Optimizing acupuncture dosing for hormone therapy-induced hot flashes in cancer patients: A regression-based analysis and narrative review

Abstract

Hormone deprivation therapy (HDT)-induced hot flashes are burdensome neuro-autonomic adverse effects in cancer patients. While acupuncture is increasingly utilized for these vasomotor symptoms, the optimal treatment exposure required for clinically meaningful benefit remains unclear. We conducted a regression-based dose–response meta-analysis and narrative review to evaluate the association between acupuncture session number and HDT-induced hot flash improvement. Including randomized controlled trials (RCTs) and case series, we analyzed hot flash frequency (HFF) and hot flash score (HFS) using random-effects meta-regression and restricted cubic spline models. Fourteen studies were included. Among ten studies reporting HFF, a linear association existed between acupuncture sessions and daily HFF reduction. Estimates indicated that symptom reduction exceeding the minimal clinically important difference emerged after approximately 10 sessions (−5.29 episodes/day [95% CI, −7.68 to −2.90]). Sensitivity analyses restricted to RCTs (−4.07 episodes/day [95% CI, −5.67 to −2.47]) and excluding auricular acupuncture (−4.13 episodes/day [95% CI, −5.83 to −2.44]) yielded consistent trends. Four studies reporting HFS revealed a nonlinear pattern: early improvement plateaued after approximately 9 sessions. This study provides quantitative evidence of a session-dependent dose–response relationship for acupuncture in managing HDT-induced hot flashes. While not establishing a definitive optimal dose, approximately 10 sessions represent a robust benchmark for clinically meaningful improvement, guiding clinical practice and future dose-optimization trials in supportive oncology.

Keywords

acupuncture / breast cancer / dose–response / hormone deprivation therapy-related hot flashes / prostate cancer

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2026 The Author(s). Precision Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Nanjing Medical University Affiliated Cancer Hospital & Jiangsu Cancer Hospital.