Sham-controlled, randomised, feasibility trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma

Abstract

Background Xerostomia (dry mouth) after head/neck radiation is a common problem among cancer patients. Quality of life (QOL) is impaired, and available treatments are of little benefit. This trial determined the feasibility of conducting a sham-controlled trial of acupuncture and whether acupuncture could prevent xerostomia among head/neck patients undergoing radiotherapy. Methods A sham controlled, feasibility trial was conducted at Fudan University Shanghai Cancer Center, Shanghai, China among patients with nasopharyngeal carcinoma undergoing radiotherapy. To determine feasibility of a sham procedure, 23 patients were randomized to real acupuncture (N = 11) or to sham acupuncture (N = 12). Patients were treated 3 times/week during their course of radiotherapy. Subjective measures were the Xerostomia Questionnaire (XQ) and MD Anderson Symptom Inventory for Head and Neck Cancer (MDASI-HN). Objective measures were unstimulated whole salivary flow rates (UWSFR) and stimulated salivary flow rates (SSFR). Patients were followed for 1 month after radiotherapy. Results XQ scores for acupuncture were significantly lower than sham controls starting in week 3 and lasted through the 1-month follow-up (all P’s < 0.001 except for week 3, which was 0.006), with clinically significant differences as follows: week 6 – RR 0.28 [95% CI, 0.10, 0.79]; week 11- RR 0.17 [95% CI, 0.03, 1.07]. Similar findings were seen for MDASI-HN scores and MDASI-Intrusion scores. Group differences for UWSFR and SSFR were not found. Conclusions In this small pilot study, true acupuncture given concurrently with radiotherapy significantly reduced xerostomia symptoms and improved QOL when compared with sham acupuncture. Large-scale, multi-center, randomized, placebo-controlled trials are now needed.

The Effect of Electroacupuncture on Osteosarcoma Tumor Growth and Metastasis: Analysis of Different Treatment Regimens

“…Over the past decade, there has been a dramatic increase in the use of complementary and alternative medicines by cancer patients despite limited research available to support their use [6]. In this regard, acupuncture has been used to treat the side effects of cancer therapy as well as the fatigue, pain, sleep disturbances, and lymphedema associated with many types of tumors [1–3, 32, 33]. While there are a number of studies that have provided evidence for the antinociceptive, antifatigue, and antiemetic effects of EA in cancer patients [4, 33], there is only one case report that suggests that acupuncture may actually affect the tumor itself (by causing regression of human ductal carcinoma [34]).…”

Use of acupuncture to alleviate side effects in radiation oncology: Current evidence and future directions

“…The Shanghai Group from Fudan University published 2 trials 26, 27. First was a feasibility study followed by a prospective randomized trial, both with the target symptom xerostomia.…”

“…This effect is observed in the verum acupuncture and in the sham acupuncture arms at least in 3 trials. The group of Meng and coworkers demonstrated a significant benefit of verum acupuncture compared with sham acupuncture 26, 27. One trial is still ongoing 28 ; thus, controversial data exist and further clarification is required.…”

“…We searched for all trials on acupuncture and RT, and at least 5 randomized controlled trials exist in this context. Of those, 3 almost consistently showed a benefit for acupuncture compared with sham acupuncture, “usual care” within the study center, or wait and see without any treatment 20, 22, 23, 24, 25, 26, 28, 29…”

Acupuncture for Neoplasms: An Update from the PubMed Database

“…44 EA preconditioning, S100 calcium-binding protein beta & neuron-specific enolas 45 Sevoflurane anesthetic requirement, and the speed of postoperation recovery 46 Head-and-neck cancer Transcutaneous nerve stimulation method, whole saliva production & related symptoms with radiation-induced xerostomia 47 Xerostomia among head/neck patients undergoing radiotherapy [48][49][50][51] Swallowing function and QoL in patients with dysphagia 69 resulting in a number of research studies on the effectiveness and safety of acupuncture. Taking into account the study period, this trend has been confirmed in acupuncture for cancer-related diseases, and, since 1979, the article numbers have been increasing gradually (Fig.…”