A clinical literature review and research-trends analysis of bee venom pharmacopuncture for cancer patients

Article information

J Korean Med. 2020;41(3):247-259

Publication date (electronic) : 2020 September 01

doi : https://doi.org/10.13048/jkm.20038

Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Sangji University, Research Institute of Korean Medicine, Sangji Univeristy

Correspondence to: Joo-Hee Kim Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Sangji University 83, Sangjidae-gil, Wonju-si, Gangwon-do, 26339, Republic of Korea, Tel: +82-33-742-9268, Fax: +82-33-732-2124, Email: jhkim712@sangji.ac.kr

Received 2020 August 06; Revised 2020 August 13; Accepted 2020 August 14.

Abstract

Objectives

This review aims to investigate clinical studies related to bee venom pharmacopuncture for cancer patients and to analyze the research trend for further study.

Methods

We searched for clinical studies using bee venom pharmacopuncture therapy on patients with cancer through the electronic databases including Pubmed, Cochrane library, OASIS, KISS, NDSL, and KMBASE. There was no restriction on language and publication date, and after selection/exclusion process, the study design, target disease, intervention details including acupoints, treatment frequency and period, outcomes, study results and adverse events were extracted.

Results

Thirteen clinical studies were finally selected. There were a randomized controlled trial RCT about the effect of sweet bee venom pharmacopuncture on cancer-related pain, and three case series about chemotherapy-induced peripheral neuropathy. In case reports, there were nine studies about oligodendroglioma, plexiform neurofibroma, breast cancer, prostate cancer, lung cancer, urachal adenocarcinoma, malignant melanoma, and atypical squamous cells of undetermined significance. The bee venom therapy affected the improvement of outcomes such as symptoms, quality of life, tumor response, and lab findings.

Conclusions

The present study found that bee venom therapy is applicable to the treatment of cancer patients, and showed some effect on various symptoms. However, due to insufficient number and quality of studies, well designed and high-quality clinical trials are necessary to confirm the effectiveness and safety of bee venom pharmacopuncture therapy in patients with cancer.

Keywords: Cancer; Neoplasm; Bee venom; Pharmacopuncture; Clinical research; Review

Fig. 1

Study flow chart

Table 1

Characteristics of the Included Studies

Acknowledgments

This research was supported by Sangji University Research Fund, 2018. I thanks to my medical student Hyeon-Jong Yoo for performing study selection and data extraction.

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Table 1

Characteristics of the Included Studies

Author, year	Study design	Patients (n)	Interventions (n)	Acupoint/Dosage	Frequency of Treatment	Concomitant treatment	Outcomes	Results	Adverse events (n)
Yoo et al., 200830)	RCT	Patients with cancer-related pain (11)	TG: SBV (6), 0.1mg/ml CG: Placebo (5), normal saline	CV12/1ml	daily for five days	-	1. NRS 1) immediate pain relief 2) long term	1. 1) T>C (p<0.05) 2) NS	NR
Kim et al., 201831)	Case report	Breast cancer patient with chemotherapy-induced Side effects (1)	nBV	ST36, ST35, ST34, GB34, Ashi/0.2–0.4cc each point	3 times/week, total 10 session	AT, MT, HM PA(CWG, TC)	1. CTCAE 2. ECOG	Improved	NR
Kim et al., 2015 41)	Case report	Oligodendroglioma (1)	BV	GV20, EX-HN1/0.2 mL each point	once weekly for 18 months	ATX, HM, PA(MG)	1. Tumor size (Brain MRI) 2. Symptoms 3. Survival	1. decreased markedly 2. improved symptoms	NR
Lim et al., 201433)	Case report	Plexiform neurofibroma (1)	SBV, intracutaneously	the borders of the PNFs/5 mL	every two weeks for 4 years	PA(MG)	1. Tumor response (MRI) 2. Symptoms (hip joint pain, ROM)	1. the growths of the PNFs have almost stopped 2. improved symptoms	NR
Park et al., 201432)	Case series	CIPN (4)	BV, Ointment	Hand and/or foot	1–2 times/day	-	1. VAS	1. improved	None
Yoon et al., 201234)	Case series	CIPN (11)	SBV, 0.1 cun	LI4, TE5, GB39, LR3/0.1 ml each point	Total 6 session for 3 weeks	-	1. WHO grading system, 2. PNQ 3. VAS 4. HRQOL	1. improved (p<0.01) 2. improved (p<0.05) 3. improved (p<0.01) 1. improved (p<0.01)	swelling and itchiness at the injection site (1) mild fever (1)
Park et al., 201240)	Case series	CIPN (5)	SBV, Melittin of 0.1 mg/mL, 0.1 cm	EX-LE10, EX-UE9/0.1 ml each point	3 sessions over a 1-week period	-	1. VAS: pain 2. WHO CIPN grade 3. FACT-G	1. improved: 8.75 –> 2.75 2. improved: 2.5–>1 3. improvedin physical section: 10.5–>18.5	None
Lee et al., 201142)	Case report	Prostate cancer patients (2)	SBV	CV12, CV6/0.3ml each point, LI4, LR3, ST36, CV3, SP6, CV1/0.1 ml each point	2–5 times/week	AT, PA(MG)	1. PSA	1. decreased	NR
Gu et al., 201143)	Case report	Lung Cancer Patient (1)	SBV, 10%	BL13, Ashi/0.4–0.6ml	3 times/week	AT, MT, cupping, HM, breathing meditation	1. BDI 2. HRSD 3. BAI 4. ASI	1. decreased 2. decreased 3. decreased 4. decreased	NR
Choi et al., 201144)	Case report	Urachal Adenocarcinoma Patient (1)	SBV	LI4, LR3/0.1ml each point, BL20, BL21/0.25ml each point	2–3 times/week	AT, HM	1. Symptoms 2. Lab finding	1. Stable 2. Stable	NR
Park et al., 201045)	Case report	lung adenocarcinoma (1)	BV	CV12, GV3	every 2 days	AT, MT, cupping, HM, PA(placenta), Massage, TENS, Hydrotherapy (hip bath and foot bath), meditation, exercise	1. Symptoms: exertional dyspnea with thoracic pain and pain in both upper limbs, emotional stress	1. improved disease-free survival of 28 months	NR
Bang et al., 200746)	Case report	Malignant melanoma (1)	BV, 10000:1	Lesion, 1.5ml	Once a day for 1 year	-	1. Tumor response (PET CT, Neck CT)	1. Stable disease	None
Kim et al., 200547)	Case report	ASCUS (2)	BV	Lesion, SC 0.2–0.6ml	Once a week, total 12 session	-	1. Pap smear 2. HPV test 3. Cervical biopsy	1. negative 2. negative 3. (1) Immature metaplasia→Squamous metaplasia (2) Squamous metaplasia→Koilocytotic change	None

SBV, Sweet Bee Venom; NRS, Numerical Rating Scale; NR, not reported; NS, non-statistically significant; nBV, non-toxic Bee Venom; CWG, Cultivated Wild Ginseng; TC, Trionycis Carapax; Common Toxicity Criteria for Adverse Event, CTCAE; ECOG, Eastern Cooperative Oncology Group; MG, mountain ginseng; ROM, range of motion; CIPN, chemotherapy-induced peripheral neuropathy; PNQ, Patient Neurotoxicity Questionnaire; HRQOL, Health-Related Quality of Life; FACT-G, Functional Assessment of Cancer Therapy-General; PSA, Prostate specific antigen; BDI, Beck’s depression inventory; HRSD, Hamilton rating scale for depression; BAI, Beck’s anxiety inventory; ASI, Anxiety status inventory; ASCUS, Atypical squamous cells of undetermined significance; HPV, human papilloma virus; SC, subcutaneous; AT, acupuncture; HM, herbal medicine; MT: Moxibustion; PA, pharmacopuncture; TENS, Transcutaneous Electrical Nerve Stimulation,