Reference Citation(s)	Type of Study	Condition Investigated	No. of Patients: Enrolled; Treated; Controlb	Strongest Benefit Reportedc	Concurrent Therapy Used (Yes/No/ Unknown)d	Level of Evidence Scoree
[1]	RCT	Immune system function and symptoms related to cancer and treatment	76; 38 radiation therapy and chemotherapy plus acupuncture; 38 radiation therapy and chemotherapy alone	Enhanced immune system function, weight gain, symptom relief, and fewer side effects from chemotherapye	No	1iiC
[2]	RCT	Leukocyte activity in cancer patients following surgery	40; 20 standard care plus acupuncture; 20 standard care alone	Leukocyte phagocytic activity enhancedf	No	1iiD
[4]	RCT	Changes in blood IL-2 levels and NK cell activity in cancer patients	45; 25 acupuncture; 20 no additional treatment or sham	Enhanced immune system function: Increases in IL-2 levels and NK cell activityg	No	1iiD
[5]	RCT	Changes in blood T-cell populations and SIL-2R and beta-endorphin levels in cancer patients	40; 20 acupuncture; 20 no additional treatment or sham	Enhanced immune system function: increases in CD3+ cells, CD4+ cells, the CD4+: CD8+ cell ratio, and beta-endorphin levels; decrease in SIL-2R levelsh	No	1iiD
[3]	Nonrandomized controlled trial	Leukopenia after radiation therapy	49; 20 MAT alone; 29 drugs alone	Increase in average WBC count for both groupsi	No	2D
[6]	Nonconsecutive case series	Leukopenia, caused by cancer, radiation therapy, or chemotherapy, rheumatoid arthritis; and other causes	48; 48 acupuncture (2 with cancer); none	Increase in leukocyte levels; improvement in immune system function as measured by IgG, IgA, and IgM levels; PHA-induced lymphocyte proliferative responses; and complement protein C3 levelsj	Unknown	3iD
[7]	Nonconsecutive case series	T-cell levels and NK cell activity inpatients treated with chemotherapy	28; 28 EA; none	No decline in T-cell levels or NK cell activity after chemotherapyk	No	3iiD

EA = electroacupuncture; IgA, IgG, and IgM = immunoglobulins; IL-2 = interleukin-2; MAT = microwave acupuncture; NK = natural killer cell; No. = number; PHA = phytohemagglutinin; RCT = randomized controlled trial; SIL-2R = soluble IL-2 receptor; WBC = white blood cell.

aSee text and the NCI Dictionary for additional information and definition of terms.

bStrongest evidence reported that the treatment under study has activity or improves the well-being of cancer patients.

cFor information about levels of evidenceanalysis and an explanation of the level of evidence scores, see Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.

dConcurrent therapy for symptoms treated (not cancer).

e P < .05, acupuncture treatment versus control.

f P < .01, daily acupuncture treatment versus control.

g P < .01, daily acupuncture treatment versus control.

h P < .01, postacupuncture treatment versus baseline levels.

i P > .05, MAT versus drug treatment controls. Drugs:vitamin B4, leucogen, butylalcohol, unspecified Chinese herbs, interferon,transfer factor (a dietary supplement purported to enhance the immune system, available through distributors on the Web), anion inhalation. An unknown drug, NDA, was also given to patients in the drug group.

j P = .05, postacupuncture treatment versus baseline levels.

k P = .05, no significant declines postacupuncture treatment versus baseline levels.

References

1. Xia YQ, Zhang D, Yang CX, et al.: An approach to the effect on tumors of acupuncture in combination with radiotherapy or chemotherapy. J Tradit Chin Med 6 (1): 23-6, 1986.  [PUBMED Abstract]
   
   
2. Zhou RX, Huang FL, Jiang SR, et al.: The effect of acupuncture on the phagocytic activity of human leukocytes. J Tradit Chin Med 8 (2): 83-4, 1988.  [PUBMED Abstract]
   
   
3. He CJ, Gong KH, Xu QZ, et al.: Effects of microwave acupuncture on the immunological function of cancer patients. J Tradit Chin Med 7 (1): 9-11, 1987.  [PUBMED Abstract]
   
   
4. Wu B, Zhou RX, Zhou MS: [Effect of acupuncture on interleukin-2 level and NK cell immunoactivity of peripheral blood of malignant tumor patients] Zhongguo Zhong Xi Yi Jie He Za Zhi 14 (9): 537-9, 1994.  [PUBMED Abstract]
   
   
5. Wu B, Zhou RX, Zhou MS: [Effect of acupuncture on immunomodulation in patients with malignant tumors] Zhongguo Zhong Xi Yi Jie He Za Zhi 16 (3): 139-41, 1996.  [PUBMED Abstract]
   
   
6. Wei Z: Clinical observation on therapeutic effect of acupuncture at zusanli for leukopenia. J Tradit Chin Med 18 (2): 94-5, 1998.  [PUBMED Abstract]
   
   
7. Ye F, Chen S, Liu W: Effects of electro-acupuncture on immune function after chemotherapy in 28 cases. J Tradit Chin Med 22 (1): 21-3, 2002.  [PUBMED Abstract]