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:: Volume 24, Issue 2 (4-2026) ::
Int J Radiat Res 2026, 24(2): 559-565 Back to browse issues page
Management of insomnia in cancer patients after radiotherapy using traditional Chinese medicine techniques: A systematic review and evidence summary
Y. Zhang , S. Wang , T. Yang
The Special Branch, The 940th Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army, Lanzhou, Gansu Province, China, 730050 , m13919936543@163.com
Abstract:   (360 Views)
Background: Insomnia is a common and debilitating complication among cancer patients after radiotherapy (RT), often aggravated by treatment-related fatigue and neuroendocrine disturbances. Traditional Chinese Medicine (TCM) techniques such as acupuncture, auriculotherapy, and aromatherapy offer non-pharmacological approaches, but evidence specific to post-RT insomnia is limited. Materials and Methods: Following PRISMA 2020 guidelines, a systematic review and evidence summary were performed across seven databases from inception to March 2025. Eligible studies involved adult cancer patients who had completed RT and received TCM interventions for insomnia. Quality assessment applied AGREE II, AMSTAR-2, and JBI checklists, with evidence graded according to the 2014 JBI hierarchy. Results: Eighteen high-quality studies were included (12 systematic reviews/meta-analyses, 4 guidelines, and 2 evidence summaries). Acupuncture improved Pittsburgh Sleep Quality Index (PSQI) scores by 3-4 points; auriculotherapy reduced sleep latency by 15-20 minutes; and aromatherapy with lavender oil decreased PSQI by about 3.5 points. Adverse events were minimal (<5%). Conclusion: TCM techniques demonstrate measurable efficacy and safety in improving sleep quality and latency among cancer patients after RT. Integrating these complementary interventions into post-RT care may enhance recovery, reduce symptom burden, and improve quality of life.
Keywords: Neoplasms, radiotherapy, sleep initiation and maintenance disorders, acupuncture therapy, medicine, Chinese traditional.
Full-Text [PDF 935 kb]   (98 Downloads)    
Type of Study: Review article | Subject: Radiation Biology
References
1. Bray F, Ferlay J, Soerjomataram I, et al. (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 68(6): 394-424. [DOI:10.3322/caac.21492]
2. Delaney G, Jacob S, Featherstone C, et al. (2005) The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer, 104(6): 1129-1137. [DOI:10.1002/cncr.21324]
3. Zhang Y, Wang S, Tao Y (2022) Advances in Chinese radiotherapy equipment: Shinva linac series for precision oncology. Chin J Radiat Oncol, 31(4): 256-262.
4. Li H and Chen X (2021) Beijing eternal medical's BET-1000 system in IMRT applications. J Med Phys, 28(2): 145-150.
5. Savard J and Morin CM (2001) Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol, 19(3): 895-908. [DOI:10.1200/JCO.2001.19.3.895]
6. Otte JL, Carpenter JS, Manchanda S, et al. (2015) Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained? Cancer Med, 4(2): 183-200. [DOI:10.1002/cam4.356]
7. Palesh OG, Roscoe JA, Mustian KM, et al. (2010) Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer. J Clin Oncol, 28(2): 292-298. [DOI:10.1200/JCO.2009.22.5011]
8. Innominato PF, Spiegel D, Lévi F, et al. (2014) The circadian timing system in clinical oncology. Ann Med, 46(4): 191-207. [DOI:10.3109/07853890.2014.916990]
9. Miller AH, Ancoli-Israel S, Bower JE, et al. (2008) Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer. J Clin Oncol, 26(6): 971-982. [DOI:10.1200/JCO.2007.10.7805]
10. Bower JE (2014) Cancer-related fatigue - mechanisms, risk factors, and treatments. Nat Rev Clin Oncol, 11(10): 597-609. [DOI:10.1038/nrclinonc.2014.127]
11. Kim JH, Jenrow KA, Brown SL (2014) Mechanisms of radiation-induced normal tissue toxicity and implications for future clinical trials. Radiat Oncol J, 32(3): 103-115. [DOI:10.3857/roj.2014.32.3.103]
12. Jereczek-Fossa BA, Marsiglia HR, Orecchia R (2002) Radiotherapy-related fatigue. Crit Rev Oncol Hematol, 41(3): 317-325. [DOI:10.1016/S1040-8428(01)00143-3]
13. Bentzen SM (2006) Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology. Nat Rev Cancer, 6(9): 702-713. [DOI:10.1038/nrc1950]
14. Stepanski EJ, Walker MS, Schwartzberg LS, et al. (2009) The relation of trouble sleeping, depressed mood, pain, and fatigue in patients with cancer. J Pain Symptom Manage, 37(5): 850-859. [DOI:10.5664/jcsm.27441]
15. Garland SN, Xie SX, DuHamel K, et al. (2019) Acupuncture versus cognitive behavioral therapy for insomnia in cancer survivors: a randomized clinical trial. J Natl Cancer Inst, 111(12): 1323-1331. [DOI:10.1093/jnci/djz050]
16. Mustian KM, Alfano CM, Heckler C, et al. (2017) Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncol, 3(7): 961-968. [DOI:10.1001/jamaoncol.2016.6914]
17. Morin CM, Colecchi C, Stone J, et al. (1999) Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. JAMA, 281(11): 991-999. [DOI:10.1001/jama.281.11.991]
18. Espie CA, Fleming L, Cassidy J, et al. (2008) Randomized controlled clinical effectiveness trial of cognitive behavior therapy compared with treatment as usual for persistent insomnia in patients with cancer. J Clin Oncol, 26(28): 4651-4658. [DOI:10.1200/JCO.2007.13.9006]
19. Lu W, Dean-Clower E, Doherty-Gilman A, et al. (2008) The value of acupuncture in cancer care. Hematol Oncol Clin North Am, 22(4): 631-648. [DOI:10.1016/j.hoc.2008.04.005]
20. Mao JJ, Xie SX, Farrar JT, et al. (2014) A randomized trial of electro-acupuncture for arthralgia related to aromatase inhibitor use. Eur J Cancer, 50(2): 267-276. [DOI:10.1016/j.ejca.2013.09.022]
21. Cheuk DK, Yeung WF, Chung KF, et al. (2012) Acupuncture for insomnia. Cochrane Database Syst Rev, 9: CD005472. [DOI:10.1002/14651858.CD005472.pub3]
22. Kasymjanova G, Grossman M, Tran T, et al. (2013) The potential role for acupuncture in treating symptoms in patients with lung cancer: an observational longitudinal study. Curr Oncol, 20(3): 152-157. [DOI:10.3747/co.20.1312]
23. Garland SN, Johnson JA, Savard J, et al. (2014) Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients. Neuropsychiatr Dis Treat, 10: 1113-1124. [DOI:10.2147/NDT.S47790]
24. Johnson JA, Rash JA, Campbell TS, et al. (2016) A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors. Sleep Med Rev, 27: 20-28. [DOI:10.1016/j.smrv.2015.07.001]
25. Mao H, Mao JJ, Guo M, et al. (2016) Effects of infrared laser moxibustion on cancer-related fatigue: a randomized, double-blind, placebo-controlled trial. Cancer, 122(23): 3667-3672. [DOI:10.1002/cncr.30189]
26. Page MJ, McKenzie JE, Bossuyt PM, et al. (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372: n71. [DOI:10.1136/bmj.n71]
27. Aromataris E, Munn Z, editors. (2020) JBI Manual for Evidence Synthesis. Adelaide: JBI.
28. Brouwers MC, Kho ME, Browman GP, et al. (2010) AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 182(18): E839-E842. [DOI:10.1503/cmaj.090449]
29. Jordan Z, Lockwood C, Munn Z, et al. (2015) The updated Joanna Briggs Institute Model of Evidence-Based Healthcare. Int J Evid Based Healthc, 13(3-4): 127-130.
30. Grassi L, et al. (2023) ESMO guidelines for insomnia in cancer. ESMO Open, 8(6): 102047. [DOI:10.1016/j.esmoop.2023.102047]
31. Li F, et al. (2023) Summary of evidence for post-RT insomnia in cancer. J Nurs, 3(1): 45-50.
32. Wang D, et al. (2022) Auriculotherapy for post-RT sleep in tumors. J Shandong Med, 43(7): 493-500.
33. Berger AM, et al. (2015) Cancer-related fatigue. J Natl Compr Canc Netw, 13(8): 1012-1039. [DOI:10.6004/jnccn.2015.0122]
34. National Comprehensive Cancer Network (NCCN) (2024) NCCN clinical practice guidelines in oncology: Survivorship, version 2.2024. Plymouth Meeting (PA): NCCN. Available from: https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1463.
35. Nissen ER, Neumann H, Knutzen SM, et al. (2024) Interventions for insomnia in cancer patients and survivors-a comprehensive systematic review and meta-analysis. JNCI Cancer Spectrum, 8(3): pkae041. https://doi.org/10.1093/jncics/pkae041 [DOI:10.1093/jncics/pkae041.]
36. Holliday EB, Dieckmann NF, McDonald TL, et al. (2016) Relationship between fatigue, sleep quality and inflammatory cytokines during external beam radiation therapy for prostate cancer: a prospective study. Radiother Oncol, 118(1): 105-111. [DOI:10.1016/j.radonc.2015.12.015]
37. Wang Y, Wu J, Li J, Zhou J (2020) Auricular point acupressure for sleep disturbance in women with breast cancer: a pilot randomized controlled trial. Sleep, 43(S1): A392. [DOI:10.1093/sleep/zsaa056.1028]
38. Wan Q, Luo S, Wang X, et al. (2022) Association of acupuncture and auricular acupressure with improvement of sleep disturbances in cancer survivors: a systematic review and meta-analysis. Front Oncol, 12: 856093. [DOI:10.3389/fonc.2022.856093]
39. Hamzeh S, Safari-Faramani R, Khatony A (2020) Effects of aromatherapy with lavender and peppermint essential oils on sleep quality of cancer patients: a randomized controlled trial. Evid Based Complement Alternat Med, 2020: 7480204. [DOI:10.1155/2020/7480204]
40. Song XJ, Zhu YH, Wu P, Du L, Li ZW (2022) Acupoint compatibility effect and mechanism of Shenmen (HT7) and Sanyinjiao (SP6) in improving daytime fatigue and sleepiness of insomnia patients. Zhen Ci Yan Jiu, 47(7): 630-635.
41. Garland SN, Xie SX, DuHamel K, et al. (2019) Acupuncture versus cognitive behavioral therapy for insomnia in cancer survivors: a randomized clinical trial. J Natl Cancer Inst, 111(12): 1323-1331. [DOI:10.1093/jnci/djz050]
42. Liu P, Li L, Xu D, et al. (2024) Acupuncture for cancer-related insomnia: systematic review and meta-analysis of randomized controlled trials. BMJ Support Palliat Care, 14: 378-391. [DOI:10.1136/spcare-2024-005051]
43. Rituraj P, Pal RS, Wahlang J, et al. (2025) Precision oncology: transforming cancer care through personalized medicine. Med Oncol, 42: 246. https://doi.org/10.1007/s12032-025-02817-y [DOI:10.1007/s12032-025-02817-y.]
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Zhang Y, Wang S, Yang T. Management of insomnia in cancer patients after radiotherapy using traditional Chinese medicine techniques: A systematic review and evidence summary. Int J Radiat Res 2026; 24 (2) :559-565
URL: http://ijrr.com/article-1-7079-en.html


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Volume 24, Issue 2 (4-2026) Back to browse issues page
International Journal of Radiation Research
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