Warming-dredging acupuncture for cancer-related pain: a systematic review and meta-analysis.

BACKGROUND/OBJECTIVES: Cancer-related pain (CRP) affects up to 60% of patients during malignancy progression, with many experiencing insufficient relief from pharmacological treatments alone. Warming-dredging acupuncture (WDA) integrates thermal and mechanical stimulation to achieve synergistic analgesic effects. This study aims to evaluate the efficacy, safety, and opioid-sparing potential of WDA in managing CRP. MATERIALS AND METHODS: We searched PubMed/MEDLINE, Embase, CENTRAL, Web of Science, CNKI, VIP, Wanfang Data, SinoMed, and the clinical trial registries (ClinicalTrials.gov and the Chinese Clinical Trial Registry) through March 9, 2026. Only randomized controlled trials (RCTs) were included. We used RevMan 5.4 and Stata 19.0 to analyze data, the RoB 2 tool to assess the risk of bias, and the GRADE system to assess the certainty of the evidence, following the PRISMA 2020 guidelines. The protocol was prospectively registered (PROSPERO: CRD420261335674). RESULTS: Seventeen RCTs involving 1278 participants were included. WDA significantly enhanced pain relief rates (RR = 1.26; 95% CI: 1.19-1.33) and reduced pain scores (MD = -1.05; 95% CI: -1.49 to -0.61) compared to controls. WDA also showed a lower risk of adverse events (RR = 0.35; 95% CI: 0.26-0.46), and evidence suggested a possible reduction trend in analgesic consumption. GRADE certainty ranged from moderate to very low. CONCLUSIONS: Warming-dredging acupuncture combined with routine pain management may offer a promising adjunct for multimodal cancer pain management, but the certainty of evidence varied across outcomes. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261335674 identifier CRD420261335674.