A global review of acupuncture and moxibustion recommendations in guidelines/expert consensus for chemotherapy-and/or radiotherapy-induced nausea and/or vomiting

Objective:To summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting,providing a basis for the development of clinical practice guidelines on acupuncture and moxibustion for chemotherapy-and/or radiotherapy-induced nausea and/or vomiting.Methods:We systematically searched 7 comprehensive databases,7 guideline libraries and 4 websites of societies/associations.The retrieval period was from the inception to April 1,2023.Two researchers independently screened the literature,extracted data,and used the Scientific,Transparent,and Applicable Rankings(STAR)tool to evaluate the quality of guidelines/expert consensus that contained acupuncture and moxibustion recommendations,and analyzed acupuncture and moxibustion recommendations in guidelines/expert consensus and their evidence base.Results:A total of 56 guidelines/expert consensus related to the prevention and treatment of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting were included,and 22 guidelines/expert consensus contained acupuncture and moxibustion recommendations,with a total of 34 recommendations on acupuncture and moxibustion(27 supports,4 neutrals,3 objections).The STAR evaluation(excluding 1 patient version of guideline)showed that none of the guidelines/expert consensus was with high quality,95.24%(20/21)with medium quality,and 4.76%(1/21)with low quality.Although there were many recommendations of acupuncture and moxibustion in the existing guidelines/expert consensus,there was great heterogeneity among the acupuncture and moxibustion treatment regimens.Moreover,most of the guidelines/expert consensus did not describe the details of acupuncture and moxibustion treatment regimens,such as acupuncture and moxibustion manipulation,acupoint selection,course and timing of treatment,which is difficult to guide the clinical practice of acupuncture and moxibustion.Conclusion:Developing clinical practice guidelines of acupuncture and moxibustion for chemotherapyand/or radiotherapy-induced nausea and/or vomiting according to the items of the STAR tool was urgent,so as to clarify the details of acupuncture and moxibustion regimens and provide standardized treatment regimens to guide the clinical practice of acupuncture and moxibustion.