{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:47:42Z","timestamp":1782841662424,"version":"3.54.5"},"reference-count":51,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n As a prevalent side effect, chemotherapy-induced nausea and vomiting (CINV) imposes a burden on the daily lives of patients with breast cancer. Multiple clinical trials have suggested the validity of acupuncture in alleviating CINV; however, the optimal acupuncture modality remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This protocol describes a systematic review and network meta-analysis to investigate the efficacy and safety of distinct acupuncture interventions for treating CINV in patients with breast cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Eight databases (PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, VIP Database, Wanfang Database, and the Chinese Biomedical Literature Database) will be searched for eligible studies from their respective inception to July 31, 2025. The language of published studies is limited to English and Chinese. Primary outcomes are CINV intensity and clinical effectiveness rates. Secondary outcomes include recurrence rates, safety outcomes, and quality of life. Risk of bias will be assessed using the Cochrane risk of bias tool. Pairwise meta-analysis will be conducted in Stata using random-effects models with Hartung-Knapp-Sidik-Jonkman CIs. Network meta-analysis will be conducted using Bayesian Markov chain Monte Carlo methods in R software. Convergence will be assessed using Gelman-Rubin statistics and trace plots. Heterogeneity will be summarized using \u03c4\n 2<\/jats:sup>\n and \u03c4, along with prediction intervals, when applicable. Consistency between direct and indirect evidence will be evaluated using the node-splitting method and design-by-treatment interaction test. Small-study effects will be assessed via comparison-adjusted funnel plots and the Egger test in Stata. Where feasible, subgroup analyses and meta-regression analyses will be performed. The certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation framework.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A preliminary scoping search was completed in August 2025, and this protocol was finalized in October 2025. The comprehensive literature search and study selection are expected to be completed by June 2026, followed by data extraction by August 2026. Data synthesis and final manuscript preparation are scheduled to be completed by December 2026.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This analysis will expand the range of evidence-based acupuncture options available to clinicians for treating CINV in patients with breast cancer.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/86384","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T20:12:15Z","timestamp":1776802335000},"page":"e86384-e86384","source":"Crossref","is-referenced-by-count":0,"title":["Acupuncture Therapies for Chemotherapy-Induced Nausea and Vomiting in Patients With Breast Cancer: Protocol for a Systematic Review and Network Meta-Analysis"],"prefix":"10.2196","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3121-0122","authenticated-orcid":false,"given":"Yutao","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5931-4644","authenticated-orcid":false,"given":"Zhujun","family":"Bian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8725-2299","authenticated-orcid":false,"given":"Qi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3216-1410","authenticated-orcid":false,"given":"Tiantian","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7187-2514","authenticated-orcid":false,"given":"Hong","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.21871","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","journal-title":"CA Cancer J Clin"},{"issue":"3","key":"R2","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","journal-title":"CA Cancer J Clin"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.2147\/BCTT.S432526","article-title":"Breast cancer: an overview of current therapeutic strategies, challenge, and perspectives","volume":"15","author":"Wang","journal-title":"Breast Cancer (Dove Med Press)"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","DOI":"10.1186\/s40659-017-0140-9","article-title":"Awareness and current knowledge of breast cancer","volume":"50","author":"Akram","journal-title":"Biol Res"},{"issue":"10","key":"R5","doi-asserted-by":"publisher","first-page":"15","DOI":"10.22271\/allresearch.2025.v11.i10a.12911","article-title":"Pharmacological management of chemotherapy of breast cancer - includes side effects","volume":"11","author":"Kavyasudha","journal-title":"Int J Appl Res"},{"issue":"5","key":"R6","first-page":"637","volume":"19","author":"Wiser","journal-title":"Oncology (Williston Park)"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1377486","article-title":"Bibliometric and visual analysis of chemotherapy-induced nausea and vomiting (2004-2023)","volume":"14","author":"Tian","journal-title":"Front Oncol"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2022.175379","article-title":"Gastrointestinal inflammation plays a critical role in chemotherapy-induced nausea and vomiting","volume":"936","author":"Chen","journal-title":"Eur J Pharmacol"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctarc.2020.100278","article-title":"Chemotherapy-induced nausea and vomiting: pathogenesis, recommendations, and new trends","volume":"26","author":"Gupta","journal-title":"Cancer Treat Res Commun"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1007\/s00520-014-2175-6","article-title":"Efficacy and safety of palonosetron for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV): a systematic review and meta-analysis of randomized controlled trials","volume":"22","author":"Popovic","journal-title":"Support Care Cancer"},{"issue":"22","key":"R11","doi-asserted-by":"publisher","first-page":"4112","DOI":"10.1200\/JCO.2003.01.095","article-title":"The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin--the Aprepitant Protocol 052 Study Group","volume":"21","author":"Hesketh","journal-title":"J Clin Oncol"},{"issue":"19","key":"R12","doi-asserted-by":"publisher","first-page":"3409","DOI":"10.1200\/JCO.2000.18.19.3409","article-title":"Contribution of dexamethasone to control of chemotherapy-induced nausea and vomiting: a meta-analysis of randomized evidence","volume":"18","author":"Ioannidis","journal-title":"J Clin Oncol"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2013.09.073","article-title":"International antiemetic guidelines on chemotherapy induced nausea and vomiting (CINV): content and implementation in daily routine practice","volume":"722","author":"Jordan","journal-title":"Eur J Pharmacol"},{"issue":"10","key":"R14","doi-asserted-by":"publisher","first-page":"749","DOI":"10.3969\/j.issn.1671-038X.2021.10.15","article-title":"Overview of traditional Chinese medicine in prevention and treatment of gastrointestinal reactions after chemotherapy","volume":"29","author":"Zhao","journal-title":"Chin J Integr Trad West Med Dig"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","DOI":"10.1186\/s12906-022-03543-y","article-title":"Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial","volume":"22","author":"Tan","journal-title":"BMC Complement Med Ther"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1188\/07.ONF.xxx-xxx","article-title":"Acupressure for chemotherapy-induced nausea and vomiting: a randomized clinical trial","volume":"34","author":"Dibble","journal-title":"Oncol Nurs Forum"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.1188\/12.ONF.E1-E9","article-title":"The effects of P6 acupressure and nurse-provided counseling on chemotherapy-induced nausea and vomiting in patients with breast cancer","volume":"39","author":"Suh","journal-title":"Oncol Nurs Forum"},{"issue":"2","key":"R18","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1017\/S1478951514000248","article-title":"The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer","volume":"13","author":"Gen\u00e7","journal-title":"Palliat Support Care"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1590\/S1980-220X2018043603525","article-title":"Auricular acupressure in the quality of life of women with breast cancer: a randomized clinical trial [Article in Portuguese, English, Spanish]","volume":"53","author":"Vallim","journal-title":"Rev Esc Enferm USP"},{"issue":"5","key":"R20","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1002\/jrsm.1700","article-title":"Twenty years of network meta-analysis: continuing controversies and recent developments","volume":"15","author":"Ades","journal-title":"Res Synth Methods"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2914","article-title":"Demystifying trial networks and network meta-analysis","volume":"346","author":"Mills","journal-title":"BMJ"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1002\/jrsm.1037","article-title":"Indirect and mixed-treatment comparison, network, or multiple-treatments meta-analysis: many names, many benefits, many concerns for the next generation evidence synthesis tool","volume":"3","author":"Salanti","journal-title":"Res Synth Methods"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7647","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation","volume":"350","author":"Shamseer","journal-title":"BMJ"},{"issue":"16","key":"R24","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1001\/jama.2015.3656","article-title":"Preferred reporting items for systematic review and meta-analyses of individual participant data: the PRISMA-IPD statement","volume":"313","author":"Stewart","journal-title":"JAMA"},{"issue":"4","key":"R25","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1089\/acu.2012.0876","article-title":"Electroacupuncture for nausea, vomiting, and myelosuppression in women receiving adjuvant chemotherapy for early breast cancer: a randomized controlled pilot trial","volume":"24","author":"Beith","journal-title":"Med Acupunct"},{"issue":"5","key":"R26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaim.2023.100794","article-title":"The effect of digital acupressure on chemotherapy-induced nausea in Indonesian patients with stages III-IV breast cancer","volume":"14","author":"Wicaksono","journal-title":"J Ayurveda Integr Med"},{"issue":"34","key":"R27","doi-asserted-by":"publisher","first-page":"4051","DOI":"10.1200\/JCO.24.00099","article-title":"Effect of adding electroacupuncture to standard triple antiemetic therapy on chemotherapy-induced nausea and vomiting: a randomized controlled clinical trial","volume":"42","author":"Shen","journal-title":"J Clin Oncol"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","first-page":"8","DOI":"10.13703\/j.0255-2930.20190116-k0003","article-title":"Clinical efficacy and action mechanism of mild moxibustion combined with salt-separated moxibustion for gastrointestinal response in breast-cancer chemotherapy patients","volume":"40","author":"Guo","journal-title":"Zhongguo Zhen Jiu"},{"issue":"8","key":"R29","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1001\/jamaoncol.2015.2639","article-title":"Validity and reliability of the US National Cancer Institute\u2019s patient-reported outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)","volume":"1","author":"Dueck","journal-title":"JAMA Oncol"},{"key":"R30","author":"He","journal-title":"Chin J Trad Chin Med"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","journal-title":"BMJ"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-25","article-title":"The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method","volume":"14","author":"IntHout","journal-title":"BMC Med Res Methodol"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.998655","article-title":"Acupuncture for gastrointestinal urticaria: a protocol for systematic review and network meta-analysis","volume":"9","author":"Li","journal-title":"Front Med (Lausanne)"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.2196\/55870","article-title":"Efficacy of electroacupuncture in the treatment of mild to moderate female stress urinary incontinence: protocol for a systematic review and network meta-analysis","volume":"13","author":"Shi","journal-title":"JMIR Res Protoc"},{"issue":"2","key":"R35","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1002\/jrsm.12","article-title":"A basic introduction to fixed-effect and random-effects models for meta-analysis","volume":"1","author":"Borenstein","journal-title":"Res Synth Methods"},{"issue":"12","key":"R36","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-074740","article-title":"Comparative efficacy of acupuncture-related therapy for postmenopausal osteoporosis: protocol for Bayesian network meta-analysis","volume":"13","author":"Xu","journal-title":"BMJ Open"},{"issue":"11","key":"R37","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057112","article-title":"Network meta-analysis for comparative effectiveness of treatments for chronic low back pain disorders: systematic review protocol","volume":"11","author":"Belavy","journal-title":"BMJ Open"},{"issue":"3","key":"R38","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1002\/jrsm.1195","article-title":"GetReal in network meta-analysis: a review of the methodology","volume":"7","author":"Efthimiou","journal-title":"Res Synth Methods"},{"issue":"6","key":"R39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0306336","article-title":"The effects of major dietary patterns on patients with type 2 diabetes: protocol for a systematic review and network meta-analysis","volume":"19","author":"Chen","journal-title":"PLoS One"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4002","article-title":"Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials","volume":"343","author":"Sterne","journal-title":"BMJ"},{"issue":"7568","key":"R41","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1136\/bmj.333.7568.597","article-title":"The case of the misleading funnel plot","volume":"333","author":"Lau","journal-title":"BMJ"},{"issue":"36","key":"R42","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000022055","article-title":"Acupuncture for mammary gland hyperplasia: a Bayesian network meta-analysis protocol","volume":"99","author":"Xiong","journal-title":"Medicine (Baltimore)"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5630","article-title":"A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis","volume":"349","author":"Puhan","journal-title":"BMJ"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-074495","article-title":"A guide and pragmatic considerations for applying GRADE to network meta-analysis","volume":"381","author":"Izcovich","journal-title":"BMJ"},{"issue":"10","key":"R45","doi-asserted-by":"publisher","first-page":"3421","DOI":"10.31557\/APJCP.2024.25.10.3421","article-title":"Acupressure on chemotherapy-induced nausea and vomiting among breast cancer patients: a systematic review and meta-analysis","volume":"25","author":"Issac","journal-title":"Asian Pac J Cancer Prev"},{"issue":"50","key":"R46","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000021820","article-title":"Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients: systematic review and meta-analysis (PRISMA-compliant)","volume":"99","author":"Jang","journal-title":"Medicine (Baltimore)"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2024.103124","article-title":"Effect of non-pharmacological interventions on chemotherapy induced delayed nausea and vomiting for tumors: a systematic review and Bayesian network meta-analysis","volume":"88","author":"Wang","journal-title":"Complement Ther Med"},{"issue":"8","key":"R48","doi-asserted-by":"publisher","first-page":"921","DOI":"10.7661\/j.cjim.20180616.026","article-title":"Influence of intradermal needle buied in Neiguan acupoint on nausea and vomiting of breast cancer patients undergoing chemotherapy","volume":"38","author":"Li","journal-title":"Chin J Integr Tradit West Med"},{"issue":"28","key":"R49","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.3969\/j.issn.1009-6493.2012.28.021","article-title":"Influence of intradermal needle buied in Neiguan acupoint on nausea and vomiting of breast cancer patients undergoing chemotherapy","volume":"26","author":"Zheng","journal-title":"Chin Nurs Res"},{"issue":"1","key":"R50","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ctim.2006.07.005","article-title":"The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients","volume":"15","author":"Molassiotis","journal-title":"Complement Ther Med"},{"issue":"21","key":"R51","doi-asserted-by":"publisher","first-page":"2755","DOI":"10.1001\/jama.284.21.2755","article-title":"Electroacupuncture for control of myeloablative chemotherapy-induced emesis: a randomized controlled trial","volume":"284","author":"Shen","journal-title":"JAMA"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e86384","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:14:17Z","timestamp":1782839657000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e86384"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":51,"URL":"https:\/\/doi.org\/10.2196\/86384","relation":{},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]},"article-number":"v15i1e86384"}}