Efficacy and safety of acupuncture for chemotherapy-induced nausea and vomiting: a systematic review and meta-analysis of randomized controlled trial

Objective Chemotherapy-induced nausea and vomiting (CINV) represents a common and debilitating side effects in cancer patients, often compromising treatment adherence and quality of life. Current management remains suboptimal, necessitating the exploration of complementary therapies. Acupuncture, as a widely used adjunctive therapy, has been attempted for the treatment of CINV. This study aims to systematically evaluate the effect and safety of acupuncture in managing CINV. Methods We comprehensively searched seven electronic databases (EMBASE, Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure, VIP Chinese Science and Technology Periodicals Databas, and Wanfang) and two clinical trial registries ( ClinicalTrials.gov , Chinese Clinical Trial Registry) for randomized controlled trials (RCTs) comparing acupuncture with sham acupuncture or conventional treatment for CINV. The primary outcomes included complete response rate (no vomiting episodes plus no or mild nausea), the frequency of vomiting episodes, and validated scale scores. Studies quality were assessed by using the Cochrane Risk of Bias tools.The registration number of this study is CRD420251102130. Results 49 RCTs involving 4,133 participants were included in this study. The results demonstrated that compared with the control group, acupuncture significantly reduced the incidence of vomiting (RR = 0.583, 95% CI: 0.523–0.650), vomiting severity (MD = −0.839, 95% CI: −1.256 to −0.422) and vomiting episodes (MD = −3.704, 95% CI: −6.256 to −1.152). Additionally, acupuncture lowered the incidence of nausea (RR = 0.532, 95% CI: 0.432–0.655), and nausea severity (MD = −0.895, 95% CI: −1.273 to −0.516). The most utilized acupoints were Zusanli (ST36, n = 42), Neiguan (PC6, n = 38), and Zhongwan (CV12, n = 23). Conclusion This study confirms that acupuncture is effective as an adjunctive therapy for CINV. While future large-scale, rigorously designed RCTs are warranted to further validate these findings, the current evidence provides a robust rationale for its integration into clinical practice. Systematic review registration The registration number of this study is CRD420251102130.