Acupuncture for the management of hot flashes in women with early stage breast cancer treated with tamoxifen or an aromatase inhibitor: A pilot study of efficacy, safety and feasibility

Abstract

703 Background: With the increasing use and duration of endocrine therapies in the treatment of adjuvant breast cancer (BC), the control of vasomotor symptoms is paramount. Complementary and alternative therapies are popular and widely available, but rigorous data evaluating their safety and efficacy are lacking. Given concerns regarding the use of hormone replacement therapy in BC symptom management, other nonhormonal means for treating hot flashes (HF) are required. Based on anecdotal information regarding the efficacy of acupuncture (AP) for treating HF, the trial was developed. Methods: We are evaluating the efficacy of 30-minute AP treatments given for 10 weeks in patients with early BC. Eligible patients had at least 14 HF/week of sufficient severity for therapeutic intervention. Use of antidepressants at a stable dose for at least 3 months was allowed. The primary objective was efficacy as measured by HF frequency (number of HF reported per day) and HF score (average intensity x frequency). The secondary objectives were safety and quality of life. The AP treatment plan was based on 6 recognized Traditional Chinese Medicine patterns of disharmony and treated accordingly by a licensed AP physician. The incidence of HF was recorded with the use of a HF diary for 14 weeks. Results: Data from 14 patients are available from 20 enrolled in this ongoing study. Nine (64%) patients had been treated with tamoxifen and 5 (36%) with an aromatase inhibitor. Six (43%) patients were taking venlafaxine when they started the study. The median HF frequency went from 6.5 (range 3.0–26.0) to 3.0 (range 1.0 to 9.0) for a 54% reduction. The mean HF score went from 19.4 to 8.7 for a 55% reduction. An improvement in HF score was greater that 30% in 11 (79%) patients and greater than 50% in 9 (64%) patients. Grade I bruising and pain were reported at the AP site in 5 patients (36%) and in 1 (7%) respectively. Patients reported improvement in several other symptoms such as night sweats and insomnia. Conclusion: The available data suggest that AP is a safe and effective therapy in BC patients with HF. This study is being sponsored by the AVON foundation. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Avon Foundation