Auriculoterapia para controle de náuseas e vômitos induzidos por quimioterapia em pacientes com câncer: revisão sistemática

Abstract

Chemotherapy-induced nausea and vomiting is one of the most frequent adverse effects that cause great suffering for cancer patients. Despite the existence of modern antiemetic drugs, they are not always controlled. Therefore, auriculotherapy represents a potential alternative to control these manifestations, causing little or no discomfort for the patient. This study aimed to synthesize the evidence available in the literature on the effects of auriculotherapy for the control of chemotherapy-induced nausea and vomiting (CINV) in cancer patients. A systematic review was performed, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Allied and Complementary Medicine Database (AMED), Auriculo Biblio, Virtual Health Library (VHL), Traditional, Complementary and Integrative Medicines (MTCI Americas) via VHL, Chinese Biomedical Literature Database (CBMdisc), Cumulative Index to Nursing and Allied Health Literature ( CINAHL), Chinese Scientific Journals database (CSJD-VIP), Physiotherapy Evidence Database (PEDro), China National Knowledge Infrastructure (CNKI), EMBASE (via Embase.com), Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed, Scopus and Web of Science. Ongoing studies were identified through the World Health Organization International Clinical Trials Registry Platform (ICTRP), Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials (CT.gov) and Brazilian Registry of Clinical Trials (ReBEC). Reference lists of systematic reviews were also explored. The entire study selection and data extraction process was carried out by two evaluators. The risk of bias was assessed using the Cochrane ROB 2.0 tool. Considering the impossibility of considering the meta-analysis, a systematic narrative synthesis was performed to present the studies included in the review. A total of 1,298 studies were located, 25 of which were included in the qualitative analysis. Auriculotherapy has shown positive results in all clinical trials. Thus, auriculotherapy can be a promising practice for the treatment of CINV in cancer patients. However, the studies showed methodological weaknesses, important reporting flaws, in addition to the fact that most are considered at high risk of bias, which means that the effectiveness of auriculotherapy for the treatment of this condition should be interpreted with caution, especially to indicate its application in clinical practice. Although there is no standardization of the protocols used in the studies, some points were more frequent, including Shenmen, sympathetic, stomach, spleen, liver, cardia and subcortex. Standardized clinical trials, with a robust and well- reported method are still needed to more assertively determine the efficacy of auriculotherapy to control nausea and vomiting in patients undergoing chemotherapy.