Acupuncture combined with methylcobalamin for the treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma

Abstract

BackgroundChemotherapy-induced peripheral neuropathy (CIPN) seriously affects the quality of life of patients with multiple myeloma (MM) as well as the response rate to chemotherapy. Acupuncture has a potential role in the treatment of CIPN, but at present there have been no randomized clinical research studies to analyze the effectiveness of acupuncture for the treatment of CIPN, particularly in MM patients.MethodsThe MM patients (104 individuals) who met the inclusion criteria were randomly assigned into a solely methylcobalamin therapy group (500 μg intramuscular methylcobalamin injections every other day for 20 days; ten injections) followed by 2 months of 500 μg oral methylcobalamin administration, three times per day) and an acupuncture combined with methylcobalamin (Met + Acu) group (methylcobalamin used the same way as above accompanied by three cycles of acupuncture). Of the patients, 98 out of 104 completed the treatment and follow-ups. There were 49 patients in each group. The evaluating parameters included the visual analogue scale (VAS) pain score, Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (Fact/GOG-Ntx) questionnaire scores, and electromyographic (EMG) nerve conduction velocity (NCV) determinations. We evaluated the changes of the parameters in each group before and after the therapies and made a comparison between the two groups.ResultsAfter 84 days (three cycles) of therapy, the pain was significantly alleviated in both groups, with a significantly higher decrease in the acupuncture treated group (P < 0.01). The patients’ daily activity evaluated by Fact/GOG-Ntx questionnaires significantly improved in the Met + Acu group (P < 0.001). The NCV in the Met + Acu group improved significantly while amelioration in the control group was not observed.ConclusionsThe present study suggests that acupuncture combined with methylcobalamin in the treatment of CIPN showed a better outcome than methylcobalamin administration alone.Trial registrationChina Clinical Trials Register (registration no. ChiCTR-INR-16009079, registration date August 24, 2016).

The Efficacy of Acupuncture in Chemotherapy-Induced Peripheral Neuropathy: Systematic Review and Meta-Analysis

“…Zhang et al 34 found electroacupuncture superior to acupuncture in terms of symptom relief and quality of life improvement in treating bortezomib-related neuropathy. Others found a positive effect for bortezomib-induced neuropathy 33,38,39 but a negative effect for taxane used for breast cancer. 32 Despite these findings, the limited number of studies prevents drawing any definite conclusions about the efficacy of acupuncture.…”

“…The study selection flowchart is shown in Figure 1. Six RCTs were included: Molassiotis et al, 31 Greenlee et al, 32 Han et al, 33 Zhang et al, 34 Lu et al, 35 and Rostock et al 36 ; 5 of these were included in the meta-analysis. The characteristic and results of the included RCTs are presented in Table 1.…”

Vinca alkaloids, thalidomide and eribulin‐induced peripheral neurotoxicity: From pathogenesis to treatment

“…One feasibility study with electroacupuncture in patients experiencing thalidomide or bortezomib‐induced peripheral neuropathy showed promising results which will need to be replicated in a randomized larger study . Several additional small trials have also investigated the benefits of neuropathy in CIPN due to various agents with inconsistent methodologies and results although it does appear that this intervention can be helpful to some patients . Additional therapeutic strategies are needed for the many cancer survivors who are living with CIPN worldwide.…”

Evidence Based Complementary Approaches in the Management of Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients

“…Hastalarda periferal nöropati şiddeti ve ağrıda azalma görülürken, nöropatik fonksiyonlarda ve yaşam kalitesinde iyileşme olduğu bildirilmiştir. (20)(21)(22)(23)(24)…”