Abstract
BackgroundChemotherapy-induced peripheral neuropathy (CIPN) seriously affects the quality of life of patients with multiple myeloma (MM) as well as the response rate to chemotherapy. Acupuncture has a potential role in the treatment of CIPN, but at present there have been no randomized clinical research studies to analyze the effectiveness of acupuncture for the treatment of CIPN, particularly in MM patients.MethodsThe MM patients (104 individuals) who met the inclusion criteria were randomly assigned into a solely methylcobalamin therapy group (500 μg intramuscular methylcobalamin injections every other day for 20 days; ten injections) followed by 2 months of 500 μg oral methylcobalamin administration, three times per day) and an acupuncture combined with methylcobalamin (Met + Acu) group (methylcobalamin used the same way as above accompanied by three cycles of acupuncture). Of the patients, 98 out of 104 completed the treatment and follow-ups. There were 49 patients in each group. The evaluating parameters included the visual analogue scale (VAS) pain score, Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (Fact/GOG-Ntx) questionnaire scores, and electromyographic (EMG) nerve conduction velocity (NCV) determinations. We evaluated the changes of the parameters in each group before and after the therapies and made a comparison between the two groups.ResultsAfter 84 days (three cycles) of therapy, the pain was significantly alleviated in both groups, with a significantly higher decrease in the acupuncture treated group (P < 0.01). The patients’ daily activity evaluated by Fact/GOG-Ntx questionnaires significantly improved in the Met + Acu group (P < 0.001). The NCV in the Met + Acu group improved significantly while amelioration in the control group was not observed.ConclusionsThe present study suggests that acupuncture combined with methylcobalamin in the treatment of CIPN showed a better outcome than methylcobalamin administration alone.Trial registrationChina Clinical Trials Register (registration no. ChiCTR-INR-16009079, registration date August 24, 2016).
Highlights
Chemotherapy-induced peripheral neuropathy (CIPN) seriously affects the quality of life of patients with multiple myeloma (MM) as well as the response rate to chemotherapy
Visual analogue scale (VAS) pain scores After 3 cycles of therapy, the pain was significantly mitigated in the Met + Methylcobalamin + acupuncture (Acu) group, while the VAS pain scores decreased in 85.7% of the patients (42/49)
After 84 days of therapy, methylcobalamin treatment alone was helpful in relieving pain and improving the quality of life, the study showed that acupuncture combined with methylcobalamin for the treatment of CIPN was significantly superior in providing pain relief (VAS pain scores) and life quality improvement (FACT/GOG-Ntx questionnaire scores)
Summary
Chemotherapy-induced peripheral neuropathy (CIPN) seriously affects the quality of life of patients with multiple myeloma (MM) as well as the response rate to chemotherapy. Multiple myeloma (MM) is a common hematologic malignancy and the incidence rate increases every year worldwide. Proteasome inhibitors such as bortezomib are commonly used for the initial treatment, as well as consolidation and maintenance therapies [1, 2]. Chemotherapy-induced peripheral neuropathy (CIPN) during MM treatments is a dose-limiting side effect and the incidence rate of bortezomib-related neuropathy has been reported to be 30–60% [3, 4]. Autonomic nervous system disorders such as orthostatic hypotension, arrhythmia, bradycardia and other symptoms may occur
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