Comparative Effectiveness of Acupoint Stimulation Therapies for Cancer‐Related Fatigue: A Network Meta‐Analysis

AIM: This study aimed to evaluate and rank the effectiveness of various acupoint stimulation therapies in alleviating cancer-related fatigue (CRF), a pervasive and distressing symptom among cancer patients. BACKGROUND: CRF severely compromises patients' quality of life across treatment and survivorship stages. Despite growing interest in nonpharmacological interventions, comparative evidence on the efficacy of acupoint stimulation therapies remains limited. METHODS: A systematic review and network meta-analysis of 28 randomized controlled trials (RCTs) involving 2370 participants was conducted. Databases searched included MEDLINE, CINAHL, Embase, Cochrane, Web of Science, and Airiti Library. Interventions included acupuncture, acupressure, oil acupressure, moxibustion, and transcutaneous electrical acupoint stimulation (TEAS). Standardized mean differences (SMDs) were calculated using a random-effects model. Surface Under the Cumulative Ranking Curve (SUCRA) was used to rank therapies. FINDINGS: Oil acupressure (SUCRA: 73.6%), relaxing acupressure (73.4%), and acupuncture (72.7%) were the most effective interventions. Both professionally administered and self-administered therapies significantly reduced CRF, with no major differences in efficacy. Subgroup analyses revealed consistent effectiveness across cancer types, particularly breast and lung cancer, and treatment stages. CONCLUSIONS: Acupoint stimulation therapies, especially acupressure and acupuncture, effectively reduce CRF and are suitable for integration into routine cancer care. Self-administered acupressure offers a practical, low-cost alternative, especially in resource-limited settings. Standardization of protocols and long-term studies are warranted to guide clinical implementation. TRIAL REGISTRATION: The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024556455).