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

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. Trial Registration: PROSPERO: CRD42024583180 (accessed September 05, 2024)