenmen and heart and standard antiemetic medication. The control group received only standard medication. The position of the two groups reversed when patients were referred for chemotherapy. |
The Morrow Standard Questionnaire was used to assess nausea and vomiting before, during and after chemotherapy, its duration, intensity and duration with a 7-degree Likert scale. |
The use of auriculotherapy led to a decrease in the number and intensity of nausea and vomiting episodes in the acute and late phases in the experimental group, which were significantly lower than in the control group (p = 0.001). The use of auriculotherapy at recommended points, along with other medical therapies, can relieve nausea and vomiting induced by chemotherapy, without producing side effects. |
Chinese |
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C8: Shin N, et al; 2018 (23) . Effect of auricular acupressure on nausea, vomiting, and retching in patients with colorectal cancer receiving chemotherapy. |
QES a
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To evaluate the effects of ear acupressure on nausea and vomiting in patients with colorectal cancer receiving chemotherapy. |
50 participants with colorectal cancer from the second cycle of chemotherapy were divided into two groups of 25 each: experimental and control. |
Auriculotherapy with seeds for 2 days. Auricular points: zero, stomach, brain stem, shenmen and heart. The control group received no intervention. |
The Korean version of the Index of Nausea, Vomiting, and Retching (INVR) to measure the frequency, distress and duration associated with nausea and the amount of vomiting. |
The experimental group showed significantly less nausea (p = 0.011) and retching (p = 0.014) than the control group. The results propose that auriculotherapy is effective in relieving nausea and vomiting after chemotherapy, and that this procedure be used as a nursing intervention because it helps to improve the quality of life of patients with colorectal cancer. |
Chinese |
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Group 4: Hot flashes
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C4: Viel E, et al; 2016 (20) . Efficiency of auricular acupuncture in climacteric symptoms after cancer treatments |
ROS c
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Highlight the efficiency of auriculotherapy in the treatment of post-therapeutic hot flashes in cancer patients. |
41 participants with cancer and hot flash symptoms, especially related to chemotherapy and/or hormone therapy |
Auriculotherapy with semi-permanent needles or cryotherapy. Auricular points: rhinencephalon, FSH and LH hormones, anterior hypothalamus, epiphysis, main point of the sympathetic nervous system and thyroid plexus. Variation from 1 to 5 applications with an interval of at least 4 weeks between two sessions. |
Evaluation of self-reported efficacy recorded in medical records.*** |
It was recognized that at least 3 sessions are needed before judging whether the intervention has failed. And 69%** of the study participants noticed an improvement in hot flashes. Auriculotherapy is an effective method among patients who have had menopause symptoms related to cancer treatment and has been considered safe and inexpensive to treat hot flashes. |
French |
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Group 5: Dyspnea
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C5: Strong RA, et al; 2015 (21) . pilot evaluation of auricular acupressure in end-stage lung cancer patients. |
RCT b
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To evaluate the effects of standardized ear acupressure therapy on the intensity of dyspnea and oxygen saturation in patients with end-stage lung cancer. |
11 participants with a lung cancer diagnosis were randomized and assigned to one of three treatment conditions: (1) Control group; (2) Placebo group and (3) Experimental group. |
(1) Standard care; (2) False auriculotherapy with seeds in a location not associated with the lung; and (3) Auriculotherapy with seeds* in a specific lung function location in both ears. True and false ear therapy with seeds kept for 3 days. |
The 12-item Cancer Dyspnea Scale (CDS) assesses three dimensions of dyspnea (feeling of effort, feeling of anxiety and feeling of discomfort) using a 5-point Likert scale to answer each item. Oxygen saturation was measured by the pulse oximeter at eight moments. |
Statistical analyzes suggest the presence of a significant effect of the experimental group on the exertion sensation of dyspnea (p = 0.43), but the oximetry values did not change. The intervention seems to be viable and potentially useful, it was well tolerated by the participants and did not have any side effects. Thus, this population, although fragile, is an appropriate focus for intervention studies aimed at reducing dyspnea, since the burden of discomfort is minimized as much as possible. |
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Group 6: Fatigue
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C6: Yeh CH, et al; 2015 (5) . |
Described in Group 1, but it also fits in Groups 6 and 7 because it addresses the following set of symptoms: Pain, fatigue and sleep disorders. |
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Group 6: Sleep disorders
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C6: Yeh CH, et al; 2015 (5) . |
Described in Group 1, but it also fits in Groups 6 and 7 because it addresses the following set of symptoms: Pain, fatigue and sleep disorders. |
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C9: Kuo HC, et al; 2018 (24) . Pilot randomized controlled trial of auricular point acupressure for sleep disturbances in women with ovarian cancer. |
RCT b
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To assess the feasibility, acceptability and efficacy of punctual acupressure to reduce sleep disorders in women with ovarian cancer undergoing chemotherapy. |
47 women with ovarian cancer with a high level of sleep disorders undergoing chemotherapy were randomized to an intervention group (n = 23) or a control group (n = 24). |
Auriculotherapy for 6 weeks with seeds. Auricular points: anxiety, heart, subcortex and endocrine, in addition to sleep hygiene practices. The participants in the control group only received sleep hygiene practices. |
The Pittsburgh Sleep Quality Index (PSQI) and a self-reported questionnaire were used. |
The results indicate that high levels of disturbed sleep were observed between the two groups after receiving the third cycle of chemotherapy, and the auriculotherapy intervention was effective in improving sleep by 13-19% in the sleep quality index scores compared to the control group (p<0.001). Auriculotherapy appears to be a promising, viable and effective approach to help women with ovarian cancer with sleep disorders. |
Chinese |
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C11: Hughes JG, et al; 2015 (26) . A feasibility study of auricular therapy and self-administered acupressure for insomnia following cancer treatment. |
RCT b
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To provide preliminary data on the effectiveness of two variants of auriculotherapy and self-administered acupressure in relieving insomnia in cancer survivors. |
7 participants diagnosed with cancer after the end of treatment were randomized to one of three treatment conditions: (1) Auriculotherapy (n = 4); (2) self-administered body acupressure (n = 1); and (3) no treatment (n=2). |
Auriculotherapy (1) was bilaterally performed with seeds on the following auricular points: shenmen, insomnia, heart, liver, kidney and subcortex. Body acupressure (2). The third group received no additional treatment (3). All arms of the study received weekly treatment for 5 weeks, according to the respective group. |
Pittsburgh Sleep Quality Index (PSQI) which measures sleep quality and the MYCaW questionnaire, which is individualized and evaluated concerns and well-being, and was developed to assess complementary therapies in cancer treatment. |
The overall PSQI score was better in the acupressure group than in the untreated group (p<0.00001). Despite the very limited sample size, all patients allocated to receive ear therapy or autoacupressure experienced significant improvements in their insomnia symptoms. Auriculotherapy is a non-invasive intervention which seems safe and acceptable for cancer patients, and can represent an effective treatment for chronic insomnia syndrome. |
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