The efficacy of moxibustion therapies for cancer-related fatigue: A systematic review and network meta-analysis

AbstractBackground: Moxibustion has been widely used to treat cancer-related fatigue (CRF) in China. However, there are many different types of moxibustion for CRF, and the comparative efficacy of different moxibustion methods is unclear. This study aims to analyse and rank the effectiveness of different moxibustion methods in relieving CRF based on network meta-analysis (NMA).Methods: This NMA was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension Statement. Nine databases were searched for randomized controlled trials (RCTs) of moxibustion to treat CRF from their inception to 11 April 2025. Quality assessment using the Cochrane Risk of Bias Assessment Tool. This NMA was conducted with Stata 14.0 and OpenBUGS software.Results: Thirty-six studies were included in the literature, involving 2,921 patients and eight different interventions. Results of NMA on effectiveness of CRF showed that the efficacy of thunder fire moxibustion was better than routine care treatment; the efficacy of direct moxibustion was better routine care treatment for CRF, and the difference was statistically significant.Conclusions: Moxibustion has a certain efficacy in relieving CRF, and the efficacy of thunder fire moxibustion is the most obvious, and the acupoints can be based on Pishu (BL20), Qihai (CV6), Zhongwan (CV12) and Shenque (CV8) for the identification of addition and subtraction of matching acupoints. However, this conclusion needs to be further verified by high-quality RCTs.