Acupuncture for Bortezomib-Induced Peripheral Neuropathy: Not Just for Pain

Abstract

Background: Bortezomib-induced peripheral neuropathy (BIPN) is a common and debilitating side effect. Our pilot study demonstrated that acupuncture is safe and can decrease total neuropathic symptoms. However, there is lack of knowledge in which individual BIPN symptoms benefited from acupuncture. Purpose: To characterize individual symptoms reduced by acupuncture in patients with BIPN. Methods: Patients with multiple myeloma treated with bortezomib who developed BIPN grade 2 or above, based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), were enrolled and received 10 acupuncture treatments over 10 weeks. Self-reported BIPN-associated symptoms assessments were collected weekly at baseline, during, and after acupuncture treatment using the Neuropathy Pain Scale (NPS) and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity (FACT/GOG-Ntx) questionnaires. Changes in individual symptoms were analyzed based on FACT/GOG-Ntx and NPS scores. Results: There were statistically significant reductions in individual symptoms in both NPS and FACT/GOG-Ntx. The FACT/GOG-Ntx reductions were most pronounced in hand/feet numbness/tingling, discomfort, and trouble walking. The sensory symptoms, such as tingling and numbness, especially in the feet, reduced the most (P < .0001), and motor dysfunction also reduced significantly (P = .0001). Both hearing and dysfunction scores were also statistically significantly increased, indicating improved symptoms. The NPS scores showed significant symptom relief in all 10 items from the NPS assessment, particularly in cold sensitivity and an unpleasant feeling. Conclusions: Acupuncture can improve multiple symptoms associated with BIPN, particularly numbness and tingling in hands and feet, cold sensitivity, and an unpleasant feeling. Further randomized control trials are warranted to confirm our findings.

Pain Management in Patients with Multiple Myeloma: An Update

“…Focal pain spots can be treated topically with lidocaine or high-dose capsaicin patches [45]. Interestingly, complementary therapies such as acupuncture have shown a significant reduction of neuropathic pain, but also motoric impairment in BIPN Grade 2 or above [79]. In cases of relevant neuropathy, BIPN pain might be addressed by reducing subsequent bortezomib doses.…”

Research Trends of Acupuncture Therapy on Cancer Over the Past Two Decades: A Bibliometric Analysis

“… 30 Besides, 2 clinical trials showed a reduction in the use of analgesics and improvement in the quality of life. 31 , 32 However, the efficacy and safety of acupuncture for CIPN should be tested by well-designed and high-quality reported randomized controlled study. Further studies in investigating the mechanism of acupuncture for neuropathic pain are also needed.…”

The role of complementary and alternative methods in the treatment of pain in patients with cancer – current evidence and clinical practice: a narrative review

“…One of the latest observational study conducted by Zhi et al . [ 31 ] assessed 27 patients experiencing bortezomib-induced CIPN, treated with acupuncture sessions. The patients were assessed for self-reported signs and symptoms of neuropathy using the Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) and neuropathic pain scale.…”