Evidence map of systematic reviews on acupuncture and moxibustion for prevention and management of cancer-related conditions

In this study, we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions, aiming to provide evidence-based support and establish levels of evidence for clinical application. A comprehensive search was conducted to identify systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions, covering databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Databases, China Science and Technology Journal Database, and Wanfang Data, from their inception to August 1, 2024. The methodological quality of the included systematic reviews was assessed by using AMSTAR 2, and bubble plots were employed to visualize the evidence. Overall, 137 systematic reviews were included, with China being the most prolific country, with 117 reviews. These reviews addressed 21 cancer-related conditions, with the three most frequently studied being cancer-related fatigue (25 reviews), nausea and vomiting (20 reviews), and cancer pain (19 reviews). The three most commonly used acupuncture modalities were manual acupuncture (81 reviews), electroacupuncture (55 reviews), and moxibustion (39 reviews). Quality assessment revealed that one systematic review was rated as ``high quality,” eight as ``low quality,” and 128 as ``critically low quality,” primarily due to the absence of protocol registration and lists of excluded studies. Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related conditions and treatment-related adverse effects, and their clinical use has been widely reported. However, the overall methodological quality of the included systematic reviews was low, limiting the reliability and the strength of the evidence. Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.