Randomized sham-controlled pilot trial of weekly electro-acupuncture for the prevention of taxane-induced peripheral neuropathy in women with early stage breast cancer

Abstract

PURPOSE To investigate the effect of electro-acupuncture (EA) as a non-pharmacological intervention to prevent or reduce chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients undergoing chemotherapy of taxane. METHODS Women with stage I-III breast cancer scheduled to receive taxane therapy were randomized to receive a standardized protocol of 12 true or sham EA (SEA) weekly treatments concurrent with taxane treatment. Subjects completed the Brief Pain Inventory-Short Form (BPI-SF), Functional Assessment of Cancer Therapy-Taxane neurotoxicity subscale (FACT-NTX), and other assessments at baseline and weeks 6, 12, and 16. RESULTS A total of 180 subjects were screened, 63 enrolled and 48 completed week 16 assessments. Mean age was 50 with 25% white, 25% black, and 43% Hispanic; 52% had no prior chemotherapy. At week 12, both groups reported an increase in mean BPI-SF worst pain score, but no mean differences were found between groups (SEA 2.8 vs. EA 2.6, p=.86). By week 16, the SEA group returned to baseline, while the EA group continued to worsen (mean=1.7 in SEA vs. 3.40 in EA, p=.03). The increase in BPI-SF worst pain score was 1.62 points higher in the EA group than in the SEA group at week 16 (p=.04). CONCLUSIONS In a randomized, sham-controlled trial of EA for prevention of taxane-induced CIPN, there were no differences in pain or neuropathy between groups at week 12. Of concern, subjects on EA had a slower recovery than SEA subjects. Future studies should focus on EA for treatment as opposed to prevention of CIPN.

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

“…Çalışmada ağrı ve nörotoksisite değerlendirilmiş olup, çalışmanın sonucuna göre her iki grupta da anlamlı bir fark bulunmadığı bildirilmiştir. (25) Farklı bir çalışmada ise hastaların 4 gruba ayrılarak sırasıyla elektroakupunktur, hidroelektrik bantlar, vitamin B1/B6, plasebo kapsülün etkinliği değerlendirildiğinde hiçbir yöntemin bir diğerine göre üstünlüğü kanıtlanamamıştır. (26) Multiple miyelom hastalarında thalidomide/bortezomib tedavisine bağlı gelişen nöropatinin yönetiminde elektroakupunkturun etkisinin değerlendirildiği non-randomize çalışmada ise 19 hasta değerlendirilmiştir.…”

The efficacy and safety of electro-acupuncture for alleviating chemotherapy-induced peripheral neuropathy in patients with coloreactal cancer: study protocol for a single-blinded, randomized sham-controlled trial

“…Systematic reviews of the CIPN found that the effectiveness of current treatments (including natural products and complementary therapies) are still unknown and only vitamin E is shown to possibly help alleviate CIPN [7,8]. The current studies of acupuncture in CIPN vary in the use of different cancer and anti-cancer drugs such as taxanes for breast cancer [9], bortezomib and thalidomide for multiple myeloma [10], and a mix of neurotoxic anticancer drugs [11]. However, studies of acupuncture for oxaliplatin-induced peripheral neuropathy are rare and there has been no randomized controlled trial [12].…”

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

“…Different acupuncture techniques, for example, auricular acupuncture, have been shown to decrease pain intensity, while more standard reference points for needle insertion have also demonstrated neuropathic symptom improvement in cancer patients. 9 , 11 - 16 Reviews of integrative oncology services at our institution found that approximately one third of the patients receiving acupuncture are treated for peripheral neuropathy, 17 suggesting the need for continued research of its effectiveness.…”