Efficacy and safety of acupuncture for dysphagia after radiotherapy or chemoradiotherapy in patients with nasopharyngeal carcinoma: a systematic review and meta-analysis

BACKGROUND: Acupuncture has been used as an adjunctive supportive intervention for various cancer-related symptoms. However, its efficacy and safety for dysphagia after radiotherapy or chemoradiotherapy in patients with nasopharyngeal carcinoma have not been systematically evaluated. OBJECTIVE: To evaluate the efficacy and safety of acupuncture for dysphagia after radiotherapy or chemoradiotherapy in patients with nasopharyngeal carcinoma. The outcomes were post-treatment Water Swallowing Test (WST) scores, the proportion of patients achieving a favorable swallowing status, the clinical effective rate, videofluoroscopic swallowing study (VFSS) outcomes, and Standardized Swallowing Assessment (SSA) scores. METHODS: PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, and VIP Database were searched from inception to March 2026. Eligible randomized controlled trials were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane risk-of-bias tool. Meta-analyses were conducted using R software. RESULTS: Twelve randomized controlled trials including 863 patients were analyzed. Acupuncture reduced post-treatment WST scores compared with control interventions (MD = -0.78, 95% CI: -1.04 to -0.51). The clinical effective rate was also higher in the acupuncture group (RR = 1.17, 95% CI: 1.08 to 1.27). Moreover, acupuncture improved VFSS outcomes (SMD = 0.76, 95% CI: 0.46 to 1.05), reduced SSA scores (MD = -7.65, 95% CI: -12.30 to -3.01), and improved quality of life and nutritional indicators. Safety reporting was limited, precluding definitive conclusions regarding the safety of acupuncture in this population. CONCLUSION: Acupuncture may have a potential adjunctive role in improving swallowing function, swallowing-related quality of life, and nutritional indicators in patients with dysphagia after radiotherapy or chemoradiotherapy for nasopharyngeal carcinoma. However, the evidence remains limited by small sample sizes, methodological limitations, and heterogeneity across outcomes. Larger, well-designed randomized controlled trials are needed to confirm these findings and further clarify the clinical role of acupuncture. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261371533.