Acupuncture for chemotherapy-induced peripheral neuropathy: a randomised controlled pilot study

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) can cause loss of independence and poor quality of life (QoL) due to severe disabilities, but in spite of its importance there is still a lack of data for the management of CIPN. Acupuncture has showed promising results and may be a cost-effective option for the treatment.ObjectivesTo evaluate the effect of acupuncture treatment on neurological symptoms of CIPN and QoL of oncological patients.MethodsWe performed a clinical, single-centre, randomised and controlled pilot study that involved 33 adult patients with cancer and CIPN randomised into two groups (control and acupuncture treated with 10 sessions, two times per week). Both groups were subjected to a complete physical examination and clinical assessment with National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Scale V.2.0, FIM Scale, European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) Scale and Visual Analogue Scale for pain before and 5 weeks after treatment.ResultsThere were no adverse events, and we found statistical differences in groups in physical (p=0.03) and function (p=0.04) domains of EORTC QLQ-C30 when comparing control and acupuncture groups. About NCI CTCAE Scale and neuropathy sensory symptoms, we found better results in acupuncture group, comparing pretreatment and post-treatment analyses (p=0.01). In control group, we have no differences after 5 weeks (p=0.11).ConclusionAlthough these results suggest an interesting effect of acupuncture on this patient population, the clinical significance has remained unclear. Given the tendency towards benefit and the lack of adverse effects, the authors recommend a follow-up acupuncture trial using higher follow-up time and better sample size.Trial registration numberNCT02309164.

Efficacy and Safety of Acupuncture against Chemotherapy‐Induced Peripheral Neuropathy: A Systematic Review and Meta‐Analysis

“…19 RCTs met the inclusion criteria: 1 study was conducted in Germany [ 42 ], 2 in the United States [ 36 , 41 ], 1 in Brazil [ 40 ], and the other 16 studies in China. In total, 1174 patients (588 in the acupuncture or electroacupuncture group, 586 in the control group) participated.…”

“…The assessment of risk of bias is summarized in Figure 2 . All studies were described as “randomized” and 10 studies [ 24 , 27 , 28 , 31 , 33 , 34 , 36 , 38 , 40 , 42 ] described appropriate methods for sequence generation. The remaining RCTs did not report specific random methods.…”

“…It is interesting to see that many non-CIPN symptoms [ 26 , 28 , 31 , 38 ] caused by chemotherapy, like nausea, appetite change, and drowsiness, had also improved,suggesting that acupuncture for CIPN can impact on a wider range of symptoms. However, on the other hand, the results [ 26 , 40 ] show that acupuncture for mild and moderate limb numbness, pain, and other sensory disorders is significantly effective, while the curative effect for severe CIPN patients was poor. And measurable results can only be found after a longer period of treatment (up to 10 weeks) [ 43 ].…”

“…On the other hand, questionnaires and self-reports are the preferred measure of CIPN [ 52 ], but they can be highly susceptible to subjective factors. Significant statistical difference is found in the change of mean values of the NCI-CTCAE Scale in Alessandro et al's experiment [ 40 ], and some literatures [ 53 ] think that the assessment modalities for neuropathy may overestimate the presence of motor neuropathy and misdiagnose CIPN. So, current scales may not be appropriate to measure CIPN in a valid way.…”

Response to: ‘Acupuncture for chemotherapy-induced peripheral neuropathy: a randomised controlled pilot study’

“…We have read, with great interest, the recent paper titled ‘Acupuncture for chemotherapy-induced peripheral neuropathy: a randomised controlled pilot study’ by D'Alessandro et al ,1 which evaluated the effect of acupuncture treatment on chemotherapy-induced peripheral neuropathy (CIPN). We would like to highlight additional points of discussion regarding this study.…”