Clinical evidence of acupressure for improving chemotherapy-induced nausea and vomiting in breast cancer patients: A systematic review and meta-analysis

Abstract

Objective

To systematically evaluate the clinical efficacy of acupressure for chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients, and to provide a reliable evidence-based medical basis for acupressure therapy in the management of CINV in this patient population.

Methods

Nine databases were searched for clinical randomized controlled trials (RCTs) on acupressure for the treatment of CINV in breast cancer patients, with the search period ranging from the inception of each database to August 1, 2025. The protocol of this meta-analysis was registered with PROSPERO (registration number: CRD420251119218). Two reviewers independently conducted literature screening and data extraction, and used the Cochrane Risk of Bias Assessment Tool to evaluate the methodological quality of included studies. Statistical analyses were performed using Review Manager 5.4 and Stata 15.0 software, and the GRADE system was applied to assess the evidence quality of outcome measures.

Results

A total of 39 studies were included, involving 3501 patients. Meta-analysis results showed that, as an adjuvant therapy to conventional antiemetic drugs, acupressure significantly improved the response rate for CINV relief (acute phase: RR 1.35, 95%CI 1.17–1.55; delayed phase: RR 1.41, 95%CI 1.19–1.66) and reduced its incidence (acute phase: RR 0.78, 95%CI 0.66–0.91; delayed phase: RR 0.58, 95%CI 0.45–0.75), with the evidence quality for outcomes in the acute phase rated as moderate. Compared with blank control, acupressure significantly improved patients’ anxiety (MD −3.08, 95%CI −4.33 to −1.83) and depression (MD −4.15, 95%CI −4.86 to −3.43) statuses, and increased patient satisfaction (RR 1.24, 95%CI 1.11–1.39). However, acupressure alone did not show superiority over conventional antiemetic treatment in terms of most outcomes.

Conclusion

This systematic review and meta-analysis found that acupressure, as an adjunct to standard antiemetic regimens, can effectively ameliorate CINV in breast cancer patients—particularly delayed-phase symptoms—and improve patients’ mental health and treatment satisfaction. Limited by the methodological quality and heterogeneity of the included studies, the strength of the current evidence requires further enhancement. Future research should conduct more high-quality, standardized clinical trials to further validate its efficacy and provide more robust evidence-based support.