This is an in-depth assessment of the current evidence for acupuncture for chemotherapy-associated nausea and vomiting. Follow the links for other information regarding acupuncture for cancer:
The findings of systematic reviews (SRs) on acupuncture for chemotherapy-induced nausea and vomiting cancer published in the past five years (since 2021) have been summarized below. The full description of the included SRs can be found in table 1.
Description of included studies
Number of studies: total of 8 SRs (Alhusamiah 2025, Chen 2021, Ho 2025, Issac 2024, Wang 2024/2025 NMA, Yan 2023, Yang 2021, Ying 2024).
Number of RCTs per SR: From 5 to 58. Participants per SR: From 280 to 4,081.
Participants: Cancer patients with various cancers. One SR focused on paediatric populations (Ho 2025).
Interventions: a wide range of 11 acupoint stimulation techniques.
Manual acupuncture, electroacupuncture (EA), laser acupuncture, auricular acupuncture.
Auricular acupressure, acupressure (P6, wristbands).
Transcutaneous electrical acupoint stimulation (TEAS), acupoint injection, acupoint patch / embedding, moxibustion, fire needle / plum-blossom needle.
Comparators: Usual care, no treatment / waitlist, other non-acupoint treatments, placebo or sham acupuncture / acupressure.
Outcomes:
Complete control / “relief efficiency” (dichotomous)
Incidence/frequency of nausea and vomiting
Severity of nausea and vomiting (VAS/INVR/RINV/MANE)
Quality of life including nausea and vomiting.
Acute (0–24h) vs delayed (24–120h) phases
Some used CTCAE/WHO grading.
Limitations of included studies
Systematic reviews: The overall quality of the included SRs were assessed by AMSTAR2 and judged as low or critically low; only Yan et al. (2023) was assessed as high quality.
The primary RCTs included in the SRs were frequently at high or unclear risk of bias. Most common problems are lack of allocation-concealment reporting, lack of participant/outcome-assessor blinding, small sample sizes and selective or nonstandard outcome measures.
GRADE certainty of evidence: Several SR authors explicitly downgraded certainty (GRADE) to low/very-low for most outcomes.
Heterogeneous trials included: many studies used non-validated or heterogeneous measures (clinical episode counts, simple VAS, trial-specific criteria) which complicates pooling and interpretation. The interventions and controls varied greatly between trials.
Geographic / publication bias concern: a large proportion of primary RCTs were conducted in China and published in Chinese journals in several SRs. This raises concerns about publication bias and generalizability. Several SRs did not adequately assess publication bias.
Often small and underpowered trials and few trials per outcome.
Results for efficacy / effectiveness
Nausea
For delayed nausea the body of evidence across SRs supports a modest-to-moderate benefit of acupoint-based interventions (auricular acupressure, P6 acupressure/wristbands, electroacupuncture/TEAS, acupoint patches) as add-on therapies to usual antiemetic care.
Effect estimates are frequently statistically significant (see Table x) but certainty is low.
For acute nausea the results are inconsistent; pooled effects are smaller and often non-significant.
Vomiting
For acute vomiting most SRs show no significant benefit for acupressure or acupuncture; except Yan 2023 showing small benefits in complete control of acute vomiting when compared with usual care, but not vs. sham evidence. Overall the certainty of evidence is low.
For delayed vomiting, more consistent improvements across reviews are reported. Several SRs report statistically significant reductions suggesting a modest-to-moderate benefit of acupoint-based interventions as add-on therapies to usual antiemetic care. Several interventions (acupoint patch, acupuncture, EA/TEAS, auricular pressure) appear beneficial in delayed phase. Network MA (Wang 2025) suggests acupoint patch and moxibustion rank highest.
Paediatric population
Results from one SR showed inconsistent and often conflicting results for acupuncture across the included RCTs; most RCTs of acupressure reported no improvement.
References
Alhusamiah B, Almomani J, Al Omari A, Abu attallah A, Yousef A, Alshraideh JA, et al. The effectiveness of P6 and auricular acupressure as a complementary therapy in chemotherapy-induced nausea and vomiting among patients with cancer: systematic review. Integr Cancer Ther. 2024;23:1-15. doi:10.1177/15347354241239110.
Chen L, Wu X, Chen X, Zhou C. Efficacy of auricular acupressure in prevention and treatment of chemotherapy-induced nausea and vomiting in patients with cancer: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2021;2021:8868720. doi:10.1155/2021/886872
Ho KY, Lam KKW, Xia W, Liu Q, Chiu SY, Chan GCF, Li WHC. Systematic review of the effectiveness of complementary and alternative medicine on nausea and vomiting in children with cancer. Cancer Nurs. 2025;48(2):89–98. doi:10.1097/NCC.0000000000001239.
Issac A, Nayak SG, Halemani K, Mishra P, Chand G. Systematic review of acupressure on chemotherapy-induced nausea and vomiting among breast cancer patients. Asian Pac J Cancer Prev. 2024;25(10):3421-3428. doi:10.31557/APJCP.2024.25.10.3421.
Wang Y, Wang F, Hu F, Long F. Effect of non-pharmacological interventions on chemotherapy induced delayed nausea and vomiting for tumors: A systematic review and Bayesian network meta-analysis. Complement Ther Med. 2025;88:103124. doi:10.1016/j.ctim.2024.103124
Yan Y, López-Alcalde J, Zhang L, Siebenhüner AR, Witt CM, Barth J. Acupuncture for the prevention of chemotherapy-induced nausea and vomiting in cancer patients: a systematic review and meta-analysis. Cancer Med. 2023;12(13):12504-12517. doi:10.1002/cam4.5962
Yang Y, Su H, Wen J, Hong J. Acupoint injection for alleviating side effects of chemotherapy in people with cancer: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2021;2021:9974315. doi:10.1155/2021/9974315
Ying Y, Wu H, Chen X, Zhou J, Sun Y, Fang L. Electrical acupoint stimulation for the treatment of chemotherapy-induced nausea and vomiting: a systematic review and meta-analysis. Heliyon. 2024;10:e30965. doi:10.1016/j.heliyon.2024.e30965
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