Efficacy and safety of acupuncture in the treatment of chemotherapy-induced peripheral neuropathy in breast cancer patients: a systematic review and meta-analysis

Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect in breast cancer survivors. This meta-analysis evaluates the efficacy and safety of acupuncture for CIPN management. Methods We systematically searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and Chinese Biomedical Literature Database from database inception to August 3, 2025, for randomized controlled trials (RCTs) on acupuncture treatment for CIPN in breast cancer patients. We used RevMan 5.2 and Stata 16.0 for meta-analysis. Results A total of 10 RCTs involving 653 patients were included. Treatment group significantly improved the clinical efficacy versus control group (RD = 0.22, 95% CI: 0.10, 0.33; p < 0.001). Chemotherapeutic agent subgroup analysis showed that acupuncture was beneficial for taxane-induced CIPN (RD = 0.26, 95% CI: 0.14, 0.38; p < 0.001) and utidelone-induced CIPN (RD = 0.33, 95% CI: 0.10, 0.56; p = 0.004), while the effect for CIPN from unspecified agents was not statistically significant (RD = 0.11, 95% CI: −0.20, 0.43; p = 0.484). The observed efficacy ranking was: utidelone-induced CIPN > taxane-induced CIPN > CIPN from unspecified agents. Acupuncture also reduced pain intensity (SMD = −0.65, 95% CI: −1.01, −0.29; p < 0.001) and FACT-NTX (WMD = 3.66, 95% CI: 1.00, 6.32; p = 0.007). No significant differences were found for peroneal nerve conduction velocity (WMD = 1.07, 95% CI: −4.25, 6.39; p = 0.694), quality of life score (SMD = 0.54, 95% CI: −0.20, 1.27; p = 0.153), or incidence of adverse reactions (RD = 0.03, 95% CI: −0.07, 0.13; p = 0.540). Conclusion In breast cancer patients with CIPN, acupuncture improved clinical efficacy, reduced pain intensity, and enhanced FACT-NTX scores, particularly in utidelone- and taxane-related cases. No clear benefits were seen for nerve conduction velocity, quality of life score, or incidence of adverse reactions. These findings support acupuncture as a safe and effective adjunct for CIPN symptom management in breast cancer patients. Systematic review registration https://www.crd.york.ac.uk/ , identifier [CRD42024615214].