MS-N128 · Supportive care · Human evidence · Appraised 24 October 2026

Can moxibustion prevent chemotherapy-induced myelosuppression in people treated for breast cancer?

Evidence at a glance

• Evidence label: Insufficient evidence; supportive care remains investigational
• Benefit: One small open-label trial reported fewer severe low-blood-count events at selected chemotherapy cycles, but results were inconsistent across time and endpoints.
• Certainty: Low certainty because there was no sham, multiple repeated tests, a small sample and limited external replication.
• Risk: Burns, allergic reactions, smoke exposure and infection are documented; low counts require standard monitoring and treatment.

What was studied

Population and design: 92 people receiving adjuvant chemotherapy after breast-cancer surgery were allocated to moxibustion (48) or usual care (44). Both groups received standard chemotherapy and granulocyte colony-stimulating factor when indicated.

Studied regimen: Moxibustion was given daily after each chemotherapy cycle. This heat-and-smoke intervention is rooted in traditional Chinese medicine; documented traditional use is not the same as proven clinical benefit.

What the evidence found

White-blood-cell counts differed only at the seventh treatment course (P=.008). Grade 1 neutrophil reduction was lower at course 7 (P=.006), and selected grade 3–4 myelosuppression outcomes favored moxibustion. Febrile neutropenia narrowly missed conventional significance (P=.051), and survival did not differ. A Cochrane review of moxibustion across cancers found very limited, low-certainty evidence; for leukopenia the pooled estimate was imprecise (risk ratio 0.50, 95% CI 0.10–2.56).

How to interpret it

Open-label care, multiple time points and outcomes, and inconsistent effects make false-positive findings plausible. The trial does not justify delaying growth factors, dose adjustment, transfusion or infection treatment. No tumor-control or survival benefit was shown.

Practical safety context

Moxibustion can cause burns, blisters, allergic reactions and smoke-related symptoms; serious infections after burns have been reported outside oncology. During neutropenia, any skin injury or fever can be consequential. Use only with oncology approval and trained delivery; fever during chemotherapy needs urgent medical advice.

Questions for the care team

• Is the symptom or complication being caused by something that needs conventional treatment first?
• Would blood counts, anticoagulants, infection risk, surgery, radiation effects or implanted devices change whether this is safe?
• What outcome will we track, and when should we stop if it is not helping?

Funding and conflicts

The breast-cancer trial reported Chinese institutional/public support; author conflict details appear in the full report. Safety reporting across older trials was incomplete.

Sources

• Breast-cancer trial (PMID 33986813; PMCID PMC8093063)
• Full text
• DOI 10.1155/2021/1347342
• Cochrane review (PMID 30480754)
• Moxibustion adverse-event review (PMID 21056845)
• Recent burn-associated infection report (PMID 42272806)

Last literature search: 24 October 2026. Record appraisal: 24 October 2026. This page is educational and does not replace individualized medical advice. Symptom improvement must not be interpreted as evidence of tumor response, delayed recurrence or longer survival.