1843P Electro-acupuncture for quality of life in gastric cancer patients undergoing adjuvant chemotherapy

Abstract

Gastrectomy followed by adjuvant chemotherapy (chemo) remains preferred strategy for local gastric cancer. However, quality of life (QoL) declines post-operatively, due to both surgery and chemotherapy. This pilot study (NCT03753399) aimed at evaluating the preliminary effect of electro-acupuncture (EA) for improving quality of life in gastric cancer patients undergoing adjuvant chemotherapy. Patients who has accepted R0 resection for gastric cancer, and who will receive adjuvant chemotherapy were randomly assigned to receive high-dose of EA (7 times each chemo-cycle for 3 cycles), low-dose of EA (3 times each chemo-cycle for 3 cycles), or no acupuncture. Functional Assessment of Cancer Therapy-Gastric (FACT-Ga) was reported by the patients at baseline and then once a week during the therapy. Primary endpoint was the total area under curves (AUCs) of FACT-Ga Trial Outcome Index (TOI) during the 3 cycles of chemotherapy, calculated by linear interpolation, among the groups. Secondary endpoints included the AUCs of FACT-Ga Gastric Cancer Subscale (GaCS), and FACT-Ga score among the groups. Of the randomized 66 patients, 45 (68.18%) were analyzed in the per-protocol set (PPS). Electro-acupuncture, both high-dose and low-dose, although not significantly, produced trend of QoL improvement. AUCs (21 days/cycle × 3 cycles), the higher, the better, of TOI in the PPS were 5360±1120, 5443±1313, and 4780±840 (p=0.188), of GaCS were 3273±591, 3261±757, and 2865±534 (p=0.126), and of FACT-Ga were 7731±1587, 7979±1702, and 7084 ±1183 (p=0.231), in high-dose EA group, low-dose EA group, and control group, respectively. When combining patients in the two EA groups, TOI (5402±1198 vs. 4780±840, p=0.048) and GaCS (3267±666 vs. 2865±534, p=0.041) AUCs of EA patients were significantly higher than those in control group. AUCs of FACT-Ga in EA patients were also higher than those in control group, although the difference was not statistically significant (7855±1620 vs. 7085±1183, p=0.074). Electro-acupuncture was associated with promising effect in improving quality of life during adjuvant chemotherapy in gastric cancer patients. Future adequately powered trial is needed to confirm the specific effect.